Department of Craniomaxillofacial Science, Shanghai Ninth People's Hospital, School of Dentistry, Shanghai Jiaotong University, Shanghai, China.
Department of Oral and Maxillofacial Surgery, Xiamen Stomatology Hospital, Fujian Province, China.
JAMA Otolaryngol Head Neck Surg. 2014 Mar;140(3):203-7. doi: 10.1001/jamaoto.2013.6300.
There are no uniform treatments, standards, and specifications for conservative and surgical management of mandibular fractures in children and adolescents.
To review the management of mandibular fractures in children and adolescents at our institution.
DESIGN, SETTING, AND PARTICIPANTS: The medical records of 104 children and adolescents (60 male and 44 female) treated for mandibular fractures from 2005 to 2012 at the Ninth People's Hospital, Shanghai, China, were retrospectively reviewed. The participants were classified as having deciduous dentition (age ≤6 years), mixed dentition (age >6 but <12 years), and permanent dentition (age ≥12 but ≤16 years).
Conservative treatment and surgical management.
Helkimo clinical dysfunction and anamnestic indices.
Condylar process fractures accounted for 55.7% of the fractures (112 fractures of 201 total fracture sites), and symphysis fractures, parasymphysis fractures, fractures of the body, and fractures of the angle accounted for 20.9%, 11.9%, 7.0%, and 3.5% of the fractures, respectively. A total of 83 cases with 159 fracture sites with complete follow-up data were included in the treatment analysis. In these 83 patients, 77 fractures were dentigerous bone fractures, 46 were intracapsular fractures, and 36 were extracapsular fractures. Dentigerous bone fractures of the mandible were managed by closed or open reduction in children younger than 12 years and were managed more often by open reduction and fixation in those between ages 12 and 16 years. Closed treatment was performed for 22 condylar process fractures (28.6%), and open reduction was carried out for 55 condylar process fractures (71.4%). In patients with intracapsular fractures, there was no significant relationship between dentation age and treatment method (P = .06). Most patients with extracapsular fractures with permanent dentition underwent surgical fixation (73.3%), whereas most with deciduous dentition received conservative treatment (87.5%). In patients with condylar process fractures, there was no significant difference in Ai and Di based on treatment method (P = .49 and P = .76, respectively).
The treatment of mandibular fractures in children and adolescents should be determined by clinical factors including age, location, and type of fracture.
儿童和青少年下颌骨骨折的保守和手术治疗没有统一的治疗、标准和规范。
回顾我院儿童和青少年下颌骨骨折的治疗情况。
设计、地点和参与者：回顾了 2005 年至 2012 年在中国上海第九人民医院接受下颌骨骨折治疗的 104 名儿童和青少年（60 名男性和 44 名女性）的病历。参与者被分为乳牙期（年龄≤6 岁）、混合牙期（年龄>6 但<12 岁）和恒牙期（年龄≥12 但≤16 岁）。
保守治疗和手术治疗。
Helkimo 临床功能障碍和病史指标。
髁突骨折占骨折的 55.7%（201 个骨折部位中的 112 个），正中联合骨折、侧方联合骨折、体部骨折和角部骨折分别占 20.9%、11.9%、7.0%和 3.5%。共有 83 例患者（159 个骨折部位）完成了随访数据的治疗分析。在这 83 例患者中，77 例为含牙骨骨折，46 例为囊内骨折，36 例为囊外骨折。12 岁以下儿童的下颌含牙骨骨折采用闭合或开放复位治疗，12-16 岁儿童采用开放复位和固定治疗。22 例髁突骨折（28.6%）采用闭合治疗，55 例髁突骨折采用开放复位（71.4%）。在囊内骨折患者中，牙龄与治疗方法无显著相关性（P = .06）。大多数恒牙期的囊外骨折患者接受手术固定（73.3%），而大多数乳牙期患者接受保守治疗（87.5%）。髁突骨折患者的治疗方法对 Ai 和 Di 无显著影响（P = .49 和 P = .76）。
儿童和青少年下颌骨骨折的治疗应根据临床因素，包括年龄、骨折部位和类型来确定。
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