Zhang Bo, Liu Zhao-Hui, Li Jian, Zhang Kevin, Chen Jing-Jing, Zhang Ricardo M
Department of Oral and Maxillofacial Surgery, Hunan Provincial People's Hospital and The First Affiliated Hospital of Hunan Normal University, Hunan Normal University, Changsha, PR China.
Xin-Cheng Hospital of Gu-Zhang County, Hunan Province, PR China.
Int J Pediatr Otorhinolaryngol. 2014 Nov;78(11):1987-92. doi: 10.1016/j.ijporl.2014.09.004. Epub 2014 Sep 16.
To evaluate the long-term clinical and radiologic outcomes of treating severely dislocated fractures of condylar neck and base with the comminuted fractures of parasymphysis or mental foramen, specially with crown fracture of deciduous molar and permanent molar or dislocation of the teeth sustained in childhood using bioabsorbable miniplate with open reduction and internal fixation (ORIF).
Five children (age ranged from 3 to 11 years old averaged 8.2 years; 3 boys and 2 girls) with severely (the condyle dislocated from the glenoid fossa) dislocated fractures of condylar neck or base with the comminuted fractures of parasymphysis or mental foramen, specially with crown fracture of deciduous molar and permanent molar or dislocation of the teeth were treated with ORIF using 1 or 2 bioabsorbable miniplates (through preauricular approach and an oral vestibular approach). All patients have been followed-up clinically and radiographically for a mean of 5.6 years (range, 3-10 years).
All patients were cured satisfactorily with excellent occluding relation without restricted mandibular movement, facial asymmetry, retrognathism and ankylosis. 3-10 years follow-up study did not occur any mandibular development disorder.
The results suggested that ORIF using bioabsorbable miniplate was a reliable fixation technique for use in the treatment of severely dislocated fractures of the condylar neck and base with the comminuted fractures of parasymphysis or mental foramen, specially with crown fracture of deciduous molar and permanent molar or dislocation of the teeth in children when the non-invasive or occlusal therapies were ineffective.
评估采用生物可吸收微型钢板切开复位内固定术(ORIF)治疗伴有下颌骨体部粉碎性骨折或颏孔区骨折,尤其是伴有乳牙或恒牙冠折或儿童期牙齿脱位的髁突颈部及髁突基部严重脱位骨折的长期临床及影像学效果。
5例儿童(年龄3至11岁,平均8.2岁;3例男孩,2例女孩),患有伴有下颌骨体部粉碎性骨折或颏孔区骨折,尤其是伴有乳牙或恒牙冠折或牙齿脱位的髁突颈部及髁突基部严重脱位骨折(髁突从关节窝脱位),采用1或2块生物可吸收微型钢板通过耳前入路和口腔前庭入路行切开复位内固定术进行治疗。所有患者均接受了平均5.6年(范围3至10年)的临床及影像学随访。
所有患者均获满意治愈,咬合关系良好,下颌运动无受限,无面部不对称、下颌后缩及关节强直。3至10年的随访研究未出现任何下颌发育障碍。
结果表明,当非侵入性或咬合治疗无效时,采用生物可吸收微型钢板切开复位内固定术是治疗伴有下颌骨体部粉碎性骨折或颏孔区骨折,尤其是伴有乳牙或恒牙冠折或儿童期牙齿脱位的髁突颈部及髁突基部严重脱位骨折的可靠固定技术。