Gopalakrishnan V, Sahoo N K, Roy I D
3 Corps Dental Unit, Dimapur, Nagaland, India.
Department of Dental Surgery, Armed Forces Medical College, Pune, Maharashtra, India.
Int J Oral Maxillofac Surg. 2017 Jan;46(1):59-61. doi: 10.1016/j.ijom.2016.08.009. Epub 2016 Sep 1.
Mandibular fractures in the neonate are rare. The aetiological factors are traumatic delivery, accidental fall, road traffic accidents, and attempted infanticide. The diagnosis is difficult due to facial oedema masking the clinical features and the absence of dentition. The treatment of fractures in the newborn represents a unique problem in terms of investigations, diagnosis, selection of anaesthesia, and method of fixation. The case of a 1-day-old infant referred for the management of a mandibular fracture sustained in an accidental fall is presented herein. During oral suctioning, the neonatologist observed continuous blood-stained secretions, which raised the suspicion of a trauma to the oral cavity. The infant was diagnosed as having a fracture of the mandibular symphysis with displacement. The fracture was reduced under local anaesthesia with sedation, and was stabilized with an acrylic splint, which was secured with circum-mandibular wiring. The patient was followed up for 1.5 years and the healing was satisfactory.
新生儿下颌骨骨折较为罕见。其病因包括分娩创伤、意外跌倒、道路交通事故以及企图杀害婴儿。由于面部水肿掩盖了临床特征且无牙齿萌出,诊断较为困难。新生儿骨折的治疗在检查、诊断、麻醉选择和固定方法方面都存在独特问题。本文介绍了一名1日龄婴儿因意外跌倒导致下颌骨骨折前来治疗的病例。在口腔吸引过程中,新生儿科医生观察到持续有血性分泌物,这引发了对口腔创伤的怀疑。该婴儿被诊断为下颌骨联合处骨折并伴有移位。骨折在局部麻醉加镇静下进行复位,并用丙烯酸夹板固定,通过环绕下颌骨的钢丝固定。对该患者进行了1.5年的随访,愈合情况良好。