Zhou Hai-Hua, Lv Kun, Yang Rong-Tao, Li Zhi, Yang Xue-Wen, Li Zu-Bing
The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, People's Republic of China; Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, People's Republic of China.
The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, People's Republic of China; Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, People's Republic of China.
Int J Pediatr Otorhinolaryngol. 2019 Aug;123:168-174. doi: 10.1016/j.ijporl.2019.05.013. Epub 2019 May 16.
This study aimed to explore and make an understanding of absorption existed in children with intracapsular fractures.
The sample was composed of all children (less than 12 years) who presented with intracapsular fractures within a 5-year period (January 2011 to April 2016). Data about age, gender, date of injury, dates of admission and discharge, transfer and/or referral by other clinics or local facilities, mechanism of trauma, location and pattern of fracture, associated injuries, centimeter of mouth opening, treatment methods, image date of pre- and post-treatment (including time of review), position of condylar head in pre-treatment or post-treatment, and absorption of condylar head in pre-treatment or post-treatment were recorded and analyzed. Data analysis included the Chi-Square test, the Fisher exact test, and the t-test. Logistic regression analysis was utilized to control the confounding variables. Probabilities of p less than 0.05 were considered statistically significantly different.
In the 5 years records retrieved during this study, 93 children patients sustained a total of 140 condylar head fractures. Statistical analysis revealed that abduction of condylar process in post-treatment was highly related to the condylar absorption. Patients associated with other mandibular fractures were highly related to abduction of condylar process. Patients with condylar head fractures, the closer to the medial of the condylar process, the higher the risk of abduction of the condyle. No matter what kind of treatment method is used, it is very difficult to reverse the abduction of condylar process in children patients with intracapsular fractures efficaciously.
Abduction of condylar process in post-treatment was highly related to the condylar absorption. Patients associated with other mandibular fractures were highly related to abduction of condylar process. Children patients who presented with condylar head fractures, the closer to the medial of the condylar process the higher the risk of abduction of the condyle. Neither surgery nor conservative treatment can recover the abduction of condylar process efficaciously.
本研究旨在探讨并了解儿童囊内骨折中存在的吸收情况。
样本包括在5年期间（2011年1月至2016年4月）出现囊内骨折的所有儿童（小于12岁）。记录并分析有关年龄、性别、受伤日期、入院和出院日期、其他诊所或当地医疗机构的转诊和/或转介、创伤机制、骨折部位和类型、相关损伤、开口厘米数、治疗方法、治疗前后的影像日期（包括复查时间）、治疗前或治疗后髁突头部的位置以及治疗前或治疗后髁突头部的吸收情况。数据分析包括卡方检验、Fisher精确检验和t检验。采用逻辑回归分析来控制混杂变量。p值小于0.05被认为具有统计学显著差异。
在本研究检索到的5年记录中，93例儿童患者共发生140例髁突头部骨折。统计分析显示，治疗后髁突的外展与髁突吸收高度相关。合并其他下颌骨骨折的患者与髁突外展高度相关。髁突头部骨折的患者，髁突越靠近内侧，髁突外展的风险越高。无论采用何种治疗方法，都很难有效逆转儿童囊内骨折患者的髁突外展。
治疗后髁突的外展与髁突吸收高度相关。合并其他下颌骨骨折的患者与髁突外展高度相关。出现髁突头部骨折的儿童患者，髁突越靠近内侧，髁突外展的风险越高。手术和保守治疗均不能有效恢复髁突的外展。
