McGoldrick David M, Parmar Paras, Williams Rhodri, Monaghan Andrew, McMillan Kevin
Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust.
Birmingham Children's Hospital, Birmingham Women and Children's Hospital NHS Foundation Trust, Birmingham, United Kingdom.
J Craniofac Surg. 2019 Oct;30(7):2045-2047. doi: 10.1097/SCS.0000000000005787.
Mandibular condyle fractures are a common type of facial fracture in children. The authors aimed to examine the demographics, etiology, treatment, and outcomes of these fractures managed in a single pediatric trauma unit.
A retrospective review was performed of patients presenting to a pediatric hospital between 2003 and 2016 with mandibular condyle fractures. Initial data was extracted from a dedicated trauma database. Included patient's medical records and imaging were then reviewed. Data on demographics, etiology, fracture type, and treatment were recorded. Univariate statistical analysis was performed.
Forty-four patients with 49 condyle fractures were included. The average age of patients was 11.4 years (range 3-15 years). A fall from a bicycle/scooter was the most common mechanism. Twenty-six fractures were isolated and 23 involved a further fracture of the mandibular arch. The condylar neck was the most common site of fracture (55%). There was no statistical significance between age (0-10 years, 10-16 years) and site of fracture or the presence of an associated arch fracture. The majority of isolated fractures (73%) were treated conservatively without inter-maxillary fixation. Thirty-nine patients attended the follow-up and the median follow-up period was 196 days (interquartile range 21-165 days). Two patients had a malocclusion at follow-up that required intervention.
There was a broad range of presentations in our cohort. Conservative management in isolated fractures resulted in stable outcomes and this large case series supports the consensus that management of pediatric condyle fractures should be as conservative as possible.
下颌髁突骨折是儿童常见的面部骨折类型。作者旨在研究在单一儿科创伤单元治疗的这些骨折的人口统计学、病因、治疗及结果。
对2003年至2016年间到儿科医院就诊的下颌髁突骨折患者进行回顾性研究。初始数据从专门的创伤数据库中提取。随后查阅纳入患者的病历和影像学资料。记录人口统计学、病因、骨折类型及治疗等数据,并进行单因素统计分析。
纳入44例患者共49处髁突骨折。患者平均年龄11.4岁(范围3 - 15岁)。从自行车/滑板车上摔落是最常见的致伤机制。26处骨折为孤立性骨折,23处合并下颌骨弓部其他骨折。髁突颈部是最常见的骨折部位(55%)。年龄(0 - 10岁、10 - 16岁)与骨折部位或是否合并弓部骨折之间无统计学差异。大多数孤立性骨折(73%)采用保守治疗,未行颌间固定。39例患者进行了随访,中位随访期为196天(四分位间距21 - 165天)。2例患者随访时出现错牙合需干预。
我们的队列中有多种表现形式。孤立性骨折的保守治疗取得了稳定的结果,这个大型病例系列支持了小儿髁突骨折治疗应尽可能保守的共识。