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我们对小儿颌面部创伤的治疗方法。

Our Treatment Approach in Pediatric Maxillofacial Traumas.

作者信息

Bilgen Fatma, Ural Alper, Bekerecioğlu Mehmet

机构信息

Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.

出版信息

J Craniofac Surg. 2019 Nov-Dec;30(8):2368-2371. doi: 10.1097/SCS.0000000000005896.

Abstract

BACKGROUND

Maxillofacial injuries in children are rarer in proportion in comparison to adult facial injuries, and they constitute 1% to 15% of all facial bone fractures. The causes and incidence of maxillofacial injuries in children differ based on social, cultural, and environmental factors.

AIM

The purpose of this study is to investigate the etiology, epidemiology, and type of injury in pediatric facial injuries, as well as analyzing types of fractures, related injuries, and treatment options.

MATERIALS AND METHODS

The study obtained the approval of the local ethics board to include 55 pediatric patients in the age group of 0 to 18 years who received inpatient treatment or surgical interventions owing to maxillofacial trauma at an Esthetic, Plastic and Reconstructive Surgery Clinic between January 2016 and December 2018. The patients were examined under 5 groups based on their causes of injury: motorized vehicle accidents (MVA); bicycle; falls (from height or ground level); assault; firearm injuries. They were examined under 6 groups based on the location of their fractures: mandibula, maxilla, orbita, frontal bone, zygomatic arch, nasal bone.

RESULTS

The study included 55 patients of the ages 0 to 18 with the mean age of 11.6 ± 3.2 years. Thirty-seven of the patients (67.2%) were male, whereas 18 (32.7%) were female. Among the causes of injury, the highest number of patients was 25 (45.4%) with MVA. The most frequent location of the fractures was the mandible.

CONCLUSIONS

Consequently, experiences regarding pediatric maxillofacial traumas are limited, and there is no complete consensus on treatment. In difference to the interventions in adults, the dental structure in pediatric patients need to be definitely considered, the least invasive intervention form should be preferred, and observation and follow-up should be practiced in minimally displaced fractures rather than surgical interventions.

摘要

背景

与成人面部损伤相比,儿童颌面部损伤的比例相对较低,占所有面部骨折的1%至15%。儿童颌面部损伤的原因和发病率因社会、文化和环境因素而异。

目的

本研究的目的是调查儿童面部损伤的病因、流行病学和损伤类型,以及分析骨折类型、相关损伤和治疗选择。

材料与方法

本研究获得当地伦理委员会批准,纳入2016年1月至2018年12月期间在一家美容、整形和重建外科诊所因颌面部创伤接受住院治疗或手术干预的55例0至18岁儿童患者。根据损伤原因将患者分为5组:机动车事故(MVA);自行车;跌倒(从高处或地面);袭击;火器伤。根据骨折部位将患者分为6组:下颌骨、上颌骨、眼眶、额骨、颧弓、鼻骨。

结果

本研究纳入55例0至18岁患者,平均年龄为11.6±3.2岁。其中男性37例(67.2%),女性18例(32.7%)。在损伤原因中,机动车事故导致的患者最多,为25例(45.4%)。骨折最常见的部位是下颌骨。

结论

因此,关于儿童颌面部创伤的经验有限,在治疗上没有完全达成共识。与成人干预不同,儿童患者的牙齿结构必须予以明确考虑,应首选侵入性最小的干预方式,对于移位最小的骨折应进行观察和随访,而非手术干预。

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