Department of Oral and Craniomaxillofacial Science, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Center for Specialty Strategy Research of Shanghai Jiao Tong University China Hospital Development Institute, Shanghai, China; Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China.
Department of Stomatology, Wuxi Children's Hospital, Wuxi, Jiangsu, China; The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, China.
J Craniomaxillofac Surg. 2020 Mar;48(3):286-292. doi: 10.1016/j.jcms.2020.01.015. Epub 2020 Feb 1.
To investigate the condylar morphology after closed treatment of unilateral intracapsular condylar fracture in children and adolescents through three-dimensional evaluation and to explore the influence of age, types of fracture, follow-up period, treatment methods, and concomitant fractures on the treatment effectiveness.
The medical records of patients who underwent closed treatment for condylar fractures from January 2006 to December 2018 were reviewed. The fractured sides were included in the study group and the opposite healthy joints were included in the control group. The height of articular eminence, depth of glenoid fossa, length & width & thickness of condylar process, length & width of the ramus, and deviation of pogonion were measured three-dimensionally.
31 participants were included in the study. The length of condylar process was 2.10 ± 3.77 mm (P = 0.004) shorter, the depth of glenoid fossa was 1.09 ± 2.13 mm (P = 0.040) shallower, and the length of ramus was 1.55 ± 2.49 mm (P = 0.002) longer in fractured side than the ones in healthy side after closed treatment. The pogonion deviated 0.48 ± 1.7 mm to the fractured side, but no statistical significance was found (P = 0.129).
Children had great growth potential to compensate the shortening of condylar process after intracapsular condylar fracture, so closed treatment could be an effective therapy for young children and adolescents.
通过三维评估研究儿童和青少年单侧关节内髁突骨折闭合治疗后的髁突形态，并探讨年龄、骨折类型、随访时间、治疗方法和伴发骨折对治疗效果的影响。
回顾 2006 年 1 月至 2018 年 12 月期间接受髁突骨折闭合治疗的患者的病历。将骨折侧纳入研究组，将对侧健康关节纳入对照组。三维测量关节突高度、关节窝深度、髁突长度和宽度及厚度、髁突长度和宽度以及颏顶点偏斜。
研究纳入 31 名参与者。与健侧相比，骨折侧的髁突长度缩短 2.10±3.77mm（P=0.004），关节窝深度变浅 1.09±2.13mm（P=0.040），髁突长度变长 1.55±2.49mm（P=0.002）。颏顶点向骨折侧偏斜 0.48±1.7mm，但无统计学意义（P=0.129）。
儿童具有较大的生长潜力来补偿关节内髁突骨折后的髁突缩短，因此闭合治疗可能是儿童和青少年的有效治疗方法。
