The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University.
Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China.
J Craniofac Surg. 2021 May 1;32(3):e293-e296. doi: 10.1097/SCS.0000000000007248.
This study aimed to assess whether ramus height is restored in children with extracapsular condylar fractures treated by conservative or surgery procedures.
The sample consisted of 35 children (collected consecutively) less than 12 years old who presented with extracapsular condylar fractures and treated within an 8-year period (June 2011 to April 2019). Data on the age, gender, date of injury, mechanism of trauma, location and pattern of mandibular condylar fracture, associated injuries and treatment methods were recorded and analyzed. Ramus height restoration is the main evaluation indicator during the follow-up period.
Within the 8-year record retrieval, the 35 children sustained 41 extracapsular condylar fractures. For the sample size, 10 (24.4%) and 31 (75.6%) had condylar neck and base fractures, respectively. Deviation and green-stick fracture were the predominant types in condylar neck and base fractures, accounting for more than 3 quarters (31, 75.6%). The majority (33, 80.5%) of patients were treated with nonsurgical treatment, and 8 (19.5%) were treated by open reduction and internal fixation (ORIF). During the follow-up period (1-1419 days, average time of 110.6 days), only 1 patient (with bilateral extracapsular condylar fractures) had their ramus height restored (follow-up period, 256 days). Most members of the ORIF group (5 of 8, 62.5%) postoperatively showed bended ramus (deviated angularly/fragment angulation).
Conservative treatment could hardly restore the ramus height of children with extracapsular condylar fractures. Anatomically or totally restoring the ramus height is difficult even with the surgical treatment of ORIF; however, surgical treatment of ORIF can substantially restore the ramus height for dislocated fractures or seriously displaced fractures.
本研究旨在评估保守或手术治疗儿童髁突囊外骨折后是否能恢复支抗高度。
本研究纳入了 35 名（连续采集）12 岁以下的髁突囊外骨折患儿，治疗时间为 2011 年 6 月至 2019 年 4 月。记录并分析了患儿的年龄、性别、受伤日期、外伤机制、下颌髁突骨折部位和类型、合并损伤及治疗方法等资料。在随访期间，支抗高度的恢复是主要评估指标。
在 8 年的病历检索中，35 名患儿共发生 41 例髁突囊外骨折。根据样本量，10 例（24.4%）和 31 例（75.6%）分别为髁突颈骨折和髁突基底部骨折。在髁突颈骨折和髁突基底部骨折中，以错位和青枝骨折为主，占 3/4 以上（31 例，75.6%）。33 例（80.5%）患儿采用非手术治疗，8 例（19.5%）患儿采用切开复位内固定术（ORIF）治疗。在随访期（1-1419 天，平均随访时间 110.6 天），仅 1 例（双侧髁突囊外骨折）患儿支抗高度恢复（随访时间 256 天）。ORIF 组中，5 例（8 例中的 62.5%）术后出现支抗弯曲（成角畸形/骨折断端成角）。
保守治疗很难恢复儿童髁突囊外骨折的支抗高度。即使采用 ORIF 手术治疗，也很难实现解剖或完全恢复支抗高度；然而，对于脱位或严重移位的骨折，ORIF 手术治疗可以显著恢复支抗高度。
