Lecturer, Plastic and Reconstructive Surgery, Mansoura University, Egypt.
Associate Professor, Plastic and Reconstructive Surgery, Mansoura University, Egypt.
J Oral Maxillofac Surg. 2021 Aug;79(8):1732.e1-1732.e6. doi: 10.1016/j.joms.2021.02.037. Epub 2021 Mar 2.
Pediatric mandibular fractures are immensely challenging compared to adult fractures. The current update management spectrum ranges from the conservative one in the form of soft diet and regular follow-up, or less invasive surgical intervention by closed reduction and nonrigid fixation, to open reduction and internal fixation with plates and screws. In this study, we investigated the use of a straightforward fabricated mold for the parasymphyseal mandibular fracture in infants with an unerupted dentition.
This prospective study was conducted on 8 infants presenting with parasymphyseal fractures with unerupted dentitions in our specialized trauma center. In the operating room before the induction of anesthesia, the authors used a straightforward plastic airway to create a splint. The curved part was split into 2 transverse halves making 2 U-shaped curved pieces that were utilized as a mold. Intraoperatively, the U-shaped piece was placed over the mandible and stabilized with circummandibular wires. This molded airway is used to stabilize the fracture site for 2-3 weeks. The average period of follow-up was around 6 months.
The average time of mandibular fixation was 17.6 ± 2.4 SD (14 to 20) days. The mean of the total operative time was 38.7 ± 3.5 SD minutes, ranging from 35 to 45 minutes. Our infants were observed in the outpatient clinic for 6 months postoperatively during the follow-up period. There were no noticeable complications nor any interference with tooth eruption or mandibular growth.
The results of this study suggest that this technique is straightforward to use and affordable. It does not require a long learning period. It also exhibits the advantage of reducing the cost in many developing countries.
与成人骨折相比，儿童下颌骨骨折极具挑战性。目前的更新管理范围从保守治疗，即软食和定期随访，或通过闭合复位和非刚性固定进行微创外科干预，到切开复位和使用钢板和螺钉的内固定。在这项研究中，我们研究了在未萌出牙的婴儿中使用简单制作的模具治疗正中联合下颌骨骨折的效果。
本前瞻性研究在我们的专门创伤中心对 8 名患有正中联合未萌出牙齿的骨折婴儿进行。在麻醉诱导前的手术室中，作者使用简单的塑料气道制作夹板。弯曲部分分为 2 个横向半部分，形成 2 个 U 形弯曲部分，用作模具。术中，将 U 形部分放置在下颌骨上，并使用circummandibular 线稳定。这个模具气道用于稳定骨折部位 2-3 周。平均随访时间约为 6 个月。
下颌骨固定的平均时间为 17.6±2.4 SD（14 至 20）天。总手术时间的平均值为 38.7±3.5 SD 分钟，范围为 35 至 45 分钟。在随访期间，我们的婴儿在术后 6 个月在门诊接受观察。没有发现明显的并发症，也没有对牙齿萌出或下颌骨生长造成任何干扰。
这项研究的结果表明，该技术使用简单，价格实惠。它不需要很长的学习时间。它还具有降低许多发展中国家成本的优势。
