Kang Won Ki, Han Dong Gil, Kim Sung-Eun, Lee Yong Jig, Shim Jeong Su
Department of Plastic and Reconstructive Surgery, Daegu Catholic University School of Medicine, Daegu, Korea.
Arch Craniofac Surg. 2021 Apr;22(2):93-98. doi: 10.7181/acfs.2021.00122. Epub 2021 Apr 20.
Pediatric nasal fractures, unlike adult nasal fractures, are treated surgically as early as 7 days after the initial trauma. However, in some cases, a week or more elapses before surgery, and few studies have investigated the consequences of delayed surgery for pediatric nasal fractures. The purpose of this study was to evaluate the postoperative outcomes of pediatric nasal fractures according to the time interval between the initial trauma and surgery.
The records of pediatric patients under 12 years old who underwent closed reduction of nasal bone fracture from March 2012 to February 2020 were reviewed. The interval between trauma and surgery was divided into within 7 days (early reduction) and more than 7 days (delayed reduction). Postoperative results were classified into five grades (excellent, good, moderate, poor, and very poor) based on the degree of reduction shown on computed tomography.
Ninety-eight patients were analyzed, of whom 51 underwent early reduction and 47 underwent delayed reduction. Forty-two (82.4%) of the 51 patients in the early reduction group showed excellent results, and nine (17.6%) showed good results. Thirty-nine (83.0%) of the 47 patients in the delayed reduction group showed excellent results and eight (17.0%) showed good results. No statistically significant difference in outcomes was found between the two groups (chi-square test p= 0.937). However, patients without septal injury were significantly more likely to have excellent postoperative outcomes (chi-square test p< 0.01).
No statistically significant difference was found in the outcomes of pediatric nasal fractures between the early and delayed reduction groups. Successful surgical results were found even in patients who received delayed reduction (more than 7 days after trauma).
与成人鼻骨骨折不同，小儿鼻骨骨折在初次受伤后最早7天就进行手术治疗。然而，在某些情况下，手术会在一周或更长时间后进行，很少有研究调查小儿鼻骨骨折延迟手术的后果。本研究的目的是根据初次受伤与手术之间的时间间隔，评估小儿鼻骨骨折的术后结果。
回顾了2012年3月至2020年2月期间12岁以下接受鼻骨骨折闭合复位的小儿患者的记录。受伤与手术之间的间隔分为7天内（早期复位）和7天以上（延迟复位）。根据计算机断层扫描显示的复位程度，术后结果分为五个等级（优、良、中、差、极差）。
分析了98例患者，其中51例接受早期复位，47例接受延迟复位。早期复位组的51例患者中，42例（82.4%）结果为优，9例（17.6%）结果为良。延迟复位组的47例患者中，39例（83.0%）结果为优，8例（17.0%）结果为良。两组之间的结果无统计学显著差异（卡方检验p = 0.937）。然而，没有鼻中隔损伤的患者术后结果为优的可能性显著更高（卡方检验p < 0.01）。
早期复位组和延迟复位组小儿鼻骨骨折的结果无统计学显著差异。即使是接受延迟复位（受伤后7天以上）的患者，手术结果也很成功。
