The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China.
Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, Hubei, People's Republic of China.
Sci Rep. 2022 Nov 19;12(1):19924. doi: 10.1038/s41598-022-24463-4.
This study aimed to explore and impart understanding of bone remodelling in children with intracapsular fractures treated conservatively. Records of children (less than 12 years), who sustained intracapsular fractures and treated conservatively, were retrieved consecutively for the period of March 2011 to February 2016. Data about age, gender, date of injury, dates of admission and discharge, mechanism of trauma, location and pattern of fracture, other mandibular fractures, treatment methods and time of review were recorded and analysed. Image dates of pre- and post-treatments, including date of review, were also recorded. A total of 22 patients complete their follow-up and show bone remodelling process. During their follow-up, all the displaced condylar fragments fused with the ramus stump at the displaced position. Regardless of the type of conservative procedure, both treatments cannot promote the spontaneous fracture reduction in patients with intracapsular condylar fractures. During follow-up, the absorption of the lateral process of the condyle after the closed treatment becomes close to the 'horizontal absorption', until the height (or articular surface) of the lateral condylar process dropped and aligned to the articular surface of the medial process. In children with intracapsular condylar fractures, the fracture fragment of the condyle determines the ramus height of the mandible. Closed treatment cannot restore the fracture fragment. If the height of the fracture fragments dropped remarkably, then open reduction and rigid internal fixation become more suitable.
本研究旨在探讨和理解儿童保守治疗的囊内骨折中的骨重建。连续检索了 2011 年 3 月至 2016 年 2 月期间接受保守治疗的儿童(<12 岁)的囊内骨折患者的记录。记录了年龄、性别、受伤日期、入院和出院日期、创伤机制、骨折部位和类型、其他下颌骨骨折、治疗方法和复查时间等数据,并进行了分析。还记录了治疗前后的影像学日期,包括复查日期。共有 22 名患者完成了随访,并显示了骨重建过程。在随访期间,所有移位的髁突碎片都在移位位置与髁突残端融合。无论保守治疗的类型如何,两种治疗方法都不能促进囊内髁突骨折患者的自发性骨折复位。在随访过程中,闭合治疗后的髁突外侧过程吸收接近于“水平吸收”,直到外侧髁突过程的高度(或关节面)下降并与内侧过程的关节面相齐。在儿童囊内髁突骨折中,髁突骨折碎片决定了下颌骨的支高度。闭合治疗不能恢复骨折碎片。如果骨折碎片的高度明显下降,则更适合采用切开复位和坚强内固定。