Oral and Maxillofacial Surgery, Hayatabad Medical Complex, Peshawar, Pakistan.
Oral and Maxillofacial Surgery, KMU-Institute of Dental Sciences, Kohat, Pakistan.
J Stomatol Oral Maxillofac Surg. 2023 Feb;124(1S):101339. doi: 10.1016/j.jormas.2022.11.015. Epub 2022 Nov 17.
Pediatric bilateral condylar fractures (PBCF) is a rare clinical pathology, where the management is carried out with both conservative and surgical approaches. The purpose of this study was to analyze and compare these two treatment approaches and their associated long term complications in PBCF. An extensive literature review- through the search of online databases- was conducted to survey, collect, analyze and compare the reported outcomes of different treatment modalities for PBCF. The number of studies presenting PBCF case reports was 16, while the number of such retrospective studies included here was 19. Analyses of these studies revealed that the conservative treatment is preferred in PBCF patients younger than 12 years of age. Moreover, a composite approach where the open reduction and internal fixation (ORIF) is carried out for one side while the intermaxillary fixation (IMF) for the contralateral side is frequently reported for the management of PBCF cases; this approach appears effective in improving daily functioning of temporomandibular joint and reducing long term complications. Performing ORIF for one side while IMF for the contralateral side seems the most common treatment approach in PBCF. This study may help in rapid decision making for treatment selection of PBCF patients while minimizing the risk for late complications.
小儿双侧髁突骨折(PBCF)是一种罕见的临床病理,其治疗方法包括保守治疗和手术治疗。本研究旨在分析和比较这两种治疗方法及其在 PBCF 中的长期并发症。通过在线数据库搜索,进行了广泛的文献回顾,以调查、收集、分析和比较 PBCF 不同治疗方法的报告结果。有 16 项研究报告了 PBCF 病例报告,而这里纳入的此类回顾性研究有 19 项。对这些研究的分析表明,对于年龄小于 12 岁的 PBCF 患者,保守治疗是首选。此外,对于 PBCF 病例的管理,经常采用一侧切开复位内固定(ORIF),另一侧颌间固定(IMF)的综合方法;这种方法似乎可以有效地改善颞下颌关节的日常功能并减少长期并发症。对于一侧进行 ORIF,对于另一侧进行 IMF 似乎是 PBCF 最常见的治疗方法。本研究可以帮助快速做出治疗选择决策,同时将晚期并发症的风险降至最低。