Bottini Gian Battista, Hitzl Wolfgang, Götzinger Maximilian, Politis Constantinus, Dubron Kathia, Kordić Mario, Sivrić Anamaria, Pechalova Petia, Sapundzhiev Angel, Pereira-Filho Valfrido Antonio, de Oliveira Gorla Luis Fernando, Dediol Emil, Kos Boris, Rahman Tabishur, Rahman Sajjad Abdur, Samieirad Sahand, Aladelusi Timothy, Konstantinovic Vitomir S, Lazić Marko, Vesnaver Aleš, Birk Anže, Sohal Karpal Singh, Laverick Sean, Rae Euan, Rossi Maria Beatrice, Roccia Fabio, Sobrero Federica
Department of Oral and Maxillofacial Surgery and Center for Reconstructive Surgery, University Hospital of the Private Medical University Paracelsus, 5020 Salzburg, Austria.
Research and Innovation Management, Biostatistics, Department of Ophthalmology and Optometry, Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, 5020 Salzburg, Austria.
J Clin Med. 2024 Sep 14;13(18):5455. doi: 10.3390/jcm13185455.
: Mandibular condyle fractures in pediatric patients can lead to crippling sequelae such as ankylosis, pain and facial deformity if not managed properly. However, there is no consensus on the best approach for treating these fractures in children. : This study aimed to describe the management of mandibular condyle fractures in growing patients across 14 maxillofacial departments worldwide. : A retrospective multicenter study was conducted on children and adolescents aged 0 to 16 who had at least one mandibular condyle fracture. This study included patients who underwent expectant, closed, or open management and were treated over an 11-year period. : 180 patients had at least one mandibular condyle fracture, and 37 had a second condylar fracture. One hundred sixteen patients (65%) were males, and 64 (35%) were females (ratio 1.8:1). An expectant strategy was chosen in 51 (28%) patients, a closed treatment-stand-alone maxillomandibular fixation (MMF)-in 47 (26%), and open reduction and internal fixation (ORIF) was performed in 82 (46%) patients. The management varied significantly between the different departments ( < 0.0001). Significant differences were also identified between the fracture type (non-displaced, displaced or comminuted) and the management of the 180 patients with a single condylar fracture. Out of 50 non-displaced fractures, only 3 (6%) had ORIF, 25 (50%) had expectant management, and 22 (44%) had MMF. Out of 129 displaced fractures, 79 (62%) had ORIF, 25 (19%) had a soft diet, and 25 (19%) had MMF. : Expectative management, MMF, and ORIF were all effective in treating pediatric mandibular condyle fractures, with a low incidence of complications and asymmetry.
小儿患者的下颌髁突骨折若处理不当，可导致诸如关节强直、疼痛和面部畸形等严重后遗症。然而，对于儿童这些骨折的最佳治疗方法尚无共识。本研究旨在描述全球14个颌面科室对生长发育期患者下颌髁突骨折的治疗情况。对年龄在0至16岁、至少有一处下颌髁突骨折的儿童和青少年进行了一项回顾性多中心研究。本研究纳入了接受观察、闭合或开放治疗且治疗时间超过11年的患者。180例患者至少有一处下颌髁突骨折，37例有第二处髁突骨折。116例（65%）为男性，64例（35%）为女性（比例为1.8:1）。51例（28%）患者选择观察策略，47例（26%）采用闭合治疗——单纯颌间固定（MMF），82例（46%）患者进行切开复位内固定（ORIF）。不同科室之间的治疗方法差异显著（<0.0001）。在180例单发髁突骨折患者中，骨折类型（无移位、移位或粉碎性）与治疗方法之间也存在显著差异。在50例无移位骨折中，只有3例（6%）进行了切开复位内固定，25例（50%）采用观察治疗，22例（44%）采用颌间固定。在129例移位骨折中，79例（62%）进行了切开复位内固定，25例（19%）采用软食，25例（19%）采用颌间固定。观察治疗、颌间固定和切开复位内固定在治疗小儿下颌髁突骨折方面均有效，并发症和不对称发生率较低。
