Koenig W R, Olsson A B, Pensler J M
Division of Plastic Surgery, Northwestern University Medical School, Chicago, IL.
Ann Plast Surg. 1994 May;32(5):503-5. doi: 10.1097/00000637-199405000-00011.
Mandibular fractures in children present the surgeon with a unique set of considerations. Tooth buds within the body and ramus of the mandible restrict the type of surgical intervention that may be used. In addition, the fate of nonerupted dentition in the direct line of the fracture remains unclear. Between July 1985 and June 1990, 30 patients in deciduous or mixed dentition presented with a total of 45 mandibular fractures. Of these 45 fractures, 33% (n = 15) involved 16 nonerupted teeth. Age at the time of fracture was 6.0 +/- 2.3 years (mean +/- SD). Thirty-three percent of patients were treated with open reduction and internal fixation of fractures; 67% of patients were treated with closed reduction and either intermaxillary fixation or a lingual splint. Normal eruption was exhibited by 82% (n = 9) of the tooth buds in the line of mandibular fracture. The results of this study indicate the following: (1) Mandibular fractures in children involve unerupted teeth directly in one-third of cases. (2) The majority of tooth buds (82%) in the line of mandibular fractures eventually erupt normally. And (3) a significant percentage of dentition (18%) may exhibit either delayed eruption or noneruption with resorption of the tooth bud if directly involved in the line of fracture.
儿童下颌骨骨折给外科医生带来了一系列独特的考量因素。下颌骨体部和升支内的牙胚限制了可能采用的手术干预类型。此外，骨折直接线上未萌出牙齿的命运仍不明确。在1985年7月至1990年6月期间，30例乳牙期或混合牙列期的患者共出现45处下颌骨骨折。在这45处骨折中，33%（n = 15）累及16颗未萌出的牙齿。骨折时的年龄为6.0 +/- 2.3岁（均值 +/- 标准差）。33%的患者接受了骨折切开复位内固定治疗；67%的患者接受了闭合复位及颌间固定或舌侧夹板治疗。下颌骨骨折线上82%（n = 9）的牙胚正常萌出。本研究结果表明：（1）儿童下颌骨骨折三分之一的病例直接累及未萌出的牙齿。（2）下颌骨骨折线上的大多数牙胚（82%）最终正常萌出。以及（3）如果直接位于骨折线上，相当比例（18%）的牙列可能出现萌出延迟或不萌出，并伴有牙胚吸收。
