儿童髁突骨折治疗方法的临床评价与分析  

Clinical evaluation of open and close treatment in pediatric condylar fractures

作　　者：韩晶[1] 李智[1] 周海华[1] 杨荣涛[1] 熊贵忠 李祖兵[1] 

机构地区：[1]武汉大学口腔医学院创伤与整形外科,430079 [2] 武汉市第五医院口腔科

出　　处：《中华口腔医学杂志》2014年第8期486-490,共5页Chinese Journal of Stomatology

摘　　要：目的 比较儿童髁突骨折手术疗法与保守疗法的远期临床效果及影像学表现,为临床治疗方法选择提供参考.方法 儿童髁突骨折患者78例（105侧髁突）,根据分类分别选择手术或保守治疗法,并在治疗后进行3年随访,检查患者的面形、开口度、开口型、咬合及髁突重建情况,比较手术与保守治疗的临床疗效及影像表现差别.依据综合分类法,Ⅰ型14侧,Ⅱ型48侧,Ⅲ型43侧.结果 Ⅰ型患者14侧均采用手术疗法;Ⅱ型患者48侧均采用保守疗法;Ⅲ型中37侧手术治疗、6侧保守治疗;105侧中手术治疗51侧,保守治疗54侧.影像重建表现手术治疗患者优于保守治疗患者.结论 建议Ⅰ型儿童髁突骨折采用手术疗法,Ⅱ型采用保守疗法,Ⅲ型应根据具体情况慎重选择.经分类建议的方法治疗后均取得较满意的临床效果;但在髁突影像表现中,手术治疗患者髁突重建效果优于保守治疗患者.Objective To evaluate the long-term clinical and radiographic outcomes of open and close treatment of condylar fractures of mandible in children.Methods A total of 78 cases （105 mandibular condylar fractures） were included in this study.All patients （younger than 12 years at the time of injury were followed up for at least 3 years.According to the classification of the condylar fractures,open or close treatment was chosen.Clinical outcomes were classified as favorable or unfavorable depending on the mouth opening,pattern of mouth opening,occlusion,facial symmetry.Condylar remodeling was defined as complete,moderate,or poor based on the radiographic findings.Depending on the classification,14 sides of type Ⅰ,48 sides of type Ⅱ and 43 sides of type Ⅲ were included in this study.Results Open treatment was chosen in 51 sides and close treatment was chosen in 54 sides.Most of the patients acquired satisfactory clinical outcomes.Better radiologic remodeling of the condylar process was found in the patients treated by open treatment.Conclusions Favorable long-term clinical outcomes were obtained in both open and close treatment of mandibular condylar fractures.A better morphological remodeling of condylar process was found in patients with open treatment.

关 键 词：下颌骨髁状突 骨折 儿童髁突骨折 

分 类 号：R782.4[医药卫生—口腔医学]