摘要
目的比较保守治疗成人与儿童髁突矢状骨折的效果。方法1985年1月至2010年12月，解放军总医院口腔颌面外科收治的67例（82侧）髁突矢状骨折患者，用咬合夹板行保守治疗3～6个月，或其他保守治疗。治疗后6个月、1年时复诊，以后每年复诊1次。67例患者按其年龄分为2组，其中≥12岁的患者28例（34侧），〈12岁患者39例（48侧）。最长随诊25年，最短2年。随诊时检查其下颌活动度、开口型，并行CT检查观测髁突形态改建情况。结果〈12岁患者下颌功能恢复良好，仅有11例患者出现开口时下颌偏斜；cT检查39例48侧发生矢状骨折的髁突中，32侧髁突形态改建良好，16侧髁突表现部分改建，无髁突形态较差的患者出现。年龄≥12岁组患者中4例发生关节强直，15例开口时下颌偏斜；CT检查显示34侧髁突中，有6侧髁突形态改建良好，16侧髁突表现部分改建，12侧髁突形态改建较差。结论儿童的髁突矢状骨折采取保守治疗后髁突形态改建较成人佳，儿童髁突的改建能力较成人强。
Objective To compare the efficaeies of non-surgical treatment for pediatric and adult sagittal fractures of mandibular condyle. Methods From January 1985 to December 2010, our department treated 67 cases （82 sides ） sagittal fractures of mandibular condyle with oeelusal splint at a height of 1 -2 mm in molar region for six months or other non-surgical treatment. Their clinical and radiological remodeling of affected condyles after treatment were reviewed at six mouths, one year and each year after treatment. They were divided into 2 groups according to age. There were 28 patients （34 sides ） aged over 12 years and 39 patients （48 sides） under 12 years. During a follow-up period of 2 -25 years, mandibular activity, mouth opening and parallel CT scan of condylar morphological alterations were examined. Results Under 12-year-old group：good mandibular function was observed in 39 patients. Maximal mouth opening over 35 mm was achieved at 6 months. Only 11 of 39 patients had deviation on mouth opening at 6 months. Radiological studies showed that 32 condyles were complete remodeling and 16 condyles were partial remodeling. Poor remodeling was not observed. Over 12-year-old group：Ankylosis occurred in 4 joints. And 15 of 28 patients had deviation on mouth opening at 6 months. Radiological studies showed the remodeling of condyles was complete （n =6）, partial （n = 16） and poor （n = 12） respectively. Conclusion Mandibular functional recovery and condylar remodeling are better in children with more powerful healing and reconstructing capacities.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第32期2578-2580,共3页
National Medical Journal of China
基金
北京市自然科学基金（7112124）
关键词
下颌骨髁状突
下颌骨折
成年人
儿童
保守治疗
Mandibular condyle
Mandibular fractures
Adult
Child
Conservative treatment
