144例儿童髁突骨折闭合性治疗回顾分析

Nonsurgical management of condylar fractures in children: a retrospective study of 144 cases

目的 :对行闭合性治疗的儿童髁突骨折病例进行回顾分析,为临床提供参考。方法 :对2008—2016年144例行闭合性治疗的儿童髁突骨折患者的年龄、性别、致伤原因、骨折类型、伴发骨折、治疗方法及预后进行回顾分析。采用SPSS 21.0软件包对数据进行χ~2检验。结果 :闭合性治疗可用于各年龄段儿童髁突骨折,尤其是12岁以下患儿,高处坠落为主要致伤原因。经闭合性治疗后6个月,患儿开口度由(19.32±6.71)mm增加至(40.51±6.14)mm。随访期间,34.72%的患儿出现开口偏斜,18.75%的患儿出现关节弹响,3例患儿出现关节强直。结论 :闭合性治疗用于儿童髁突骨折效果理想。对严重骨折断端外上移位、关节间隙消失的病例,应密切随访,考虑开放性治疗。

PURPOSE： To evaluate the therapeutic effect of closed treatment on children with condylar fractures. METHODS： A retrospective study was conducted in 144 children with condylar fractures treated with closed treatment from 2008 to 2016. The age, sex, causes, fracture characteristics, concomitant injury, and treatment outcomes were analyzed. Chi-square test was performed using SPSS 21.0 software package. RESULTS： Closed treatment of condylar fracture was effective in children of all ages, especially in children under 12 years. Fall was the leading cause of condylar fractures in children. After 6 months of follow-up, the maximum month opening increased from （19.32±6.71） mm to （40.51± 6.14） mm. 34.74% cases presented mouth deviation from midline; 18.75% cases presented temporomandibular joint clicking during wide month opening; and 3 cases developed ankylosis. CONCLUSIONS： Closed treatment of condylar fracture in children is proved to be effective. For cases with severely dislocated condylar fractures, surgical treatment is suggested.