CAJ | 학술논문

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.
목적 비교인동과돌골절수술요법여보수요법적원기림상효과급영상학표현,위림상치료방법선택제공삼고.방법 인동과돌골절환자78례(105측과돌),근거분류분별선택수술혹보수치요법,병재치료후진행3년수방,검사환자적면형、개구도、개구형、교합급과돌중건정황,비교수술여보수치료적림상료효급영상표현차별.의거종합분류법,Ⅰ형14측,Ⅱ형48측,Ⅲ형43측.결과 Ⅰ형환자14측균채용수술요법;Ⅱ형환자48측균채용보수요법;Ⅲ형중37측수술치료、6측보수치료;105측중수술치료51측,보수치료54측.영상중건표현수술치료환자우우보수치료환자.결론 건의Ⅰ형인동과돌골절채용수술요법,Ⅱ형채용보수요법,Ⅲ형응근거구체정황신중선택.경분류건의적방법치료후균취득교만의적림상효과;단재과돌영상표현중,수술치료환자과돌중건효과우우보수치료환자.
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.