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.

abstractsObjective To compare the efficacies 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 occlusal 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.