Conservative vs. Surgical Management of Condylar Fractures in Pediatric Populations: Complications and Factors for Consideration.

IF 2 4区 医学 Q2 PEDIATRICS
Chaim Ohayon, Amit Perelman, Adi Katz Biton, Andrei Krasovsky, Nidal Zeineh, Jiriys George Ginini, Adi Rachmiel, Amir Bilder, Omri Emodi
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Abstract

Background: The optimal treatment decision for pediatric condylar fractures is influenced by various factors, including the child's age, fracture type, degree of displacement, and the presence of concomitant injuries. While non-surgical treatments are generally preferred due to high remodeling capacity in children, there remains a lack of comprehensive research comparing the long-term outcomes of open reduction internal fixation (ORIF) versus conservative management.

Methods: Retrospective analysis of medical records of 71 pediatric patients (aged 0-18 years) treated for condylar fractures at the Department of Oral and Maxillofacial Surgery, Rambam Healthcare Campus, between 2010 and 2020 was completed. Gender, age, admission date, cause of injury, treatment methods, length of hospital stay, follow-up duration, and follow-up status were studied to help determine association with modality of treatment and complications.

Results: No statistically significant differences were seen in complication rates across different age groups, genders, trauma etiologies, fracture sites (head/neck/base), laterality of fractures, nor was there an impact on choice of surgical vs. conservative intervention. Similar length of hospital stay was observed, even in cases with delayed surgical intervention. There was also no statistical significance of injury distribution based on socioeconomic standing.

Conclusions: Our research showed similar rates of complications in both surgically treated and conservatively treated cases. This solidifies the importance of practitioner experience, as well as comprehensive anamnesis to help caretakers most effectively determine the optimal treatment for each patient. As the surgical study group is substantially smaller than the conservatively treated group, large-scale prospective studies with extended follow-up will more conclusively help solidify results and establish guidelines.

儿童髁突骨折的保守治疗与手术治疗:并发症和考虑因素。
背景:儿童髁突骨折的最佳治疗决策受多种因素的影响,包括儿童的年龄、骨折类型、移位程度以及是否存在伴发损伤。虽然由于儿童的重塑能力高,非手术治疗通常是首选,但仍然缺乏比较切开复位内固定(ORIF)与保守治疗的长期结果的全面研究。方法:回顾性分析2010 ~ 2020年在兰巴姆医院口腔颌面外科治疗髁突骨折的71例儿童患者(0 ~ 18岁)的病历。研究了性别、年龄、入院日期、损伤原因、治疗方法、住院时间、随访时间和随访状态,以帮助确定与治疗方式和并发症的关系。结果:不同年龄组、性别、创伤病因、骨折部位(头/颈/基底)、骨折侧边性的并发症发生率无统计学差异,手术和保守干预的选择也没有影响。即使在延迟手术干预的病例中,也观察到类似的住院时间。基于社会经济地位的伤害分布也没有统计学意义。结论:我们的研究显示手术治疗和保守治疗的并发症发生率相似。这巩固了执业经验的重要性,以及全面的记忆,以帮助护理人员最有效地确定每个病人的最佳治疗。由于手术研究组比保守治疗组小得多,大规模的前瞻性研究和延长的随访将更确切地帮助巩固结果和建立指南。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Children-Basel
Children-Basel PEDIATRICS-
CiteScore
2.70
自引率
16.70%
发文量
1735
审稿时长
6 weeks
期刊介绍: Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries. The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.
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