小儿上颌骨颧骨复合体骨折的切开复位内固定术：一项为期11年的多中心回顾性研究。

IF 2.3 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Dental Traumatology Pub Date : 2024-06-20 DOI:10.1111/edt.12976

Fabio Roccia, Federica Sobrero, Carlo Strada, Gian Battista Bottini, Maximilian Goetzinger, Sahand Samieirad, Aleš Vesnaver, Anže Birk, Luis Fernando de Oliveira Gorla, Valfrido Antonio Pereira-Filho, Emil Dediol, Boris Kos, Petia Pechalova, Angel Sapundzhiev, Marko Lazíc, Vitomir S. Konstantinovic, Kathia Dubron, Constantinus Politis, Paolo Garzino Demo, Anamaria Sivrić, Mario Kordić, Sajjad Abdur Rahman, Tabishur Rahman, Karpal Singh Sohal, Timothy Aladelusi, Euan Rae, Sean Laverick

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引用次数: 0

摘要

背景/目的：小儿颌颧复合体（MZC）骨折并不常见，有关其手术治疗的数据也很少。本研究旨在分析全球14个颌面中心对MZC骨折进行切开复位内固定术（ORIF）的选择和结果：这项多中心回顾性观察研究纳入了2011年1月至2022年12月期间接受开放复位内固定术治疗的16岁以下四足MZC骨折患者。研究收集了以下数据：年龄、性别、牙齿分期（乳牙期、混合牙期和恒牙期）、受伤原因、骨折类型、手术方式、骨合成部位（眶下缘、颧颌托、前颧骨和颧颞骨缝）、使用的钢板材料（钛或可吸收钢板）和数量以及治疗结果。最短随访时间为 6 个月。统计分析采用费雪精确检验或卡方检验（视情况而定）：共纳入64例四叉MZC骨折患者（平均年龄12.3岁）。72%的患者接受了单点固定。无论是单点固定还是两点固定，颧颌托都是最常见的固定部位，尤其是结合前颧骨缝合。年龄的增长与钢板移除率的增加有关（P .05）：本研究强调了使用 ORIF（即使是单点固定）治疗儿科移位的四足 MZC 骨折的可能性。颧颌托是首选的固定部位，可实现充分稳定，且无外部疤痕，牙齿损伤风险较低。未来需要进行长期随访的前瞻性研究，以制定明确的手术方案，并明确手术决策。

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Open reduction and internal fixation of paediatric maxillozygomatic complex fractures: An 11-year multicentric retrospective study

Background/aim

Paediatric maxillozygomatic complex (MZC) fractures are uncommon, and there is a scarcity of data regarding their surgical treatment. The aim of this study was to analyse choices and outcomes of open reduction and internal fixation (ORIF) for MZC fractures among 14 maxillofacial centers around the world.

Materials and Methods

This multicentric retrospective observational study included patients ≤16 years of age with quadripod MZC fractures treated with ORIF from January 2011 and December 2022. The following data were collected: age, gender, dentition stage (deciduous, mixed, and permanent), cause of injury, type of fracture, surgical approach, site of osteosynthesis (infraorbital rim, zygomaticomaxillary buttress, frontozygomatic, and zygomaticotemporal sutures), material (titanium or resorbable) and number of plates used, and outcome. The minimum follow-up was 6 months. Statistical analyses were performed with Fisher's exact test or chi-squared test, as appropriate.

Results

Sixty-four patients (mean age, 12.3 years) with quadripod MZC fractures were included. Seventy-two percent of patients received a single-point fixation. The zygomaticomaxillary buttress was the most common site for fixation, both in single-point and two-point fixation schemes, especially in combination with the frontozygomatic suture. Increasing age was associated with a higher rate of plate removal (p < .001). Postoperative complications included 5 (7.8%) cases of wound infections, 2 (3.1%) infraorbital paraesthesia, 1 (1.6%) ectropion. Residual facial asymmetry was found in 5 (7.8%) patients and was not associated with the type of fixation (p > .05).

Conclusions

This study highlights the possibility of using ORIF, even with a single point of fixation, for the treatment of displaced quadripod MZC fractures in the paediatric population. The zygomaticomaxillary buttress was the preferred site of fixation and allowed for adequate stabilization with no external scars and a low risk of tooth damage. Future prospective studies with long-term follow-up are needed to establish definitive surgical protocols and clarify the surgical decision-making.

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来源期刊

Dental Traumatology 医学-牙科与口腔外科

CiteScore

6.40

自引率

32.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Dental Traumatology is an international journal that aims to convey scientific and clinical progress in all areas related to adult and pediatric dental traumatology. This includes the following topics: - Epidemiology, Social Aspects, Education, Diagnostics - Esthetics / Prosthetics/ Restorative - Evidence Based Traumatology & Study Design - Oral & Maxillofacial Surgery/Transplant/Implant - Pediatrics and Orthodontics - Prevention and Sports Dentistry - Endodontics and Periodontal Aspects The journal"s aim is to promote communication among clinicians, educators, researchers, and others interested in the field of dental traumatology.