Objective: To summarize and analyze clinical characteristics of pediatric mandibular condylar fractures and the long-term therapeutic effects of closed treatment. Methods: A retrospective study was conducted for pediatric condylar fracture in the Department of Oral and Maxillofacial Surgery of Peking University School and Hospital of Stomatology from October 2015 to October 2019, including 33 males (67.3%) and 16 females (32.7%), with an average age of (8.3±2.1) years old. According to the treatment methods, the children were divided into two groups: group A was a removable occlusal splint accompanied with functional exercise, group B was a pure functional exercise. Forty-nine cases (76 sides) children with intracapsular condylar fracture were included in this study. Twenty-three cases in group A and 26 cases in group B. The maximum month opening increased from (20.0±6.2) mm to (46.0±5.3) mm 6 months after closed treatment. Subjective evaluation, special examination, qualitative analysis and quantitative analysis of imaging were used to evaluate the condylar remodeling and functional recovery of temporomandibular joint in two groups of children after closed treatment of intracapsular condyle fracture. Results: There was no significant difference in subjective evaluation, maximum opening examination, mouth open-type, mandibular protrusion, lateral movement and qualitative analysis of imaging at the six-month follow-up after injury. Quantitative imaging measurements showed that the condylar anteroposterior diameter and condylar height in Group B were significantly higher than those in Group A after 1 year of injury. Conclusions: Closed treatment for pediatric condylar fractures can achieve satisfactory results. After 6 months of injury, the children in the two groups could recover the temporomandibular joint function and promote the condylar adaptative remodeling.
目的： 比较分析儿童髁突囊内骨折两种不同保守治疗方法的近期临床疗效。 方法： 回顾性收集2015年10月至2019年10月就诊于北京大学口腔医学院·口腔医院口腔颌面外科的49例（76侧）儿童髁突囊内骨折患儿的临床资料，其中男性33例（67.3%），女性16例（32.7%），年龄（8.3±2.1）岁。根据是否使用(牙合)垫将患儿分为两组，A组为全牙列软(牙合)垫配合功能性训练组23例（34侧），B组为单纯功能性训练组26例（42侧）。采用主观评价、专科检查、影像学定性观察和定量测量分析两组患儿的数据资料，评价两组患儿的髁突改建及颞下颌关节功能恢复的程度。 结果： 49例（76侧）患儿伤后开口度为（20.0±6.2）mm，伤后6个月患儿最大开口度为（46.0±5.3）mm；两组患儿伤后6个月复查时主观评价、最大开口度、开口型、下颌前伸运动度、侧方运动度、影像学定性分析差异均无统计学意义（P>0.05）。影像学定量测量B组患儿伤后1年髁突前后径、髁头高度、髁突高度较A组的差异均有统计学意义（P<0.05）。 结论： 全牙列软(牙合)垫配合功能性训练和单纯功能性训练均可使髁突得到良好的改建，颞下颌关节功能恢复正常。.