小児顎関節突起骨折の予後について

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5 cases (6 condyles) of condylar fractures in children whose term of observation is more than 5 years are presented. The age ranged from 2 years, 4 months to 8 years, 6 months, with mean age of 5 years, 2 months. The follow-up term ranged from 5 years, 6 months to 10 years, 6 months, with a mean term of 8 years, 2 months. Of the 5 cases, 4 were unilateral, 1 bilateral. Of the 6 condyles classified according to the fracture site, 2 were condylar head, 2 condylar neck and 2 subcondyle. Of the 6 condyles classified according to fracture type, 1 was fracture-deviation, 2 fracture-dislocation deviation and 3 fracture-dislocation displacement. The treatment was conservative for all the condylar fractures, but in 4 cases with fractures of the mandibular body, open reduction at the same sites and intermaxillary fixation for 1 or 3 weeks were performed. One case with non displaced mandible was only treated by active movements. The postoperative course was uneventful in all cases. Clinical and radiographic studies on these cases after treatment gave the following results: 1) The degree of mouth opening, mandibular movement and occlusion were satisfactory in all patients, and deviation on openning was not observed. In addition, growth disturbance of the mandible and asymmetry of the face were also not observed. 2) In the case of fracture-deviation, "straightening" of the condyle occurred in a short term with d small extent of the remodelling process. 3) In the case of fracture-dislocation deviation, dislocated condyle was repositioned by means of the remodelling process. 4) In the case of fracture-dislocation displacement, firstly the small fragment was resorbed and then the condyle was reformed by means of the remodelling process. 5) In all cases except for one case, shortening of the condyle, flattening of the articular fossa and widening of the articular space were observed.

小児顎関節突起骨折の予後について

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