Pediatrik maksillofasiyal travmaların epidemiyolojik analizi

Year 2021, Volume: 46 Issue: 3, 1293 - 1299, 30.09.2021

İbrahim Tabakan Ömer Kokaçya Cengiz Eser Eyüp Gencel

https://doi.org/10.17826/cumj.920560

Abstract

Amaç: Bu çalışmanın amacı beş yıl boyunca Plastik, Rekonstrüktif ve Estetik Cerrahi Anabilim Dalına başvuran pediatrik maksillofasiyal travma hastalarının epidemiyolojisinin ve tedavi yaklaşımlarının analiz edilmesidir.
Gereç ve Yöntem: Hastaların yaş ve cinsiyet dağılımları belirlendi. Hastanede yatış süresi, travmanın etyolojisi, fraktürün yeri, uygulanan tedavi yöntemleri tespit edilirken bu tedavilerin sonuçları ve gelişen komplikasyonlar değerlendirildi.
Bulgular: Kırıkların en sık görüldüğü yaş 17’ydi (%18,3). Maksillofasiyal travma nedeniyle opere edilen hastalarda en sık travma nedeni düşmeydi (%48,3). En fazla opere edilen yaş aralığı 12-18 (%50,6), en fazla opere edilen kırık lokalizasyonu panfasiyal kırıklardı (%27,58).
Sonuç: Çocukluk çağı maksillofasiyal travmalarda en basit ve en etkili tedavinin uygulanması gerekir. Az deplasmanlı kırıklarda konservatif tedaviler yeterli olabilirken daha fazla deplasman olan kırıklarda açık redüksiyon ve internal tespit yöntemleri uygulanmaktadır. Kemik büyümesini engellediğinden dolayı tespit materyallerin mutlaka çıkarılması gereklidir. Son yıllarda eriyebilen plakların yüksek maliyetleri nedeniyle kullanımı kısıtlı olmaktadır.

Keywords

pediatrik maksillofasiyal travma, panfasiyal fraktür, yaş, cinsiyet, düşme

Epidemiologic analysis of pediatric maxillofacial trauma

Abstract

BPurpose: This study aimed to analyze epidemiology and the treatment approaches for pediatric maxillofacial trauma patients who presented to the Department of Plastic, Reconstructive, and Aesthetic Surgery during 5 years period.
Materials and Methods: Age and gender distributions of the patients were determined. Duration of hospitalization, etiology of trauma, location of the fracture, and treatment methods applied was determined, and the results of these treatments and complications that developed were evaluated.
Results: The fractures were the most common at the age of 17 years (18.3%). The most common cause of trauma in patients operated for maxillofacial trauma was fall (48.3%). Most operations were performed in the age range of 12–17 years (50.6%), and panfacial fractures were the most frequently operated fracture localization (27.58%).
Conclusion: The simplest and most effective treatment should be applied for pediatric maxillofacial trauma. While conservative treatments may be sufficient in minimally displaced fractures, open reduction and internal fixation methods are applied in fractures with greater displacement. Fixation materials must necessarily be removed since they prevent bone growth. The use of bioabsorbable plates has been limited in recent years due to their high costs.

Keywords

pediatric maxillofacial trauma, panfacial fracture, age, gender, fall

References

• 1. Chandra SR, Zemplenyi KS. Issues in pediatric craniofacial trauma. Facial Plast Surg Clin North Am 2017;25:581-591.
• 2. Gassner R, Tuli T, Hächl O, et al. Craniomaxillofacial trauma in children: a review of 3,385 cases with 6,060 injuries in 10 years. J Oral Maxillofac Surg 2004;62:399-407.
• 3. Vyas RM, Dickinson BP, Wasson KL, et al. Pediatric facial fractures: current national incidence, distribution, and health care resource use. J Craniofac Surg 2008;19:339-349.
• 4. Imahara SD, Hopper RA, Wang J, et al. Patterns and outcomes of pediatric facial fractures in the United States: a survey of the National Trauma Data Bank. J Am Coll Surg 2008;207:710-716.
• 5. Haug RH, Foss J. Maxillofacial injuries in the pediatric patient. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:126-134.
• 6. Hatef DA, Cole PD, Hollier LH, Jr. Contemporary management of pediatric facial trauma. Curr Opin Otolaryngol Head Neck Surg 2009;17:308-314.
• 7. Grunwaldt L, Smith DM, Zuckerbraun NS, et al. Pediatric facial fractures: demographics, injury patterns, and associated injuries in 772 consecutive patients. Plast Reconstr Surg 2011;128:1263-1271.
• 8. Braun TL, Xue AS, Maricevich RS. Differences in the management of pediatric facial trauma. Semin Plast Surg 2017;31:118-122.
• 9. JK K. Pediatric facial trauma. Plastic surgery indication, operation and outcomes, ed. A. BM, et al. 2000. Philadelphia.
• 10. Xun H, Lopez J, Darrach H, et al. Frequency of cervical spine injuries in pediatric craniomaxillofacial trauma. J Oral Maxillofac Surg 2019;77:1423-1432.
• 11. Posnick JC, Wells M, Pron GE. Pediatric facial fractures: evolving patterns of treatment. J Oral Maxillofac Surg 1993;51:836-844.
• 12. Bartlett SP, DeLozier JB, 3rd. Controversies in the management of pediatric facial fractures. Clin Plast Surg 1992;19:245-258.
• 13. Gerbino G, Roccia F, Bianchi FA, et al. Surgical management of orbital trapdoor fracture in a pediatric population. J Oral Maxillofac Surg. 2010;68:1310-1316.
• 14. Ellis E, 3rd, Tan Y. Assessment of internal orbital reconstructions for pure blowout fractures: cranial bone grafts versus titanium mesh. J Oral Maxillofac Surg 2003;61:442-453.
• 15. Cordewener FW, Bos RR, Rozema FR, et al. Poly(<span class="small">l</span>-lactide) implants for repair of human orbital floor defects: clinical and magnetic resonance imaging evaluation of long-term results. J Oral Maxillofac Surg 1996;54:9-13.
• 16. Abumanhal M, Ben-Cnaan R, Feldman I, et al. Polyester urethane implants for orbital trapdoor fracture repair in children. J Oral Maxillofac Surg 2019;77:126-131.
• 17. Al-Sukhun J, Lindqvist C. A comparative study of 2 implants used to repair inferior orbital wall bony defects: autogenous bone graft versus Bioresorbable poly-L/DL-lactide [P(L/DL)LA 70/30] plate. J Oral Maxillofac Surg 2006;64:1038-1048.
• 18. Ozturk S, Sengezer M, Isik S, et al. Long-term outcomes of ultra-thin porous polyethylene implants used for reconstruction of orbital floor defects. J Craniofac Surg 2005;16:973-977.
• 19. Aryasit O, Ng DS, Goh ASC, et al. Delayed onset porous polyethylene implant-related inflammation after orbital blowout fracture repair: four case reports. BMC Ophthalmol 2016;16:94.
• 20. Song X, Li L, Sun Y, et al. Long-term infectious complications of using porous polyethylene mesh for orbital fracture reconstruction. Medicine 2016;95:e3819.
• 21. Al-Khdhairi OBH, Abdulrazaq SS. Is orbital floor reconstruction with titanium mesh safe? J Craniofac Surg 2017;28:e692-e694.
• 22. Yi WS, Xu XL, Ma JR, et al. Reconstruction of complex orbital fracture with titanium implants. Int J Ophthalmol 2012;5:488-492.
• 23. Kersey TL, Ng SG, Rosser P, et al. Orbital adherence with titanium mesh floor implants: a review of 10 cases. Orbit 2013;32:8-11.
• 24. Haug RH, Cunningham LL, Brandt MT. Plates, screws, and children: their relationship in craniomaxillofacial trauma. J Long Term Eff Med Implants 2003;13:271-287.
• 25. Lin KY, Bartlett SP, Yaremchuk MJ, et al. An experimental study on the effect of rigid fixation on the developing craniofacial skeleton. Plast Reconstr Surg 1991;87:229-235.
• 26. Anderson PJ. Fractures of the facial skeleton in children. Injury 1995;26:47-50.
• 27. Yu J, Dinsmore R, Mar P, et al. Pediatric maxillary fractures. J Craniofac Surg 2011;22:1247-1250.
• 28. Koltai PJ, Rabkin D. Management of facial trauma in children. Pediatr Clin North Am 1996;43:1253-1275.
• 29. Iizuka T, Thorén H, Annino DJ, et al. Midfacial fractures in pediatric patients: frequency, characteristics, and causes. Arch Otolaryngol Head Neck Surg 1995;121:1366-1371.
• 30. Kaban LB, Troulis MJ. Pediatric oral and maxillofacial surgery. W B Saunders Company; 2004.
• 31. Iida S, Matsuya T. Paediatric maxillofacial fractures: their aetiological characters and fracture patterns. J Craniomaxillofac Surg 2002;30:237-241.
• 32. Lund K. Mandibular growth and remodelling processes after condylar fracture. A longitudinal roentgencephalometric study. Acta odontol Scand Suppl 1974;32:3-117.
• 33. Lindahl L. Condylar fractures of the mandible: I. Classification and relation to age, occlusion, and concomitant injuries of teeth and teeth-supporting structures, and fractures of the mandibular body. Int J Oral Surg 1977;6:12-21.
• 34. Lindahl L, Hollender L. Condylar fractures of the mandible: II. A radiographic study of remodeling processes in the temporomandibular joint. Int J Oral Surg 1977;6:153-165.
• 35. Feifel H, Albert-Deumlich J, et al. Long-term follow-up of subcondylar fractures in children by electronic computer-assisted recording of condylar movements. Int J Oral Maxillofac Surg 1992;21:70-76.
• 36. Thorén H, Iizuka T, Hallikainen D, et al. An epidemiological study of patterns of condylar fractures in children. Br J Oral Maxillofac Surg 1997;35:306-311.
• 37. Eppley BL. Use of resorbable plates and screws in pediatric facial fractures. J Oral Maxillofac Surg 2005;63:385-391.