Voronezh, Voronezh, Russian Federation
The choice of treatment of facial bone fractures in the early age remains a challenge for dentists and maxillofacial surgeons due to the peculiarities of child organism. The purpose of this study was to develop a differential approach to the choice of treatment of children´s facial bone fractures taking into account the age of a child, location of injury and possible complications. This paper presents the analysis of current epidemiological situation regarding to facial bone fractures in children in Voronezh city and Voronezh region. It is shown that the most common injuries is a fall from a height of its own growth, i.e. low-trauma; at the same time the number of high-speed traumas, such as road-traffic accidents, high falls, has decreased. The analysis was carried out 58 cases of facial bone fractures in a group of children from 1 month to 16 years being treated in Maxillofacial Department of Voronezh Regional Pediatric Hospital №2. The developed model of differential choice of treatment of facial bone fractures in children allows to choosing the method taking into account a child age, location of injury and severity, as well as possible consequences of surgery. The clinical monitoring has proved the efficacy of the model which gives an opportunity to decrease post-traumatic complications associated with growth and occlusion deformations as well as complications of inflammatory genesis. It was convincingly shown the need for follow-up care of children with facial fracture that the doctor-orthodontist should continue. The presented data of this study about correlation between surgical and conservative treatment of facial bone fractures in children coincide with the worldwide statistics showing the current tendency to a wide application of mini-invasive methods of fractures fragments immobilization.
facial bone fractures in children, maxillofacial surgery, osteosynthesis, conservative treatment
Переломы костей лицевого скелета у детей составляют до 5% от всех видов переломов в детском возрасте [1, 2]. Вопрос лечения переломов костей лица у пострадавших старше 18 лет изучен достаточно полно, существующие в настоящее время методики остеосинтеза титановыми минипластинами, биорезорбируемыми пластинами являются «золотым» стандартом челюстно-лицевой травматологии [3,4]. В то же время, особенности детского организма: прежде всего рост костей, в том числе и лицевого скелета, несколько иной биохимический состав костной ткани у детей, присутствие зачатков зубов – не всегда позволяют воспользоваться хирургическими методами лечения переломов костей лица [1].
Материал и методы исследования. В период с 2008 по 2011год на базе отделения челюстно-лицевой хирургии Областной детской клинической больницы №2 г. Воронежа было проведено обследование и лечение 58 детей с 64 переломами костей лица в возрасте от 8 месяцев до 16 лет.
По возрасту пострадавшие распределились следующим образом:
1. Holland AJA, Broome C, Steinberg A, et al. Facial fractures in children. Pediatr Emerg Care.2001;17(3):157-60.
2. Iida S, Matsuya T. Pediatric maxillofacial fractures: their etiological characters and fracture patterns. J Craniomaxillofac Surg.2002;30(4):237-41.
3. Kieser J, Stephenson S, Liston PN, et al. Serious facial fractures in New Zealand from 1979 to 1998. Int J Oral Maxillofac. 2002;31(2):206-9.
4. Ogundare BO, Bonnick A, Bayley N. Pattern of mandibular fractures in an urban major trauma center. J Oral Maxillofac Surg. 2003;61:713-8.
