Objective: To investigate the influence of condylar fractures on the growth of condylars after conservative treatments by three-dimensional measurement. Methods: Twenty three children with unilateral condylar fracture followed-up for at least 1 year in Shanghai Ninth People's Hospital were included from June 2016 to March 2017. CT scans were performed for each patient. Three-dimensional virtual skulls were reconstructed and measuring points were defined with Simplant 11.04 software. The depth of glenoid fossa, height of articular eminence, width, height and depth of condylar, deviation of pogonion were measured. Statistical analyses were conducted to assess difference between the bifid group and the normal group. Results: No difference was observed in the vertical position of crest of the articular eminence between two groups (P=0.110). The vertical position of roof of the glenoid fossa in bifid side was significantly superior than the one in normal side (P=0.010). Bifid side had a shorter (P=0.002) and wider(P=0.002) condylar than normal side did. No difference was observed in the depth of condylar between two groups (P=0.071). The average deviation of pogonion was (0.69±1.75) mm (P=0.072) from sagittal plan. Conclusions: This short-termed study indicates that children's growth potential of condylar is under average after conservative treatments. Because the bone hyperosteogeny of glenoid fossa compensates the hypotrophy of condylar, no deviation of pogonion is detected.
目的： 评价2~15岁单侧髁突骨折患者双侧髁突及颞下颌关节区的对称性，分析保守治疗后髁突生长改建的差异。 方法： 收集2016年6月至2017年3月于上海交通大学医学院附属第九人民医院口腔颅颌面科就诊的23例单侧髁突骨折行保守治疗并随访1年及以上2~ 15岁患者的全头颅螺旋CT数据，导入Simplant 11.04软件进行三维重建，对相关解剖结构三维定点、设定测量项目后，测量颞下颌关节窝深度、关节结节高度，髁突的长度、宽度及厚度和骨性颏点偏斜程度，比较患侧与健侧髁突及邻近结构的生长情况。 结果： 23例患者患侧关节结节最下点到眶耳平面的距离与健侧差异无统计学意义（P=0.110），患侧颞下颌关节窝最上点到眶耳平面的距离显著大于健侧（P=0.010）；患侧髁突长度显著小于健侧（P=0.002），患侧髁突宽度显著大于健侧（P=0.002），患侧髁突厚度与健侧差异无统计学意义（P=0.071）；骨性颏点向患侧偏斜（0.69±1.75）mm，患侧与健侧颏点偏斜程度差异无统计学意义（P=0.072）。 结论： 短期随访发现保守治疗后患儿骨折侧髁突的生长能力较正常侧差，但通过颞下颌关节窝骨质增生以代偿髁突高度不足，骨性颏点未发现偏斜。.
Keywords: Condylar fracture; Conservative treatment; Mandibular fracture; Three-dimensional measurement.