持続出血に対して緊急治療を要した小児の口腔顎顔面外傷の1例

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  • A case of pediatric oral and maxillofacial trauma requiring emergent treatment for continuous hemorrhage
  • ジゾク シュッケツ ニ タイシテ キンキュウ チリョウ オ ヨウシタ ショウニ ノ コウコウ ガク ガンメン ガイショウ ノ 1レイ

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Panfacial fractures are rare in children. A 9-year-old boy was transferred to the Emergency and Critical Care Center of our hospital with a Glasgow Coma Scale score of 14. He had panfacial and knee fractures due to a hit-and-run traffic accident. He was referred to the Oral and Maxillofacial Surgery division after primary examination, and facial computed tomography showed Le Fort I/II midface fractures and mandibular symphyseal fractures, as well as multiple luxations of the maxillary and mandibular teeth. He presented with dyspnea, continuous intraoral hemorrhage, and swelling of the oral floor. Emergent intubation was performed under intranasal endoscopic guidance, followed by open reduction and internal fixation and the replantation of some luxated intact permanent teeth under general anesthesia. After 3 days, the endotracheal tube was safely removed. A soft diet was initiated soon after discharge from the intensive care unit on the fourth postoperative day. Since clinical examinations confirmed complete bone union, a sound structure, and root growth in the replanted teeth, the internal fixation plates were removed 5 months after placement. The satisfactory re-establishment of the facial skeleton and recovery of ophthalmological and intraoral functions were achieved. This good outcome has been maintained for 9 months after the injury.

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