Biller Jason A, Pletcher Steven D, Goldberg Andrew N, Murr Andrew H
Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, USA.
Laryngoscope. 2005 May;115(5):769-72. doi: 10.1097/01.MLG.0000157328.10583.A7.
Treatment delays in the operative management of mandible fractures are often unavoidable. We were interested in determining whether delays increased the incidence of complications in these patients.
A retrospective chart review was performed on all patients who presented to the San Francisco General Hospital with an operative mandible fracture in 2002. On the basis of the number of days from initial injury to surgery, the patients were divided into two groups: those repaired in 3 days or less and those repaired after 3 days. The incidence of infectious and technical complications was then compared between these groups. Substance abuse was also evaluated for its role in complication risk.
Of the 84 patients in the study, 11 had infectious complications, and 10 had technical complications. Although treatment delay did not increase the risk of developing an infectious complication, substance abuse considerably increased this risk. The incidence of technical complications was remarkably higher in patients repaired after 3 days.
Although patients with mandible fractures treated after 3 days do not have a higher risk of developing an infectious complication, this risk is elevated in patients who abuse substances regularly. The risk of technical complications increases with treatment delay, and therefore the surgical team must be even more vigilant when reducing these fractures.
下颌骨骨折手术治疗中的延迟往往不可避免。我们旨在确定延迟是否会增加这些患者并发症的发生率。
对2002年在旧金山总医院接受下颌骨骨折手术的所有患者进行回顾性病历审查。根据从受伤到手术的天数,将患者分为两组:3天或更短时间内进行修复的患者和3天后进行修复的患者。然后比较这两组患者感染性和技术性并发症的发生率。还评估了药物滥用在并发症风险中的作用。
在该研究的84例患者中,11例发生感染性并发症,10例发生技术性并发症。虽然治疗延迟并未增加发生感染性并发症的风险,但药物滥用显著增加了这一风险。3天后进行修复的患者技术性并发症的发生率明显更高。
虽然3天后接受治疗的下颌骨骨折患者发生感染性并发症的风险并不更高,但经常滥用药物的患者这一风险会升高。技术性并发症的风险随着治疗延迟而增加,因此手术团队在复位这些骨折时必须更加警惕。