Brandt K E, Burruss G L, Hickerson W L, White C E, DeLozier J B
Department of Surgery, University of Tennessee, Memphis 38103.
J Trauma. 1991 Jan;31(1):15-9. doi: 10.1097/00005373-199101000-00003.
Recent advances have radically changed the management of facial fractures. CT scanning, extensive exposure, and rigid plate fixation in the setting of the trauma center have permitted early operation with improved results. A subset of patients with facial fractures will also have intracranial injuries (ICI). We sought to identify parameters associated with an increased risk for ICI. We also sought to examine the safety and limits of early craniofacial repair in patients with intracranial injuries. Of 114 mid-face fractures treated over a 1-year period, 43 (38%) had a concomitant ICI. The majority, 36 (84%), were from motor vehicle accidents (MVA). Frontal sinus and orbitoethmoid fractures were at the highest risk for ICI, although orbitozygomatic fractures caused by MVAs also had a surprisingly high incidence of ICI. Our results show that early craniofacial repair can be performed safely with appropriate general surgical and neurosurgical support.
近年来的进展已彻底改变了面部骨折的治疗方式。在创伤中心，CT扫描、广泛暴露以及坚固接骨板固定使得早期手术成为可能，且效果更佳。一部分面部骨折患者还会伴有颅内损伤（ICI）。我们试图确定与颅内损伤风险增加相关的参数。我们还试图研究颅内损伤患者早期颅面修复的安全性及局限性。在1年时间里治疗的114例面中部骨折患者中，43例（38%）伴有颅内损伤。其中大多数，36例（84%）是由机动车事故（MVA）导致的。额窦和眶筛骨折发生颅内损伤的风险最高，不过机动车事故导致的眶颧骨折发生颅内损伤的几率也出奇地高。我们的结果表明，在适当的普通外科和神经外科支持下，早期颅面修复可以安全进行。
