Boston, Mass. From the Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School.
Plast Reconstr Surg. 2014 Mar;133(3):627-638. doi: 10.1097/01.prs.0000438457.83345.e9.
Facial fractures are commonly encountered scenarios for surgeons in the emergency room. The aim of this study was to assess epidemiology and complication rates of facial fractures and the impact of surgical specialty on facial fracture repair using the American College of Surgeons National Surgical Quality Improvement Program database.
The authors performed a retrospective review of prospectively collected data from the 2005 to 2011 American College of Surgeons National Surgical Quality Improvement Program databases using Current Procedural Terminology codes to identify patients undergoing facial fracture repair. Demographic data, postoperative complications, comparison between single and multiple facial fractures, and surgical specialty were accessed. Chi-square tests or Fisher's exact test were used for comparing categorical variables and t tests for continuous variables.
A total of 1170 patients were analyzed. The mean age was 38.7 ± 17.0, and the male-to-female ratio was 3.72:1. The most prevalent facial fracture was mandibular fracture in the single-fracture group and zygomatic fracture in the multiple-fracture group. Mandibular fractures were more prevalent in males and orbital fractures in females. Wound complication, morbidity, and mortality rates were 1.8, 1.3, and 0.1 percent, respectively. Multiple facial fractures and orbital fractures were more frequently treated by plastic surgeons among all surgeons.
Epidemiologic analysis of facial fractures identifies the most affected patient populations and the characteristics of their fractures. Comparison of complication rates and surgical specialty may permit broad insight into how patients are currently managed.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
面部骨折是急诊外科医生常见的情况。本研究旨在评估使用美国外科医师学会国家外科质量改进计划数据库评估面部骨折的流行病学和并发症发生率，以及外科专业对其修复的影响。
作者使用当前手术程序术语代码对 2005 年至 2011 年美国外科医师学会国家外科质量改进计划数据库中前瞻性收集的数据进行回顾性分析，以确定接受面部骨折修复的患者。获取人口统计学数据、术后并发症、单一和多处面部骨折之间的比较以及外科专业。使用卡方检验或 Fisher 精确检验比较分类变量，使用 t 检验比较连续变量。
共分析了 1170 例患者。平均年龄为 38.7 ± 17.0 岁，男女比例为 3.72:1。单一骨折组中最常见的骨折是下颌骨骨折，多发骨折组中最常见的是颧骨骨折。男性更常见下颌骨骨折，女性更常见眼眶骨折。伤口并发症、发病率和死亡率分别为 1.8%、1.3%和 0.1%。在所有外科医生中，多发性面部骨折和眼眶骨折更多地由整形外科医生治疗。
对面部骨折的流行病学分析确定了受影响最大的患者人群及其骨折特征。比较并发症发生率和外科专业知识可能为当前患者管理提供广泛的见解。
临床问题/证据水平：治疗，III 级。
