Kamath Rajay A D, Bharani Shiva, Hammannavar Reshma, Ingle Sumit P, Shah Ankit G
Department of Oral and Maxillofacial Surgery, College of Dental Sciences and Hospital, Karnataka, INDIA.
Craniomaxillofac Trauma Reconstr. 2012 Dec;5(4):197-204. doi: 10.1055/s-0032-1322536. Epub 2012 Jul 31.
Materials and Methods A 6-year retrospective analysis of 111 patients treated for maxillofacial fractures in Davangere, Karnataka from January 2004 to December 2009 was performed. Variables like age, gender, occupation, type of fracture and mechanism of injury, concomitant injury, mode of treatment, and complications were recorded and assessed. Results Men between 21 and 30 years were mostly affected (male-to-female ratio = 10:1; age range = 17.60 years; mean 31.7 ± 9.8 [standard deviation]). Most fractures were caused by road traffic accidents (RTAs; 74.7%), followed by interpersonal violence (IPV; 15.8%), falls (4.2%), industrial hazards and animal attacks (2.1% each), and self-inflicted injury (1.1%). Forty-two cases were isolated zygomaticomaxillary complex (ZMC) fractures. The total number of facial fractures documented was 316, of which 222 were purely related to the ZMC; however, 11 were confined only to the midface. Fifty-three cases had concomitant lower jaw fractures, totaling 83. Ophthalmic injuries occurred in 30.52% of cases. Ninety-two cases were treated with open reduction and internal fixation (ORIF), and three cases were managed conservatively. The complication rate observed was 25.26%. Conclusion RTA continues to be the chief etiological factor in maxillofacial injury with males being affected predominantly. IPV and falls next contribute significantly to the incidence of such injuries. Concomitant injuries, however, require prompt recognition and appropriate management. ORIF still remains the mainstay of treatment; however, fixation devices are constantly being improved upon in an attempt to reduce immobilization time thereby facilitating early return to function with minimal morbidity. Nevertheless, future advances in maxillofacial trauma diagnosis and management are likely to reduce associated morbidity.
对2004年1月至2009年12月在卡纳塔克邦达万盖尔接受治疗的111例颌面部骨折患者进行了为期6年的回顾性分析。记录并评估了年龄、性别、职业、骨折类型和损伤机制、合并伤、治疗方式及并发症等变量。结果:21至30岁男性受影响最为严重(男女比例为10:1;年龄范围为17.60岁;平均31.7±9.8[标准差])。大多数骨折由道路交通事故(RTA;74.7%)引起,其次是人际暴力(IPV;15.8%)、跌倒(4.2%)、工业事故和动物袭击(各2.1%)以及自残(1.1%)。42例为孤立性颧上颌复合体(ZMC)骨折。记录的面部骨折总数为316例,其中222例与ZMC直接相关;然而,11例仅局限于中面部。53例伴有下颌骨折,共计83处。30.52%的病例发生眼部损伤。92例采用切开复位内固定(ORIF)治疗,3例采用保守治疗。观察到的并发症发生率为25.26%。结论:RTA仍然是颌面部损伤的主要病因,男性受影响最为显著。IPV和跌倒其次是此类损伤发生率的重要因素。然而,合并伤需要及时识别和适当治疗。ORIF仍然是主要的治疗方法;然而,固定装置不断改进,试图减少固定时间,从而以最小的发病率促进早期功能恢复。尽管如此,颌面部创伤诊断和治疗的未来进展可能会降低相关发病率。