Pham-Dang Nathalie, Barthélémy Isabelle, Orliaguet Thierry, Artola Alain, Mondié Jean-Michel, Dallel Radhouane
Faculté de Chirurgie Dentaire, 11 Boulevard Charles de Gaulle, 63000 Clermont-Ferrand, France,
Med Oral Patol Oral Cir Bucal. 2014 May 1;19(3):e261-9. doi: 10.4317/medoral.19077.
This study evaluated the trends and factors associated with maxillofacial fractures treated from 1997 to 2007 in the Oral and Maxillofacial Surgery Department of the Clermont-Ferrand University Hospital.
This study included 364 patients of which 82% were men and 45%, 20-29-years old. The etiology, anatomical distribution, treatment modality and complications of maxillofacial fractures were examined.
Overall, interpersonal violence, traffic accidents and falls were the most common mechanisms of injury. There was a decreasing trend in traffic accidents and increasing one in falls as a cause of fracture over the 11-years period of this study. Young male patients were preferentially victim of interpersonal violence and traffic accidents, while middle-aged ones were of falls and work-related accidents. Middle-aged female patients were preferentially victim of traffic accidents and interpersonal violence, while older ones were of falls. And the number of fractures per patient varied according to the mechanism of injury: low after work-related accidents and high after traffic accidents. About two-third of fractures involved the mandible. Most of these mandibular fractures were treated by osteosynthesis with or without intermaxillary fixation, with the proportion of the latter increasing over time. There were very few postoperative infections and only in mandible.
Maxillofacial fractures predominantly occur in young men, due to interpersonal violence. There is nevertheless an increasing trend in falls as a cause of fracture, especially in female patients, consistent with the increasing trend in presentation of older people. Most maxillofacial fractures involve the mandible and there is an increasing trend in treating these fractures by osteosynthesis without intermaxillary fixation. Antibiotic prophylaxis associated with dental hygiene care can be indicated to prevent postoperative infections.
本研究评估了1997年至2007年期间克莱蒙费朗大学医院口腔颌面外科治疗的颌面骨折的趋势及相关因素。
本研究纳入364例患者，其中82%为男性，45%年龄在20至29岁之间。对颌面骨折的病因、解剖分布、治疗方式及并发症进行了检查。
总体而言，人际暴力、交通事故和跌倒为最常见的受伤机制。在本研究的11年期间，交通事故导致骨折的情况呈下降趋势，而跌倒导致骨折的情况呈上升趋势。年轻男性患者主要因人际暴力和交通事故受伤，中年患者主要因跌倒和工作相关事故受伤。中年女性患者主要因交通事故和人际暴力受伤，老年患者主要因跌倒受伤。每位患者的骨折数量因受伤机制而异：工作相关事故后骨折数量少，交通事故后骨折数量多。约三分之二的骨折累及下颌骨。这些下颌骨骨折大多采用有或无颌间固定的骨合成术治疗，后者的比例随时间增加。术后感染极少，且仅发生在下颌骨。
颌面骨折主要发生在年轻男性，原因是人际暴力。然而，跌倒作为骨折原因呈上升趋势，尤其是在女性患者中，这与老年人就诊人数增加的趋势一致。大多数颌面骨折累及下颌骨，采用无颌间固定的骨合成术治疗这些骨折的趋势在增加。可采用与口腔卫生护理相关的抗生素预防措施来预防术后感染。
