Afrooz Paul N, Bykowski Michael R, James Isaac B, Daniali Lily N, Clavijo-Alvarez Julio A
Resident, Department of Plastic and Reconstructive Surgery, University of Pittsburgh, Pittsburgh, PA.
Medical Student Research Fellow, Department of Plastic and Reconstructive Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA.
J Oral Maxillofac Surg. 2015 Dec;73(12):2361-6. doi: 10.1016/j.joms.2015.04.032. Epub 2015 May 11.
To date, no studies have analyzed the national demographics of mandibular fractures in the United States. This report is part 1 of a 2-part series characterizing the modern demographics, epidemiology, and outcomes of mandibular fractures in the United States. The purpose of this study was to characterize mandibular fractures in relation to age, gender, mechanism of injury, and anatomic location of fracture.
A retrospective cohort study was conducted using the National Trauma Data Bank (NTDB). The sample was derived from the population of hospitalized patients enrolled in the NTDB from 2001 to 2005 using mandibular fracture (International Classification of Diseases, Ninth Revision codes 802.21 through 802.39) as an inclusion criterion. Patient- and injury-related variables, including age, gender, anatomic location of fracture, and mechanism of injury, were analyzed by Fisher exact and χ(2) testing.
A total of 13,142 patients with mandibular fractures from participating trauma centers were included in the study. Eighty percent of patients were male. Fracture distribution by age was roughly bell-shaped, with fractures occurring most frequently at 18 to 54 years of age. Mechanism of injury differed by gender, with men most often sustaining mandibular fracture from assault (49.1%), followed by motor vehicle accidents (MVAs; 25.4%) and falls (12.8%). Women most commonly sustained mandibular fracture from MVAs (53.7%), followed by assault (14.5%) and falls (23.7%). Falls were a significantly more common mechanism in patients who were at least 65 years old (P < .001).
This study sought to characterize the largest, modern, population-based sample of mandibular fractures in the United States. Overall, men had a 4-fold higher incidence, but this distribution varied by age. Similarly, mechanism of injury varied across gender and age range. A better understanding of the influence of age and gender on mechanism of injury and anatomic site is of great clinical importance in the assessment, diagnosis, and treatment of traumatic mandibular fractures.
迄今为止，尚无研究分析美国下颌骨骨折的全国人口统计学特征。本报告是一个两部分系列研究的第1部分，该系列研究旨在描述美国下颌骨骨折的现代人口统计学、流行病学及治疗结果。本研究的目的是根据年龄、性别、损伤机制及骨折的解剖位置来描述下颌骨骨折的特征。
利用国家创伤数据库（NTDB）进行了一项回顾性队列研究。样本取自2001年至2005年纳入NTDB的住院患者群体，纳入标准为下颌骨骨折（国际疾病分类第九版编码802.21至802.39）。通过Fisher精确检验和χ²检验分析患者及损伤相关变量，包括年龄、性别、骨折的解剖位置及损伤机制。
本研究共纳入了来自参与研究的创伤中心的13142例下颌骨骨折患者。80%的患者为男性。按年龄划分的骨折分布大致呈钟形，骨折最常发生于18至54岁年龄段。损伤机制因性别而异，男性下颌骨骨折最常见的原因是袭击（49.1%），其次是机动车事故（MVA；25.4%）和跌倒（12.8%）。女性下颌骨骨折最常见的原因是MVA（53.7%），其次是袭击（14.5%）和跌倒（23.7%）。跌倒在至少65岁的患者中是一种明显更常见的损伤机制（P < .001）。
本研究旨在描述美国规模最大、基于现代人群的下颌骨骨折样本的特征。总体而言，男性的发病率高出4倍，但这种分布因年龄而异。同样，损伤机制在不同性别和年龄范围内也有所不同。更好地理解年龄和性别对损伤机制及解剖部位的影响，对于创伤性下颌骨骨折的评估、诊断和治疗具有重要的临床意义。
