Yamamoto Kazuhiko, Matsusue Yumiko, Horita Satoshi, Murakami Kazuhiro, Sugiura Tsutomu, Kirita Tadaaki
Department of Oral and Maxillofacial Surgery, Nara Medical University, Kashihara, Nara, Japan.
Craniomaxillofac Trauma Reconstr. 2015 Dec;8(4):281-8. doi: 10.1055/s-0034-1399797. Epub 2015 Jan 16.
Trend and characteristics of maxillofacial fractures in 2,636 patients over 32 years were analyzed retrospectively. Patients comprised 1,764 males and 872 females with ages ranging from 0 to 99 years. Patients younger than 30 years consisted of 60% maxillofacial fractures in the early period but decreased to 40% in the late period. In contrast, patients older than 60 years gradually increased to 30%. In terms of cause, traffic accidents consisted of more than 50%, predominantly motorcycle accidents, but gradually decreased to 40%. In contrast, falls markedly increased from less than 10 to 30%. Fractures occurred in the midface in 938 patients, in the mandible in 1,490, and in both in 208. In the midface, zygoma fractures consisted of 50% throughout the period. In the mandible, condyle fractures were observed in 40%, followed by fractures of the symphysis and angle. The ratio of condylar fractures slightly increased. Open reduction and internal fixation (ORIF) were performed in 782 patients, followed by observation in 716, maxillomandibular fixation (MMF) in 605, intramaxillary splinting (IMS) in 294, transcutaneous reduction (TCR) in 126, and others in 113. MMF markedly decreased from more than 30 to less than 5% and observation increased from 20 to 40%.
回顾性分析了32年间2636例患者颌面部骨折的趋势和特征。患者包括1764名男性和872名女性,年龄从0岁到99岁不等。30岁以下的患者早期颌面部骨折占60%,但后期降至40%。相比之下,60岁以上的患者逐渐增至30%。就病因而言,交通事故占比超过50%,主要是摩托车事故,但逐渐降至40%。相比之下,跌倒所致骨折从不到10%显著增至30%。938例患者发生面中部骨折,1490例发生下颌骨骨折,208例两处均发生骨折。在面中部,颧骨骨折在整个时期均占50%。在下颌骨,髁突骨折占40%,其次是颏部和下颌角骨折。髁突骨折的比例略有增加。782例患者接受了切开复位内固定术(ORIF),其次是716例接受观察,605例接受颌间固定(MMF),294例接受颌内夹板固定(IMS),126例接受经皮复位(TCR),113例接受其他治疗。MMF从超过30%显著降至不到5%,观察治疗从20%增至40%。