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南美一家创伤护理中心的勒福骨折趋势:特征与处理

Trends in Le Fort Fractures at a South American Trauma Care Center: Characteristics and Management.

作者信息

Oliveira-Campos Gustavo Halak, Lauriti Leandro, Yamamoto Marcos Kazuo, Júnior Rubens Camino, Luz João Gualberto C

机构信息

Hospital M. "Dr. Arthur R. de Saboya", São Paulo, SP Brazil.

Surgery Sector, Nove de Julho University, São Paulo, SP Brazil.

出版信息

J Maxillofac Oral Surg. 2016 Mar;15(1):32-7. doi: 10.1007/s12663-015-0808-z. Epub 2015 May 26.

Abstract

PURPOSE

To assess the trends in Le Fort (maxillary) fractures in patients seen at a South American trauma care center based on the characteristics and management of these.

MATERIALS AND METHODS

Of all patients with facial fractures seen at a trauma hospital during a six-year period, 50 (6.6 %) presented with Le Fort fractures. Medical charts were reviewed for characteristics presented and management performed. To improve the analyses, computed tomography and intraoperative findings were used. Statistical analyses involved descriptive statistics and the likelihood ratio test.

RESULTS

The fractures were Le Fort II (52 %), Le Fort I (22 %), Le Fort type-associated (20 %) and Le Fort III (6 %). Male patients (90 %) in their third decade of life (38 %) were more frequent (p = 0.022). Traffic accidents (56 %) were the major etiologic factor (p = 0.048). There were 1.4 additional facial fractures per patient, with predominance of zygoma fractures (36.5 %). Most of the cases were managed by open reduction (60 %) (p = 0.015) with the subciliary approach (42.7 %) (p = 0.001). The 1.5-mm system was the most used fixation and the zygomaticomaxillary suture the most frequent location (p = 0.001).

CONCLUSION

the most common patient with a Le Fort fracture is an adult male, with a Le Fort II fracture due to a traffic accident requiring surgical fixation on zygomaticomaxillary suture.

摘要

目的

基于Le Fort(上颌骨)骨折患者的特征及治疗情况,评估一家南美创伤护理中心此类患者的发病趋势。

材料与方法

在一家创伤医院六年期间收治的所有面部骨折患者中,50例(6.6%)为Le Fort骨折。回顾病历以了解患者的特征及接受的治疗。为完善分析,采用了计算机断层扫描及术中所见。统计分析包括描述性统计和似然比检验。

结果

骨折类型为Le Fort II型(52%)、Le Fort I型(22%)、Le Fort相关型(20%)和Le Fort III型(6%)。成年男性患者(90%)在第三个十年年龄段(38%)更为常见(p = 0.022)。交通事故(56%)是主要病因(p = 0.048)。每位患者平均合并1.4处其他面部骨折,以颧骨骨折为主(36.5%)。大多数病例采用切开复位治疗(60%)(p = 0.015),其中采用下睑缘切口的比例最高(42.7%)(p = 0.001)。1.5毫米系统是最常用的固定方式,颧上颌缝是最常见的固定部位(p = 0.001)。

结论

Le Fort骨折最常见于成年男性,多为因交通事故导致的Le Fort II型骨折,需对颧上颌缝进行手术固定。

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