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上颌骨矢状骨折的回顾性临床研究:术后结果的预测因素

Retrospective Clinical Study of Maxillary Sagittal Fractures: Predictors of Postoperative Outcome.

作者信息

Regmi Krishna Prasad, Tu JunBo, Ge SuMeng, Hou ChengQun, Hu XiaoYi, Li ShiXian, Du JingTing

机构信息

Resident, Oral and Maxillofacial Surgery, Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research and the Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, and the Research Center of Stomatology, Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.

Professor, Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research and the Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, and the Research Center of Stomatology, Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.

出版信息

J Oral Maxillofac Surg. 2017 Mar;75(3):576-583. doi: 10.1016/j.joms.2016.11.012. Epub 2016 Nov 23.

Abstract

PURPOSE

Because of less attention to the sagittal component of maxillary fractures, these fractures are often misdiagnosed or the reduction is missed leading to maxillary transverse discrepancies. Therefore, the purpose of this study was to identify factors associated with good or adverse postoperative outcomes of maxillary sagittal fractures.

MATERIALS AND METHODS

This study was a single-center retrospective cohort study. The sample was composed of cases of maxillary sagittal fractures treated at the Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Trauma Unit of Xi'an Jiaotong University (Xi'an, China) from January 2008 through December 2013. The predictor variables were age, gender, occupation, cause of injury, injury severity, treatment timing, treatment method, and quality of fracture reduction. The outcome variable was the postoperative treatment effect index. Descriptive, bivariate, and multivariate statistics were computed. The P value was set to .05.

RESULTS

The sample was composed of 40 cases. The male-to-female ratio was 4:1; the most vulnerable age group was 20 to 30 years (30%); laborers (72.5%) were more prone to injury; and the main cause of injury was motor vehicle accident (62.5%). No cases of isolated sagittal fracture were found and most (35%) occurred with other maxillary fractures, including Le Fort fractures. A statistically significant association between treatment timing and quality of fracture reduction and the postoperative treatment effect index (P < .05) was found.

CONCLUSION

The results of this study suggest that better results are achieved when fractured bone is treated sooner. Anatomic repositioning of the fractured bone is the important predictor for good postoperative outcomes.

摘要

目的

由于对上颌骨骨折矢状面成分关注较少,这些骨折常被误诊或复位遗漏,导致上颌骨横向差异。因此,本研究的目的是确定与上颌骨矢状面骨折术后良好或不良结果相关的因素。

材料与方法

本研究为单中心回顾性队列研究。样本由2008年1月至2013年12月在西安交通大学口腔颌面外科颅颌面创伤科(中国西安)治疗的上颌骨矢状面骨折病例组成。预测变量包括年龄、性别、职业、损伤原因、损伤严重程度、治疗时机、治疗方法和骨折复位质量。结果变量为术后治疗效果指数。进行了描述性、双变量和多变量统计分析。P值设定为0.05。

结果

样本包括40例病例。男女比例为4:1;最易受伤的年龄组为20至30岁(30%);劳动者(72.5%)更容易受伤;主要损伤原因是机动车事故(62.5%)。未发现孤立性矢状面骨折病例,大多数(35%)与其他上颌骨骨折同时发生,包括Le Fort骨折。发现治疗时机和骨折复位质量与术后治疗效果指数之间存在统计学显著关联(P < 0.05)。

结论

本研究结果表明,骨折骨尽早治疗可取得更好的效果。骨折骨的解剖复位是术后良好结果的重要预测指标。

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