Lin Ko-Chien, Peng Shu-Hui, Kuo Pao-Jen, Chen Yi-Chun, Rau Cheng-Shyuan, Hsieh Ching-Hua
Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Ta-Pei Road, Niao-Song District, Kaohsiung City 833, Taiwan.
Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Ta-Pei Road, Niao-Song District, Kaohsiung City 833, Taiwan.
Int J Environ Res Public Health. 2017 Jul 24;14(7):821. doi: 10.3390/ijerph14070821.
This study aimed to determine the patterns associated with adult mandibular fractures from a Level-I trauma center in southern Taiwan. The data of adult trauma patients admitted between 1 January 2009 and 31 December 2014 were retrieved from the Trauma Registry System and retrospectively reviewed. Fracture site and cause of injury were categorized into groups for comparison, and corresponding odds ratios (ORs) and 95% confidence intervals (CIs) were obtained by multivariate logistic regression. Motorcycle accidents were the most common cause of mandibular fractures (76.3%), followed by falls (10.9%), motor vehicle accidents (4.8%), and being struck by/against objects (4.5%). Of the 503 cases of mandibular fractures, the condylar neck and head were the most common sites (32.0%), followed by the parasymphysis (21.7%), symphysis (19.5%), angle and ramus (17.5%), and body (9.3%). The location of mandibular fractures in patients who had motorcycle accidents was similar to that in all patients. Motor vehicle accidents resulted in a significantly higher number of body fractures (OR 3.3, 95% CI 1.24-8.76, = 0.017) and struck injury in a significantly higher number of angle and ramus fractures (OR 3.9, 95% CI 1.48-10.26, = 0.006) compared to motorcycle accidents. The helmet-wearing status and body weight were not associated with the location of mandibular fractures in motorcycle accidents. Our study revealed that the anatomic fracture sites of mandible were specifically related to different etiologies. In southern Taiwan, motorcycle accidents accounted for the major cause of mandibular fractures and were associated with the condylar neck and head as the most frequent fracture sites. In contrast, motor vehicle accidents and struck injuries tended to cause more body fracture as well as angle and ramus fracture compared to motorcycle accidents. Furthermore, the status of helmet-wearing and body weight were not associated with the location of mandible fractures caused by motorcycle accidents.
本研究旨在确定台湾南部某一级创伤中心成人下颌骨骨折的相关模式。从创伤登记系统中检索并回顾性分析了2009年1月1日至2014年12月31日期间收治的成年创伤患者的数据。将骨折部位和损伤原因进行分组比较，并通过多因素逻辑回归获得相应的比值比（OR）和95%置信区间（CI）。摩托车事故是下颌骨骨折最常见的原因（76.3%），其次是跌倒（10.9%）、机动车事故（4.8%）以及被物体撞击（4.5%）。在503例下颌骨骨折病例中，髁突颈部和头部是最常见的部位（32.0%），其次是颏孔旁（21.7%）、正中联合（19.5%）、角部和升支（17.5%）以及体部（9.3%）。摩托车事故患者下颌骨骨折的部位与所有患者相似。与摩托车事故相比，机动车事故导致体部骨折的数量显著更多（OR 3.3，95% CI 1.24 - 8.76，P = 0.017），角部和升支骨折中因撞击受伤的数量也显著更多（OR 3.9，95% CI 1.48 - 10.26，P = 0.006）。在摩托车事故中，佩戴头盔的情况和体重与下颌骨骨折的部位无关。我们的研究表明，下颌骨的解剖骨折部位与不同病因存在特定关联。在台湾南部，摩托车事故是下颌骨骨折的主要原因，且与髁突颈部和头部作为最常见骨折部位相关。相比之下，与摩托车事故相比，机动车事故和撞击伤往往导致更多的体部骨折以及角部和升支骨折。此外，佩戴头盔的情况和体重与摩托车事故导致的下颌骨骨折部位无关。
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