Dept. of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University, 2177 Dalgubeol-daero, Jung-gu, Daegu, 41940, Republic of Korea.
J Craniomaxillofac Surg. 2020 Apr;48(4):427-434. doi: 10.1016/j.jcms.2020.02.018. Epub 2020 Feb 29.
The purpose of this study was to investigate concomitant injuries and complications in patients with panfacial fracture (PF) according to patterns of PF.
PF is defined as fractures involving at least three of the four facial parts (frontal, upper midface, lower midface, and mandible). The data for this study were retrospectively analysed. A simple regression analysis, Cramer's V analysis, and Pearson's correlation analysis were used for verifying significance and correlation between the investigated factors and patterns of PF. Short-term postoperative surgical complications were classified according to the Clavien-Dindo classification (CDC).
There was a statistically significant association between age and PF pattern (ULM: 44.9 ± 19.2; FUL: 42.0 ± 16.8; FULM: 33.6 ± 15.3; FUM: 65; p = 0.024), between the cause of injury and PF pattern (p = 0.047), and between operative time and fracture pattern (ULM: 4h 45min ± 2h 21min; FUL: 5h 19min ± 2h 54min; FULM: 7h 19min ± 4h 13min; FUM: 2h 15min ± 0; p = 0.008). 89% of patients had concomitant injuries in other body parts. In the CDC grade groups, rade IVa cases (n = 4) showed statistically significant differences with PF patterns (p = 0.006). Of all the patients, 58.6% (n = 58) complained of postoperative complications.
PF patients can have different fracture patterns, depending on age and cause of trauma. Consequently, different PF patterns have different types of concomitant injuries and complications. PF patients with frontal area fracture have higher CDC grades, and may need ICU care. Therefore, classifying PFs will be a first step towards a systemic approach for treating and reducing complications.
本研究旨在根据面中部骨折(PF)的类型,调查 PF 患者的合并伤和并发症。
PF 定义为至少涉及四个面部区域(额部、面中部上部、面中部下部和下颌骨)中的三个区域的骨折。本研究的数据进行了回顾性分析。采用简单回归分析、Cramer's V 分析和 Pearson 相关分析来验证调查因素与 PF 类型之间的显著性和相关性。根据 Clavien-Dindo 分类(CDC)对短期术后手术并发症进行分类。
年龄与 PF 类型之间存在统计学显著关联(ULM:44.9±19.2;FUL:42.0±16.8;FULM:33.6±15.3;FUM:65;p=0.024),受伤原因与 PF 类型之间存在统计学显著关联(p=0.047),手术时间与骨折类型之间存在统计学显著关联(ULM:4h 45min±2h 21min;FUL:5h 19min±2h 54min;FULM:7h 19min±4h 13min;FUM:2h 15min±0;p=0.008)。89%的患者在其他身体部位有合并伤。在 CDC 分级组中,IVa 级(n=4)病例与 PF 类型之间存在统计学显著差异(p=0.006)。所有患者中,58.6%(n=58)诉术后并发症。
PF 患者可根据年龄和创伤原因出现不同的骨折类型。因此,不同的 PF 类型有不同类型的合并伤和并发症。具有额区骨折的 PF 患者 CDC 分级更高,可能需要 ICU 护理。因此,PF 的分类将是治疗和减少并发症的系统方法的第一步。