Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, PO BOX 100, FI-00029, HUS, Finland.
Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Turku, Turku, FI-20014, Finland; Department of Oral and Maxillofacial Diseases, Turku University Hospital, FI-20521, Turku, Finland.
J Craniomaxillofac Surg. 2021 May;49(5):387-393. doi: 10.1016/j.jcms.2021.01.025. Epub 2021 Feb 5.
Evidence supports the notion that craniofacial fractures are significant predictors of cervical spine injuries (CSIs), but some debate remains on the injury mechanism of co-existing CSIs in craniofacial fractures and the relationship between CSI and specific facial fractures. In this retrospective study, we aim to assess the incidence rates of specific facial fracture types as well as other important variables and their relationship with CSIs. The primary outcome variable, CSI, and several predictor variables, including facial fracture type, were evaluated with logistic regression analyses. Of 2919 patients, the total CSI incidence rate was 3.0%. Rates of CSI in patients with isolated mandibular fractures (OR 0.26 CI 0.10, 0.63; p = 0.006) were lower than those previously reported, whereas isolated nasal fractures were strongly associated with CSI (OR 2.67 CI 1.36, 5.22; p = 0.004). Patients with concomitant cranial injuries were twice as likely to have CSI (OR 2.00, CI 1.22, 3.27; p = 0.006). Even though there is a strong occurrence rate of CSIs in patients with cranial injuries, clinicians should be aware that patients presenting with isolated facial fractures are at significant risk for sustaining CSIs also.
有证据表明，颅面骨折是颈椎损伤（CSIs）的重要预测因素，但关于颅面骨折中并存 CSI 的损伤机制以及 CSI 与特定面部骨折之间的关系仍存在一些争议。在这项回顾性研究中，我们旨在评估特定面部骨折类型的发生率以及其他重要变量及其与 CSI 的关系。主要观察变量 CSI 以及包括面部骨折类型在内的几个预测变量，均采用逻辑回归分析进行评估。在 2919 名患者中，CSI 的总发生率为 3.0%。与先前报道相比，单纯下颌骨骨折患者的 CSI 发生率较低（OR 0.26 CI 0.10, 0.63; p = 0.006），而单纯鼻骨骨折与 CSI 强烈相关（OR 2.67 CI 1.36, 5.22; p = 0.004）。伴有颅部损伤的患者发生 CSI 的可能性是前者的两倍（OR 2.00, CI 1.22, 3.27; p = 0.006）。尽管伴有颅脑损伤的患者发生 CSI 的发生率很高，但临床医生应注意到，同时存在单纯面部骨折的患者也有发生 CSI 的高风险。
