Bicsák Ákos, Dietmar Abel, Wruck Yannic, Hassfeld Stefan, Bonitz Lars
Department of Oral and Maxillofacial Surgery, Dortmund General Hospital, Dortmund, Germany.
Department of Oral and Maxillofacial Surgery, University of Witten Herdecke, Witten, Germany.
Ann Maxillofac Surg. 2021 Jan-Jun;11(1):97-102. doi: 10.4103/ams.ams_418_20. Epub 2021 Jul 24.
Panfacial fractures represent the most severe injuries to the face. The combination of these fractures determines the treatment strategy. This study aims to retrospectively review the data of adult patients treated for complex facial skull fractures in a hospital in Dortmund, Germany from 2015-2017.
We extracted related patient data from the hospital electronic repository and reviewed the patient files and radiological images. The fractures were classified based on the AO-Classification. The statistical analysis was performed by descriptive statistical methods. The main goal was to determine the most common fracture combinations.
A total of 188 patients with panfacial fractures were identified (181 adults, 7 children and adolescents). The gender and age distribution corresponded to the international literature (male-to-female ratio: 3.1:1, most common injuries among young men). 2-9 fracture sites were identified per patient, resulting in a fracture frequency of 3.13 per patient. 69 different fracture combinations have been identified. The most common ones were combinations of lateral and central mid-face fractures, and combinations of nasal bone fractures with lateral midface fractures or nasal bone fractures combined with mandibular fractures. Between 1 and 13 osteosynthesis implants per patient were used for osteosynthesis; the most commonly used plates were 2.0 mm and 1.5 mm straight plates. The average inpatient stay was 3 days (standard deviation [SD] = 3.0 days), and the average operation time (incision to suture) was 39.5 min (SD = 53.5 min).
Panfacial fractures are the most complex maxillofacial injuries. The complication rate in this study (4.5%) is below the international data. The treatment of panfacial fractures requires designated centers with experienced teams and good interdisciplinary cooperation.
面颅骨骨折是面部最严重的损伤。这些骨折的组合决定了治疗策略。本研究旨在回顾性分析2015年至2017年在德国多特蒙德一家医院接受治疗的成年复杂面部颅骨骨折患者的数据。
我们从医院电子资料库中提取相关患者数据，并查阅患者病历和影像学资料。骨折根据AO分类法进行分类。采用描述性统计方法进行统计分析。主要目的是确定最常见的骨折组合。
共识别出188例面颅骨骨折患者（181例成人，7例儿童和青少年）。性别和年龄分布与国际文献相符（男女比例为3.1:1，年轻男性中最常见损伤）。每位患者识别出2至9个骨折部位，每位患者的骨折频率为3.13。已识别出69种不同的骨折组合。最常见的是外侧和中央中面部骨折的组合，以及鼻骨骨折与外侧中面部骨折的组合或鼻骨骨折与下颌骨骨折的组合。每位患者用于骨固定的骨固定植入物为1至13枚；最常用的钢板是2.0mm和1.5mm的直板。平均住院时间为3天（标准差[SD]=3.0天），平均手术时间（切开至缝合）为39.5分钟（SD=53.5分钟）。
面颅骨骨折是最复杂的颌面损伤。本研究中的并发症发生率（4.5%）低于国际数据。面颅骨骨折的治疗需要有经验丰富团队的指定中心以及良好的多学科合作。
