Ritschl Lucas M, Wittmann Matthias, von Bomhard Achim, Koerdt Steffen, Unterhuber Tobias, Kehl Victoria, Deppe Herbert, Wolff Klaus-Dietrich, Mücke Thomas, Fichter Andreas M
Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Klinikum Rechts der Isar, Ismaninger Straße 22, 81675 Munich, Germany.
Department of Oral and Maxillofacial Surgery, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 13353 Berlin, Germany.
J Clin Med. 2022 Apr 14;11(8):2187. doi: 10.3390/jcm11082187.
Systematic assessment of computed tomography (CT) scans and clinical symptoms is necessary to quickly indicate the correct treatment of zygomatico-orbital (ZMO) fractures. For this purpose, a clinical scoring system (=Clinical Score) was developed and correlated with CT scans to analyse its validity. Every operated, isolated, and unilateral ZMO fracture between January 2012 and December 2016 was screened retrospectively, including patient and treatment data. All available CT scans were analysed, and the grade of dislocation was measured for each case and plane. Four hundred and sixty-one cases were included and showed a median surgery time of 66.0 min (5.0−361.0) and a median postoperative hospital stay of three days (0−25). The distribution of gender, aetiologies and age groups was significantly different (each p = 0.001), and the aetiology had a significant influence on the Clinical Score (p = 0.038). The degree of dislocation in the coronary and sagittal planes correlated significantly with the Clinical Score with regard to the orbital involvement (p < 0.001, ρ = 0.566; p < 0.001, ρ = 0.609). The simple, quick, and easy-to-apply Clinical Score showed a significant correlation with the most important planes in CT scans as well as with the clinical course. It may facilitate fast risk stratification of the patient. However, the validity of the proposed score in determining indications must now be evaluated in a prospective setting, including both operated and non-operated fractures.
系统评估计算机断层扫描（CT）和临床症状对于快速指明颧骨眶部（ZMO）骨折的正确治疗方法很有必要。为此，开发了一种临床评分系统（=临床评分），并将其与CT扫描结果相关联以分析其有效性。对2012年1月至2016年12月期间每例接受手术的、孤立的、单侧ZMO骨折进行回顾性筛查，包括患者和治疗数据。分析所有可用的CT扫描结果，测量每个病例和平面的脱位等级。纳入461例病例，中位手术时间为66.0分钟（5.0 - 361.0），中位术后住院时间为三天（0 - 25）。性别、病因和年龄组的分布存在显著差异（各p = 0.001），病因对临床评分有显著影响（p = 0.038）。冠状面和矢状面的脱位程度与涉及眼眶的临床评分显著相关（p < 0.001，ρ = 0.566；p < 0.001，ρ = 0.609）。简单、快速且易于应用的临床评分与CT扫描中最重要的平面以及临床病程显著相关。它可能有助于对患者进行快速风险分层。然而，现在必须在前瞻性研究中评估所提议评分在确定治疗指征方面的有效性，研究对象包括接受手术和未接受手术的骨折患者。
