Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Oral and Maxillofacial Surgery, Institute of Dentistry, University of Turku, Turku, Finland.
Dent Traumatol. 2022 Dec;38(6):487-494. doi: 10.1111/edt.12778. Epub 2022 Aug 11.
BACKGROUND/AIMS: Delayed treatment of a mandibular fracture can lead to complications. Therefore, early diagnosis is important. The aim of this study was to clarify the specific features of mandibular fractures in aged patients and the effect of age on possible missed diagnoses.
Patients aged over 60 years with a recent mandibular fracture were included in the study. The outcome variable was a missed mandibular fracture during the patient's first assessment in the primary health care facility. Predictor variables were age group, categorized as older adults (aged ≥60 and <80 years), elders (aged >80 years), patient's age as a continuous variable and age sub-group divided into decades. Additional predictor variables were the patient's memory disease and injury associated with intracranial injury. Explanatory variables were gender, injury mechanism, type of mandibular facture, combined other facial fracture, edentulous mandible/maxilla/both, surgical treatment of the mandibular fracture, and scene of injury.
Mandibular fractures were missed in 20.0% of the 135 patients during their first healthcare assessment. Significant associations between missed fractures and age group, gender, fracture type, or injury mechanism were not found. By contrast, memory disorder (p = .02) and site of injury (p = .02) were significantly associated with missed fractures. Fractures were missed more frequently in patients who were in hospital or in a nursing home at the time of injury.
There is an increased risk of undiagnosed mandibular fractures in the aged population. Small injury force accidents may cause fractures in old and fragile individuals. Careful examination is necessary, especially in patients with memory disorder.
背景/目的：下颌骨骨折的延迟治疗可能会导致并发症。因此，早期诊断很重要。本研究旨在阐明老年患者下颌骨骨折的具体特征以及年龄对可能漏诊的影响。
研究纳入了最近发生下颌骨骨折且年龄在 60 岁以上的患者。结局变量为患者在初级保健机构首次评估时漏诊的下颌骨骨折。预测变量为年龄组，分为老年人（年龄≥60 岁且<80 岁）和老年人（年龄>80 岁），患者年龄为连续变量和年龄亚组分为十年。其他预测变量为患者的记忆疾病和与颅内损伤相关的损伤。解释变量为性别、损伤机制、下颌骨骨折类型、合并其他面部骨折、无牙下颌骨/上颌骨/两者、下颌骨骨折的手术治疗以及损伤部位。
在 135 名患者中，有 20.0%的患者在首次医疗评估时漏诊了下颌骨骨折。未发现漏诊骨折与年龄组、性别、骨折类型或损伤机制之间存在显著相关性。相比之下，记忆障碍（p=0.02）和损伤部位（p=0.02）与漏诊骨折显著相关。受伤时在医院或疗养院的患者，骨折漏诊的风险更高。
老年人群中未确诊的下颌骨骨折风险增加。小的损伤力事故可能导致年老体弱的人骨折。需要仔细检查，特别是对于有记忆障碍的患者。
