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约旦一家三级医院的面部骨折模式及其与颈椎损伤的关系。

Pattern of Facial Fractures and Its Association with a Cervical Spine Injury in a Tertiary Hospital in Jordan.

机构信息

Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan.

出版信息

Int J Clin Pract. 2022 Jul 30;2022:4107382. doi: 10.1155/2022/4107382. eCollection 2022.

Abstract

BACKGROUND

Facial fractures can be accompanied by serious and life-threatening injuries such as cervical spine injury (CSI), which can lead to serious consequences if misdiagnosed.

OBJECTIVE

To assess the patterns of maxillofacial fractures and to explore the association between these fractures and cervical spine injuries (CSIs) in patients with a traumatic facial injury.

METHODS

A retrospective analysis was conducted on the data of the subjects who were admitted to the King Abdullah University Hospital (KAUH) and had a maxillofacial fracture in the period from January 2017 through December 2020. Stepwise binary logistic regression analysis was conducted to find the variables which are significantly and independently associated with CSIs.

RESULTS

A total of 394 maxillofacial fractures were reported for a total of 221 subjects. The mandible was the most common site of the reported fractures (41.88%). The majority of the subjects had associated injuries (70.6%), of which 82.7% were CSIs. The most common type of the CSIs was the vertebral fracture (52%). Increased age (OR = 1.543, < 0.05), having a mandibular fracture (OR = 4.382, < 0.01), and having a maxillary fracture (OR = 3.269, < 0.05) were significantly associated with the presence of CSI.

CONCLUSION

The current study revealed that the most common type of facial fracture occurred in the mandible area, and CSI was the most common fracture-associated injury (82.7%). Increased age and having mandibular or maxillary fracture were associated with an increased risk of developing CSI. Therefore, it is necessary to rule out the presence of concomitant CSI during the emergency management of maxillofacial fractures, particularly for elderly patients and those with mandibular or maxillary fractures.

摘要

背景

面部骨折可伴有严重且危及生命的损伤,如颈椎损伤(CSI),如果误诊可能会导致严重后果。

目的

评估颌面骨折的模式,并探讨创伤性面部损伤患者颌面骨折与颈椎损伤(CSI)之间的关系。

方法

对 2017 年 1 月至 2020 年 12 月期间在阿卜杜拉国王大学医院(KAUH)住院且有颌面骨折的患者进行回顾性分析。采用逐步二项逻辑回归分析,寻找与 CSI 显著相关的独立变量。

结果

共报告了 221 例患者的 394 例颌面骨折。下颌骨是报告骨折最常见的部位(41.88%)。大多数患者有合并伤(70.6%),其中 82.7%为 CSI。最常见的 CSI 类型是椎体骨折(52%)。年龄增加(OR=1.543,<0.05)、下颌骨骨折(OR=4.382,<0.01)和上颌骨骨折(OR=3.269,<0.05)与 CSI 的发生显著相关。

结论

本研究表明,最常见的面部骨折类型发生在下颌骨区域,CSI 是最常见的骨折相关损伤(82.7%)。年龄增加和下颌骨或上颌骨骨折与发生 CSI 的风险增加相关。因此,在颌面骨折的紧急处理中,特别是对于老年患者和下颌骨或上颌骨骨折患者,有必要排除 CSI 的存在。

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本文引用的文献

1
Cervical Spine Injuries and Maxillofacial Trauma: A Systematic Review.颈椎损伤与颌面创伤:一项系统综述。
Saudi Dent J. 2021 Dec;33(8):805-812. doi: 10.1016/j.sdentj.2021.09.006. Epub 2021 Sep 14.
2
The Management of Cervical Spine Injuries - A Literature Review.颈椎损伤的管理——文献综述
Orthop Res Rev. 2021 Sep 28;13:151-162. doi: 10.2147/ORR.S324622. eCollection 2021.
3
Risk Factors for Cervical Spine Injury in Patients With Mandibular Fractures.下颌骨骨折患者颈椎损伤的危险因素。
J Oral Maxillofac Surg. 2019 Jan;77(1):109-117. doi: 10.1016/j.joms.2018.07.032. Epub 2018 Aug 7.
5
Patterns of Maxillofacial Fractures in Uttar Pradesh, India.印度北方邦的颌面骨折模式。
Craniomaxillofac Trauma Reconstr. 2017 Mar;10(1):48-55. doi: 10.1055/s-0036-1597581. Epub 2016 Dec 16.

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