Shivakotee Satyapriya, Menon Suresh, Sham M E, Kumar Veerendra, Archana S
Department of Oral and Maxillofacial Surgery, Kantipur Dental College, Kathmandu, Nepal.
Department of Oral and Maxillofacial Surgery, Vydehi Institute of Dental Sciences, Bengaluru, Karnataka, India.
Natl J Maxillofac Surg. 2022 May-Aug;13(2):238-242. doi: 10.4103/njms.njms_378_21. Epub 2022 Jul 15.
The midface with multiple bones and cavities is vulnerable to fractures more commonly. Midface is one of the most frequently injured areas of the body, accounting for 23%-97% of all facial fractures. The classic LeFort type of fractures are uncommon nowadays and a more common picture is more severe forms primarily due to the high-speed vehicles that are a major cause of these fractures. It, therefore, has become imperative to determine the commonly occurring patterns of fractures in this area in the present time for a better insight into diagnosis and treatment plans. The aim of this article was to determine fracture patterns in midface trauma to ease the treatment planning in such a scenario.
This prospective study included 114 patients who reported to a tertiary hospital during a 4-year period and were diagnosed with suspected midface fractures. The etiology and pattern of fractures of midface were assessed based on history, clinical examination, and imaging data. The diagnosis of a fracture was based on the clinical history, signs and symptoms, manual examination, and correct interpretation of radiographs and computed tomography. Midface fractures were recorded as LeFort I, II, III, dentoalveolar, palatal, zygomatic complex fracture, nasal bones, naso-orbital-ethmoidal complex, and orbital and zygomatic arch fractures. Etiological factors were classified as road traffic accidents (RTAs), fall, assault, and sports injuries.
During the 4-year period, a total of 114 patients were included. Patients' ages ranged from 17 to 68 years, with 102 males and 12 females. The most common fracture in this study was found to be zygomatic complex fractures (52%), and RTA was identified as the main cause of fracture in this study (79.2%).
The midface fractures are more common in males due to the propensity of males to use two-wheelers more than females. The prominence of the zygoma makes it more vulnerable to fractures than rest of the bones in the midface. Increased speed of vehicles and lack of discipline in following traffic rules have resulted in RTA, being the biggest etiological factor in midface injuries.
包含多块骨骼和腔隙的面中部更容易发生骨折。面中部是身体最常受伤的部位之一，占所有面部骨折的23% - 97%。如今，经典的LeFort型骨折并不常见，更常见的情况是骨折形式更为严重，这主要归因于高速行驶的车辆，它们是这些骨折的主要成因。因此，为了更好地洞察诊断和治疗方案，当下确定该区域常见的骨折模式变得势在必行。本文的目的是确定面中部创伤的骨折模式，以便在这种情况下简化治疗计划。
这项前瞻性研究纳入了114名在4年期间到一家三级医院就诊且被诊断为疑似面中部骨折的患者。基于病史、临床检查和影像学数据对面中部骨折的病因和模式进行评估。骨折的诊断基于临床病史、体征和症状、手法检查以及对X线片和计算机断层扫描的正确解读。面中部骨折记录为LeFort I型、II型、III型、牙槽突骨折、腭骨骨折、颧骨复合体骨折、鼻骨骨折、鼻眶筛复合体骨折以及眼眶和颧弓骨折。病因因素分为道路交通事故（RTAs）、跌倒、袭击和运动损伤。
在这4年期间，共纳入114名患者。患者年龄在17岁至68岁之间，其中男性102名，女性12名。本研究中最常见的骨折是颧骨复合体骨折（52%），道路交通事故被确定为本研究中骨折的主要原因（79.2%）。
由于男性比女性更倾向于骑两轮车，面中部骨折在男性中更为常见。颧骨突出使其比面中部其他骨骼更容易发生骨折。车辆速度的增加以及遵守交通规则方面缺乏纪律导致道路交通事故成为面中部损伤的最大病因因素。
