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单中心经验:一项关于下颌骨骨折的10年回顾性研究。

A Single Center Experience: A Retrospective Study Over 10-Years Period on Mandible Fractures.

作者信息

Monarchi Gabriele, Girotto Riccardo, Paglianiti Mariagrazia, Balercia Paolo

机构信息

Department of Medicine, Section of Maxillo-facial Surgery, University of Siena, Siena, Italy.

Division of Maxillofacial Surgery, Department of Neurological Sciences, University Hospitals of Ancona, Ancona, Italy.

出版信息

Craniomaxillofac Trauma Reconstr. 2024 Sep;17(3):232-237. doi: 10.1177/19433875231176338. Epub 2023 May 18.

Abstract

STUDY DESIGN

The purpose of this study was to do a retrospective analysis about patients with mandibular fracture who were treated at the department of Maxillofacial Surgery, Regional University Hospital of Ancona, Italy, between 2011 and 2021.

OBJECTIVE

In this study we evaluated clinical and epidemiological findings of mandible fractures focusing on the association between surgical timing, type of surgical approach and mid- and long-term outcomes.

METHODS

Patients were evaluated based on various parameters including age, sex, etiology, symptoms, comorbidity, clinical findings, mandible fracture type, other facial fractures, treatment, waiting time before the operation, complications and sequelae. In the period described, we recorded 1023 mandibular fractures. 93% of patients underwent surgery under general anesthesia, almost exclusively patients undergoing an open approach to internal fixation.

RESULTS

Of the patients, 684 were male (66.86%) and 339 were female (33.13%). The average age of the patients was 42, 38 years (range, 7-94 years). The leading cause of these fractures was traffic accidents (27.3%) and mandibular parasymphysis fractures were the most frequent (34.1%). The most common clinical signs and symptoms were malocclusion, difficulty in chewing, limitation of the buccal opening, hypoesthesia extending through the territory of the inferior alveolar nerve, difficulty in protrusion movements and mandibular lateralization.

CONCLUSIONS

The continuous research in epidemiology, etiology, materials, and techniques will further refine the treatments of mandible fractures, which are nowadays more and more customized according to the type of trauma.

摘要

研究设计

本研究旨在对2011年至2021年期间在意大利安科纳地区大学医院颌面外科接受治疗的下颌骨骨折患者进行回顾性分析。

目的

在本研究中,我们评估了下颌骨骨折的临床和流行病学结果,重点关注手术时机、手术方式与中长期预后之间的关联。

方法

根据年龄、性别、病因、症状、合并症、临床检查结果、下颌骨骨折类型、其他面部骨折、治疗方法、术前等待时间、并发症和后遗症等各种参数对患者进行评估。在所述期间,我们记录了1023例下颌骨骨折。93%的患者在全身麻醉下接受手术,几乎所有患者都采用开放入路进行内固定。

结果

患者中,男性684例(66.86%),女性339例(33.13%)。患者的平均年龄为42.38岁(范围7 - 94岁)。这些骨折的主要原因是交通事故(27.3%),下颌骨正中联合骨折最为常见(34.1%)。最常见的临床体征和症状是咬合不正、咀嚼困难、颊部开口受限、下牙槽神经分布区域感觉减退、前伸运动困难和下颌骨侧方运动困难。

结论

在流行病学、病因学、材料和技术方面的持续研究将进一步完善下颌骨骨折的治疗方法,如今下颌骨骨折的治疗越来越根据创伤类型进行定制。

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本文引用的文献

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Mandibular trauma: a two-centre study.下颌骨创伤:一项双中心研究。
Int J Oral Maxillofac Surg. 2015 Aug;44(8):998-1004. doi: 10.1016/j.ijom.2015.02.022. Epub 2015 Mar 23.
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Complications and the time to repair of mandible fractures.下颌骨骨折的并发症及修复时间
Laryngoscope. 2005 May;115(5):769-72. doi: 10.1097/01.MLG.0000157328.10583.A7.
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Subclassification of fractures of the condylar process of the mandible.下颌骨髁突骨折的亚分类
Br J Oral Maxillofac Surg. 2005 Feb;43(1):72-3. doi: 10.1016/j.bjoms.2004.08.018.
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Consideration of 180 cases of typical fractures of the mandibular condylar process.
Br J Plast Surg. 1952 Jul;5(2):122-8. doi: 10.1016/s0007-1226(49)80020-8.

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