Alfonso Allyson R, Wang Maxime M, Gursky Alexis K, Wyatt Hailey P, Bekisz Jonathan M, Bruckman Karl, Frangos Spiros G, Saadeh Pierre B
Bellevue Hospital Center, New York City, NY 10016, USA.
Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health, 222 East 41st Street, 7th Floor, New York, NY 10017, USA.
J Clin Med. 2025 Jul 3;14(13):4707. doi: 10.3390/jcm14134707.
: Facial trauma is one of the few surgical conditions that is routinely managed by three distinct disciplines, including Oral and Maxillofacial Surgery (OMS), Plastic and Reconstructive Surgery (PRS), and Otolaryngology (ENT). This study aims to evaluate mandibular trauma management strategies and clinical outcomes among three operating services. : An IRB-approved, retrospective chart review was performed over a ten-year period (2007-2016) at a major, urban, Level I trauma center for all patients treated for an isolated mandibular injury determined by ICD-9 codes. Of the 2299 patients evaluated for traumatic facial injuries, 191 met the inclusion criteria and 137 had longitudinal data. Patient, fracture, and management characteristics and clinical outcomes were compared among three surgical services. : Most patients were male (95.3%), and assaults were the most common etiology of injury (79.1%). The angle/ramus was the most common single location (31.4%), and 47.6% of patients had multiple fractures. There was a statistically significant difference between specialties when assessing the use of operative versus non-operative approaches to fracture management ( < 0.001), and within operative management, for the use of open reduction-internal fixation (ORIF) alone versus ORIF with maxillomandibular fixation (MMF) ( = 0.002). There was no significant difference in the overall complications between specialties ( = 0.227). : Services differ in their decision to pursue operative versus non-operative management, as well as the decision for postoperative MMF, though these differences in decision-making were not associated with a significant difference in the overall complications.
面部创伤是少数由三个不同学科常规管理的外科病症之一，这三个学科包括口腔颌面外科（OMS）、整形与重建外科（PRS）以及耳鼻喉科（ENT）。本研究旨在评估三种手术科室在下颌骨创伤管理策略及临床结果方面的情况。
在一所大型城市一级创伤中心进行了一项经机构审查委员会（IRB）批准的回顾性病历审查，审查时间跨度为十年（2007 - 2016年），涵盖所有根据国际疾病分类第九版（ICD - 9）编码确定为单纯下颌骨损伤的患者。在评估的2299例面部创伤患者中，191例符合纳入标准，137例有纵向数据。对三个外科科室的患者、骨折及管理特征和临床结果进行了比较。
大多数患者为男性（95.3%），袭击是最常见的损伤原因（79.1%）。角部/升支是最常见的单一骨折部位（31.4%），47.6%的患者有多发性骨折。在评估骨折管理采用手术与非手术方法时，各专科之间存在统计学显著差异（<0.001）；在手术管理中，单纯采用切开复位内固定（ORIF）与采用ORIF联合颌间固定（MMF）之间也存在统计学显著差异（=0.002）。各专科之间总体并发症无显著差异（=0.227）。
各科室在决定采用手术还是非手术管理以及术后是否采用MMF方面存在差异，尽管这些决策差异与总体并发症的显著差异无关。
