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人际暴力相关面部骨折:南欧一级创伤中心的12年趋势及手术结果

Interpersonal Violence-Related Facial Fractures: 12-Year Trends and Surgical Outcomes in a Southern European Level-I Trauma Centre.

作者信息

Cirignaco Giulio, Catarzi Lisa, Monarchi Gabriele, Committeri Umberto, Frosolini Andrea, Togni Lucrezia, Mascitti Marco, Balercia Paolo, Santarelli Andrea, Consorti Giuseppe

机构信息

Department of Medicine, Section of Maxillo-Facial Surgery, University of Siena, Viale Bracci, 53100 Siena, Italy.

Division of Maxillofacial Surgery, Department of Neurological Sciences, Marche University Hospitals-Umberto I, 60126 Ancona, Italy.

出版信息

Medicina (Kaunas). 2025 Aug 11;61(8):1443. doi: 10.3390/medicina61081443.

Abstract

Interpersonal violence (IPV) has overtaken road traffic collisions as a leading cause of facial fractures, yet regional data from Southern Europe are limited. We retrospectively reviewed all adults (≥18 y) treated between 1 January 2011 and 31 December 2022 for radiologically confirmed IPV-related facial fractures. Recorded variables were demographics, AO-CMF (Arbeitsgemeinschaft für Osteosynthesefragen-Craniomaxillofacial) fracture site, Facial Injury Severity Score (FISS), presence of facial soft-tissue wounds, treatment modality, and length of stay; associations between variables were explored. A total of 224 victims were identified; 94% were men (median age 26 y, IQR 22-34). The mandible was the most frequently involved bone (42%), followed by the orbit (25%); 14% sustained fractures at multiple sites. Facial soft-tissue wounds occurred in 9% of cases, three-quarters of which were associated with mandibular injury ( = 0.005). The median FISS was 2 and was higher in males, patients > 34 y, those with multiple fractures, and those with wounds (all < 0.05). FISS showed a weak positive correlation with hospital stay (r = 0.23), which averaged 4.1 ± 1.6 days. Open reduction and internal fixation were required in 78% of patients, most often 24-72 h after admission. Annual IPV-related admissions remained stable throughout the 12-year period. : IPV in this region consistently injures young men, with the mandible and orbit most at risk. FISS is a practical bedside indicator of resource use. The unchanging incidence-likely underestimated because isolated nasal fractures and minor injuries are often managed outside maxillofacial services or never reported-highlights the urgency of targeted prevention programs, routine screening, and streamlined multidisciplinary pathways.

摘要

人际暴力(IPV)已超过道路交通事故,成为面部骨折的主要原因,但南欧的区域数据有限。我们回顾性分析了2011年1月1日至2022年12月31日期间接受治疗的所有成年人(≥18岁),这些患者经放射学确诊为与IPV相关的面部骨折。记录的变量包括人口统计学数据、AO-CMF(骨科学会颅颌面)骨折部位、面部损伤严重程度评分(FISS)、面部软组织伤口的存在情况、治疗方式和住院时间;探讨了变量之间的关联。共识别出224名受害者;94%为男性(中位年龄26岁,四分位间距22 - 34岁)。下颌骨是最常受累的骨骼(42%),其次是眼眶(25%);14%为多处骨折。9%的病例出现面部软组织伤口,其中四分之三与下颌骨损伤相关(P = 0.005)。FISS中位数为2,在男性、年龄>34岁的患者、多处骨折患者和有伤口的患者中更高(均P < 0.05)。FISS与住院时间呈弱正相关(r = 0.23),平均住院时间为4.1±1.6天。78%的患者需要切开复位内固定,大多数在入院后24 - 72小时进行。在这12年期间,每年与IPV相关的入院人数保持稳定。结论:该地区的IPV持续伤害年轻男性,下颌骨和眼眶风险最高。FISS是资源利用的实用床边指标。发病率不变——可能因孤立性鼻骨骨折和轻伤常由颌面外科以外的科室处理或从未报告而被低估——凸显了针对性预防计划、常规筛查和简化多学科诊疗路径的紧迫性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dafc/12387832/947e7c41f87c/medicina-61-01443-g006.jpg

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