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高容量教育中心下颌骨骨折的管理——一项回顾性研究

Management of Mandibular Fractures at a High-Volume Educational Center-A Retrospective Study.

作者信息

Hashemi Helya, Qundos Yousuf, Farzad Payam

机构信息

Department of Oral and Maxillofacial Surgery and Jaw Orthopedics, Karolinska University Hospital, Gävlegatan 55 NA2, SE-17176 Stockholm, Sweden.

出版信息

J Clin Med. 2025 Sep 13;14(18):6467. doi: 10.3390/jcm14186467.

Abstract

Mandibular fractures are often treated with open reduction and internal fixation in order to restore function and anatomy. This study analyzes postoperative complications and outcomes over one year at a high-volume teaching hospital, focusing on fracture types, treatment methods, and the impact of providers' experience. This retrospective study included patients 12 years of age or older with mandibular fractures resulting from trauma during a 1-year period, January-December 2022 in a level 1 trauma center. Medical records were reviewed, and patient data was collected. Patients were categorized into 3 groups: Group 1 (surgical treatment), Group 2 (closed treatment, i.e., dental splints, arch bars/eyelets), and Group 3 (observation/soft diet). The results were tabulated, and standard descriptive statistics were used. 141 patients with 223 mandibular fractures met inclusion criteria. Throughout all groups, 18 surgically treated patients (12.7%) and one patient treated with arch bars (0.07%) required additional unintended surgical procedure such as plate removal with/without re-plating, or orthognathic surgery for occlusal correction. The complication rates in this cohort align with the existing literature, though variations may origin from limited sample size, short follow-up and patient comorbidities. The involvement of less experienced surgeons during on-call hours most likely contributed to outcome variability. Despite challenges, most patients had favorable outcomes.

摘要

下颌骨骨折通常采用切开复位内固定术进行治疗,以恢复功能和解剖结构。本研究分析了一家大型教学医院一年多来的术后并发症及治疗结果,重点关注骨折类型、治疗方法以及医疗人员经验的影响。这项回顾性研究纳入了2022年1月至12月在一级创伤中心因创伤导致下颌骨骨折的12岁及以上患者。查阅了病历并收集了患者数据。患者被分为3组:第1组(手术治疗)、第2组(保守治疗,即牙弓夹板、牙弓杆/小孔)和第3组(观察/软食)。结果制成表格,并使用了标准描述性统计方法。141例患者的223处下颌骨骨折符合纳入标准。在所有组中,18例接受手术治疗的患者(12.7%)和1例接受牙弓杆治疗的患者(0.07%)需要额外进行意外的手术,如取出钢板并/或重新植入钢板,或进行正颌手术以矫正咬合。尽管该队列中的并发症发生率与现有文献一致,但差异可能源于样本量有限、随访时间短和患者合并症。经验不足的外科医生在值班时间参与治疗很可能导致了结果的差异。尽管存在挑战,但大多数患者的治疗结果良好。

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