Hussain K, Wijetunge D B, Grubnic S, Jackson I T
Department of Emergency Medicine, St. Georges Hospital, London, United Kingdom.
J Trauma. 1994 Jan;36(1):34-47. doi: 10.1097/00005373-199401000-00006.
A review of the literature identified a need for a prospective study of the complete range of craniofacial trauma. The aims of this study were to determine the incidence, etiology, and mechanisms of craniofacial and associated injuries, enabling a greater understanding of their range and magnitude. Nine hundred fifty consecutive patients seen at an urban university hospital with any degree of craniofacial trauma were prospectively investigated. Craniofacial trauma was found to be very common at all ages. The causes were directly related to age, sex, and alcohol consumption, and determine the type and severity of injury. The commonest cause of soft-tissue injury was falls, whereas that of fractures was interpersonal violence. Falls accounted for most of the injuries in children and the elderly, whereas interpersonal violence was mainly responsible for those occurring in patients aged 15 to 50 years. Interpersonal violence mostly involved young male adults: fights occurring mainly between strangers who had consumed excessive amounts of alcohol. Women were usually assaulted by assailants known to them, their partners. Pedestrians showed a propensity to sustain cranial fractures, whereas motor vehicle occupants tended to sustain midfacial fractures and bicyclists mandibular fractures. Pedestrians incurred the severest injuries of all road users, and a significant proportion of road user collisions involved bicyclists. Sports were responsible for a significant proportion of craniofacial injuries in youths and young adults. Craniofacial soft-tissue injuries overall occurred most frequently on the forehead, nose, lips, and chin, and a method for their classification is proposed. The commonest craniofacial fracture was that of the nasal bones (45%), followed by cranial bones (24%), mandible (13%), zygoma (13%), orbital blow-out (3%), and maxilla (2%). The incidence of craniofacial trauma can be greatly reduced by improvements in interior home design, school education in alcohol abuse and handling potentially hostile situations (especially for men), improvement in automotive safety devices and compliance by motor vehicle occupants, and utilization of full-face helmets by bicyclists and motorcyclists.
文献综述表明，需要对全范围的颅面创伤进行前瞻性研究。本研究的目的是确定颅面及相关损伤的发生率、病因和机制，以便更好地了解其范围和严重程度。对一家城市大学医院连续收治的950例有任何程度颅面创伤的患者进行了前瞻性调查。发现颅面创伤在各年龄段都很常见。其病因与年龄、性别和饮酒直接相关，并决定损伤的类型和严重程度。软组织损伤最常见的原因是跌倒，而骨折的常见原因是人际暴力。跌倒占儿童和老年人损伤的大多数，而人际暴力主要导致15至50岁患者的损伤。人际暴力大多涉及年轻男性成年人：打架主要发生在过量饮酒的陌生人之间。女性通常受到其认识的人即伴侣的袭击。行人颅骨骨折的倾向较高，而机动车乘客往往发生面中部骨折，骑自行车的人则易发生下颌骨骨折。行人是所有道路使用者中受伤最严重的，且相当一部分道路使用者碰撞事故涉及骑自行车的人。体育运动导致青少年和年轻成年人中相当一部分颅面损伤。颅面软组织损伤总体上最常发生在前额、鼻子、嘴唇和下巴，并提出了一种分类方法。最常见的颅面骨折是鼻骨骨折（45%），其次是颅骨骨折（24%）、下颌骨骨折（13%）、颧骨骨折（13%）、眼眶爆裂骨折（3%）和上颌骨骨折（2%）。通过改善室内家居设计、开展关于酗酒和应对潜在敌对情况的学校教育（尤其是针对男性）、改进汽车安全装置以及机动车乘客遵守规定，以及骑自行车者和骑摩托车者使用全脸头盔，颅面创伤的发生率可大幅降低。
