1246例颌面骨折的回顾性研究
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摘要
目的：回顾分析本院20年来颌面骨折的发生特点，为颌面创伤数据库建立奠定基础。
患者和方法：以1983年至2002年的1246例颌面骨折住院病人为研究对象，其中，男性1011例，占81％；女性235例，占19％，患者年龄在0.5岁至83岁之间，平均年龄为28.1岁，在1246例病例中有2112处骨折，平均每人1.69处，详细分析了患者的性别与年龄分布、骨折原因、发病时间、骨折类型和治疗方式。
结果：男女性别比为4.3：1，21-30岁年龄组有448例，占36％，为最好发年龄组；31-40岁年龄组有298例，占24％；车祸为骨折的最主要的病因，其次为跌倒。下颌骨骨折有1477处，占骨折总数的70％；颧骨颧弓骨折有340处，占16％；上颌骨骨折有274处，占13％；鼻骨额骨骨折有21处，占1％。在下颌骨骨折中，髁状突骨折有480处，为最多，占40.0％；下颌角处骨折，有171例，占14.1％，下颌骨体部骨折有269例，占22.4％，下颌颏部有258例，占21.5％，其它部位有24例，占2.0％。上颌骨骨折可分为LeFort Ⅰ型、LeFort Ⅱ、LeFort Ⅲ型和其它，分别有47例、92例、43例和20例。
结论：颌面骨折好发于男性，女性所占比例会逐步增加；好发年龄为21-40岁，老年人骨折会增加；车祸为骨折的最主要原因，并有增加的趋势，政府应强制司机使用安全带，限制车速，严惩酒后架车；坚固内固定是颌面骨折最主要的治疗方式。
Purpose:The study purpose was to assess the sex,age,aetiology,month in which injury occurred,anatomical site and treatment of fractures.The study was prepared for the establishment of the maxillofacial trauma database system.
Materials and Methods:A total of 1246 patients with 2112 facial fractures treated between 1983 and 2002,were retrospectively analysed.there were 1011 male patients(81%) and 235(19%) female patients.The average number of fractures for each patient was 1.69.The patients ranged in age from 0.5 to 83 years.The mean age was 28.1 years.Date were collected on gender,age,etiologic factor,month in which injury occurred,anatomical site and treatment of fractures.
Results: The ratio of male to female was 4.3:l.The patients in the 21-to 40-year age group accounted for 60%.Traffic accidents were the major cause of fractures followed by falls.There were 1477 (70%) mandibular,340 (16%) zygomatic and zygomatic arch's,274 (13%) maxillary,and 21 (1%) nasal and cranial injuries.Regarding distuibution of mandibular fractures,40.0% were seen in the condylar region,22.4% in the body,21.5% in the mental symphysis region, 14.1% in the angle region,and 2.0% in the other region.The distuibution of maxillary fractures was Le Fort IIin 92(51%),Le Fort I in 47(26%),Le Fort III in 33(18%) and others in 10(5%).
Conclusion:The male was prone to being attacked with the maxillofacial fractures.The ratio of male to female has discreasedA significant increase will be found in future in patients older than 61 years.Traffic accidents were the most common etiologic factor of maxillofacial fractures.There is a need to enforce seat belt use,speed limit,and drink driving laws to reduce maxillofacial injuries caused by traffic accidents. Rigid internal fixation was the mainest treatment.
患者和方法：以1983年至2002年的1246例颌面骨折住院病人为研究对象，其中，男性1011例，占81％；女性235例，占19％，患者年龄在0.5岁至83岁之间，平均年龄为28.1岁，在1246例病例中有2112处骨折，平均每人1.69处，详细分析了患者的性别与年龄分布、骨折原因、发病时间、骨折类型和治疗方式。
结果：男女性别比为4.3：1，21-30岁年龄组有448例，占36％，为最好发年龄组；31-40岁年龄组有298例，占24％；车祸为骨折的最主要的病因，其次为跌倒。下颌骨骨折有1477处，占骨折总数的70％；颧骨颧弓骨折有340处，占16％；上颌骨骨折有274处，占13％；鼻骨额骨骨折有21处，占1％。在下颌骨骨折中，髁状突骨折有480处，为最多，占40.0％；下颌角处骨折，有171例，占14.1％，下颌骨体部骨折有269例，占22.4％，下颌颏部有258例，占21.5％，其它部位有24例，占2.0％。上颌骨骨折可分为LeFort Ⅰ型、LeFort Ⅱ、LeFort Ⅲ型和其它，分别有47例、92例、43例和20例。
结论：颌面骨折好发于男性，女性所占比例会逐步增加；好发年龄为21-40岁，老年人骨折会增加；车祸为骨折的最主要原因，并有增加的趋势，政府应强制司机使用安全带，限制车速，严惩酒后架车；坚固内固定是颌面骨折最主要的治疗方式。
Purpose:The study purpose was to assess the sex,age,aetiology,month in which injury occurred,anatomical site and treatment of fractures.The study was prepared for the establishment of the maxillofacial trauma database system.
Materials and Methods:A total of 1246 patients with 2112 facial fractures treated between 1983 and 2002,were retrospectively analysed.there were 1011 male patients(81%) and 235(19%) female patients.The average number of fractures for each patient was 1.69.The patients ranged in age from 0.5 to 83 years.The mean age was 28.1 years.Date were collected on gender,age,etiologic factor,month in which injury occurred,anatomical site and treatment of fractures.
Results: The ratio of male to female was 4.3:l.The patients in the 21-to 40-year age group accounted for 60%.Traffic accidents were the major cause of fractures followed by falls.There were 1477 (70%) mandibular,340 (16%) zygomatic and zygomatic arch's,274 (13%) maxillary,and 21 (1%) nasal and cranial injuries.Regarding distuibution of mandibular fractures,40.0% were seen in the condylar region,22.4% in the body,21.5% in the mental symphysis region, 14.1% in the angle region,and 2.0% in the other region.The distuibution of maxillary fractures was Le Fort IIin 92(51%),Le Fort I in 47(26%),Le Fort III in 33(18%) and others in 10(5%).
Conclusion:The male was prone to being attacked with the maxillofacial fractures.The ratio of male to female has discreasedA significant increase will be found in future in patients older than 61 years.Traffic accidents were the most common etiologic factor of maxillofacial fractures.There is a need to enforce seat belt use,speed limit,and drink driving laws to reduce maxillofacial injuries caused by traffic accidents. Rigid internal fixation was the mainest treatment.
引文
1. Adebayo ET, Ajike O.S, Adekeye E.O. Analysis of the pattern maxillofacial fractures in Kaduna, Nigeria. Br J Oral Maxillofac Surg. 2003 Dec;41(6):396-400.
2. Motamedi MHK, An assessment of maxillofacial fractures:a 5-year study of 237 patients J Oral Maxillofac Surg,2003,61:61-4
3. Fasola AO, Nyako E.A, Obiechina A.E. Trends in the characteristics of maxillofacial fractures in Nigeria. J Oral Maxillofac Surg. 2003,61(10):1140-3.
4. Beek V, Merkx CA. Changes in the pattern of fractures of the maxillofacial skeleton. Int J Oral Maxillofac Surg. 1999 Dec;28(6):424-8.
5. Ansari MH. Maxillofacial fractures in Hamedan Province, Iran:a retrospective study(1987-2001). J Cranio-Maxillofac Surg,2004,32:82-34
6. Iida S, Matsuya T. Paediatric maxillofacial fractures: their aetiological characters and fracture patterns. J Craniomaxillofac Surg. 2002 Aug;30(4):237-41.
7. Fasola AO, Obiechina AE, Arotiba JT. Incidence and pattern of maxillofacial fractures in the elderly. Int. J. Oral Maxillofac. surg.2003,32:206-208
8. Bataineh AB. Aetiology and incidence of maxillofacial fractures in the north of Joran. Oral Surg Oral Med Pathol Oral Radiol Endod,1998, 86:31-35
9. Iida S, Kogo M, Sugiura T. Retrospective analysis of 1502 patients with facial fractures. Int J Oral Maxillofac Surg,2001, 30:286-290
10. Telfer MR, Jones GM, Shepherd IR. Trends in the etiology of maxillofacial fractures in the United Kingdom (1977-1987). Br J Oral Maxillofac Surg,1991,25:250
11. Roberts AHN, Caroll MJ, Lamb Rj. Windscreed injuries and seatbelts. Lancet,1983, 845:340-342
12. Asola AO, Lawoyin JO, Obiechina AE. Inner city maxillofacial fractures due to road traffic accidents. Dent Traumatol,2003,19(1):2-5
13. Chidzonga MM. Mandibular fractures: Analysis of 541 cases. Cent Af J Med,1990,36:97,
2. Motamedi MHK, An assessment of maxillofacial fractures:a 5-year study of 237 patients J Oral Maxillofac Surg,2003,61:61-4
3. Fasola AO, Nyako E.A, Obiechina A.E. Trends in the characteristics of maxillofacial fractures in Nigeria. J Oral Maxillofac Surg. 2003,61(10):1140-3.
4. Beek V, Merkx CA. Changes in the pattern of fractures of the maxillofacial skeleton. Int J Oral Maxillofac Surg. 1999 Dec;28(6):424-8.
5. Ansari MH. Maxillofacial fractures in Hamedan Province, Iran:a retrospective study(1987-2001). J Cranio-Maxillofac Surg,2004,32:82-34
6. Iida S, Matsuya T. Paediatric maxillofacial fractures: their aetiological characters and fracture patterns. J Craniomaxillofac Surg. 2002 Aug;30(4):237-41.
7. Fasola AO, Obiechina AE, Arotiba JT. Incidence and pattern of maxillofacial fractures in the elderly. Int. J. Oral Maxillofac. surg.2003,32:206-208
8. Bataineh AB. Aetiology and incidence of maxillofacial fractures in the north of Joran. Oral Surg Oral Med Pathol Oral Radiol Endod,1998, 86:31-35
9. Iida S, Kogo M, Sugiura T. Retrospective analysis of 1502 patients with facial fractures. Int J Oral Maxillofac Surg,2001, 30:286-290
10. Telfer MR, Jones GM, Shepherd IR. Trends in the etiology of maxillofacial fractures in the United Kingdom (1977-1987). Br J Oral Maxillofac Surg,1991,25:250
11. Roberts AHN, Caroll MJ, Lamb Rj. Windscreed injuries and seatbelts. Lancet,1983, 845:340-342
12. Asola AO, Lawoyin JO, Obiechina AE. Inner city maxillofacial fractures due to road traffic accidents. Dent Traumatol,2003,19(1):2-5
13. Chidzonga MM. Mandibular fractures: Analysis of 541 cases. Cent Af J Med,1990,36:97,