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1项目简介 近年来,我国地震、洪涝等灾害事故多发,安全生产、交通事故死亡人数居世界前列,来自临床的统计结果显示,我国14~40岁人群的最大死因是创伤。创伤现场迅速有效的救治也许能挽回其中许多人的生命,但长期以来,我国缺乏对突发自然灾害及意外事故中受伤人员救治的系统、规范、实用的培训。     

Management of maxillofacial trauma in prisoners

The incidence of injuries among prisoners is much higher than in the general population, and in the UK the number of prisoners and the incidence of injuries are rising. Maxillofacial trauma is common. Based on the cases of 12 patients, we have identified eight challenges that are associated with the management of maxillofacial trauma in this group: patient-reported mechanisms of injury that are often inconsistent with the fracture pattern, complex fracture patterns, delayed presentation, high prevalence of dental disease and of smoking, complicating medical factors such as drug use and blood-borne viruses, increased risk of further violence after discharge, and problems with follow-up logistics. By actively addressing these challenges we can provide a better service to these patients.     

现代创伤救治理念与口腔颌面部多发伤救治

多发伤的救治需要应用现代创伤救治理念,通过加强多学科间的合作,共同制定救治方案,达到理想的救治效果。本文在了解现代创伤救治理念,理解理念要点的基础上,分析口腔颌面部多发伤救治中伤情评估的策略和方法,探讨专科救治的时机和影响因素,提出伴发身体其他部位损伤的颌面伤患者综合救治中专科确定性手术的时机和适应证,以加深口腔医学专业医生对现代创伤救治理念的理解,提高其对口腔颌面部多发伤的救治能力和治疗效果。     

Maxillofacial trauma in major trauma patients

BACKGROUND: Trauma has been identified as a major public health problem in Australia. Maxillofacial trauma constitutes a significant proportion of trauma, although epidemiological studies in Australia are few. The purpose of this study was to assess the prevalence and the epidemiological pattern of maxillofacial trauma occurring in major trauma patients. METHODS: Data were obtained from the Victorian State Trauma Registry, which included all major trauma patients in Victoria. All data relating to maxillofacial trauma defined according to Abbreviated Injury Scale and International Classification of Diseases codes from 1 July 2001 to 30 June 2004 were selected. Data collected included demographic and injury details, and operative procedures carried out. RESULTS: Sixteen per cent of major trauma patients sustained maxillofacial trauma. The highest frequency of injuries occurred in the 15-24 years age group. More males were affected than females (3:1). The majority of injuries were due to transportrelated causes (69 per cent) and occurred mostly on roads, streets or highways (70 per cent). Falls were the cause of 15 per cent of injuries, 10.5 per cent of these injuries were fatal while 20.7 per cent needed rehabilitation. The most common type of bony injury was a fractured maxilla. CONCLUSION: The need for preventive strategies to be reinforced has been highlighted as transport-related injuries remain high especially in the younger age groups.     

Toxicology screening in oral and maxillofacial trauma patients

The role of alcohol in facial trauma is recognised but we know of no research on the possible contribution made by the use of illicit drugs in patients with facial injuries, or the interactions that may occur during anaesthesia. We aimed to find out whether illegal drugs were identified in the urine of patients with maxillofacial injuries, what substances were present, and whether patients were willing to disclose use of drugs at the time of injury. Over a 12-month period we prospectively studied consecutive patients with facial injuries who were referred by accident and emergency (A&E) to the department of oral and maxillofacial surgery (OMFS) for inpatient assessment and treatment within 24 h of injury. Anonymised data on patients were obtained from questionnaires that were linked to a urine sample provided on admission. Results were obtained using immunoassay and gas chromatography with mass spectrometry. A total of 105 patients with facial injuries were eligible and 95 (90%) provided a urine sample and completed the questionnaire; 2 samples were of insufficient volume and were discarded before analysis. Twelve patients (13%) admitted using drugs at the time of injury but 44 (47%) samples tested positive for illegal drugs; fewer showed the presence of alcohol (n = 37; 40%). Use of drugs, although often denied, is widespread among patients with facial injuries. It is important to consider the role that drugs have in patients who present with traumatic injuries, the interactions misused drugs may have with anaesthesia, and any possible benefits that targeted prevention strategies would have in this group.     

Epidemiological aspects of dental trauma associated with maxillofacial injures: Ten years of clinical experience in Trieste,Italy

Background/Aims

The prevalence of dental injuries in patients with facial fractures is relevant. Epidemiologically, dental trauma in association with facial fractures generally affects the age group between 20 and 40 years old, with a higher prevalence in males. The aim of this retrospective study was to identify the incidence and etiology of dental trauma associated with facial fractures over a 10-year period.

Methods

From January 2009 to April 2019, among 381 patients with facial fractures, 353 were included in this study. Age, gender, trauma etiology, injured teeth and dental treatment were investigated.

Results

From 353 patients, with a mean age of 49.7 ± 19.9 years, 247 (70%) were males and 106 (30%) were females. Accidental falls were the most common type of injury (n = 118, 33.4%), followed by road accidents (n = 90, 25.5%), assaults (n = 60, 17%) and sports trauma (n = 37, 10.5%). Fifty-five subjects (15.60%) had dental injuries associated with facial fractures. Of the 145 teeth involved, 48 (33.1%) were diagnosed with luxation, 22 teeth (15.2%) were avulsed, 11 teeth (7.5%) suffered a concussion and there were 10 (6.8%) alveolar wall fractures.Uncomplicated enamel-dentin fracture was the more frequent hard tissue injury (n = 21, 14.5%), followed by complicated crown-root fracture (n = 10, 6.9%), infraction (n = 8, 5.5%), enamel fracture (n = 3, 2%) and complicated enamel-dentin fracture (n = 3, 2%). There was a peak in incidence between 21 and 40 years (42%). Males had a significantly higher risk of facial fractures with dental injury (75%). Maxillary incisors and canines (62.8%) were the most affected teeth.

Conclusions

There was a high prevalence of dental injuries associated with facial fractures. Maxillary incisors were the most injured teeth, with a higher prevalence in males.     

Oral myiasis in a maxillofacial trauma patient

Oral Myiasis is a rare disease that is mostly reported in developing countries. It is primarily caused by the invasion of the human body by fly larvae. The phenomenon is well-documented in the skin, especially among animals. This case report describes the presentation of Oral Myiasis caused by Musca Nebulo (common house fly), in a 28-year-old patient, with recent maxillofacial trauma. The patient was treated by manual removal of the larvae, after topical application of turpentine oil, followed by surgical debridement and oral therapy with Ivermectin.     

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目的了解儿童颌面创伤发生的原因及危险因素,以提出有效的预防措施。方法对2005年6月至2008年6月东南大学附属南京江北人民医院口腔科就诊的439例儿童颌面创伤病例进行回顾性临床分析,包括年龄、性别、创伤原因、创伤部位、创伤类型等相关因素。结果儿童颌面创伤的发生在年龄、性别、创伤原因、创伤部位、创伤类型方面差异有统计学意义。6～11岁年龄段发生率最高,男孩明显多于女孩,上、下唇及牙齿最易受伤。结论儿童颌面创伤有特定的发病规律,采取针对性有效的预防措施可减少其发生。     

Analysis of the pattern of maxillofacial injuries in Saudi Arabia: A systematic review

ObjectivesMaxillofacial trauma (MFT) is a serious health problem and in Saudi Arabia is mainly caused by road traffic accidents (RTAs). MFT commonly associated with injuries to the face, head, and jaws and may cause soft tissue lacerations and bruises. MFT can also cause fatal blood loss and airway obstruction. The objective of this review was to determine the prevalence of MFT, identify the major causative factors in males and females in the main cities of Saudi Arabia.Materials and methodsWe performed literature searches of all published studies describing MFT from KSA during the last 20 years.ResultsIn Saudi Arabia, males are more prone to MFT than females, although the male: female ratio of MFT varies between different cities. Specifically, Aseer has the highest male: female ratio (10:1), followed by AlHofuf (8.3:1) while AlQurayyat had the least gender ratios of MFT (2:1). Most cases of MFT are associated with RTAs, which accounted for (63%–90.3%) in Medina, (89.1%) in Aseer, (86.1% –87.1%) in Riyadh, (67%–73.1%) in Jeddah, (71%) in Khamis Mushait, (64.2%) in Makkah and (63.3%) in Al-Hofuf. The least percentage of RTA resulting into MFT was recorded in AlQurayyat (24%).ConclusionMaxillofacial trauma is a serious health problem in Saudi Arabia. RTAs remain the major cause of maxillofacial injuries especially among males, thus strict implementation of traffic rules is a must to minimize maxillofacial injuries and its physical and psychological impact.     

Incidence of dental trauma associated with facial trauma in Brazil: a 1-year evaluation

Abstract –  Dental trauma occurs frequently in young people, and mostly occurs in conjunction with facial trauma. In the literature, there are still few reports relating dental trauma, facial trauma, and soft-tissue injuries. This research aimed to evaluate: (i) the overall incidence of dental trauma in 340 patients who presented with facial trauma over a 1-year-period, (ii) the epidemiology of these related diseases, and (iii) the most common dental trauma when a facial trauma was present. Of all facial trauma, 15.29% presented dental trauma, of which luxations and avulsions were the most frequent injuries (40.30% each), occurring mainly on weekends (38.46%) and in October (15.38%), followed by March and June (13.46% each). The sex ratio presented the proportion of 3.3:1 (M:F). Trauma occurred mainly in the second decade (44.23%). These results highlight the high incidence of dental and facial trauma, and suggest the importance of the adoption of appropriate prevention protocols and effective therapeutic methods.     

Severity and causality of maxillofacial trauma in the Southern region of Saudi Arabia

ObjectiveThe purpose of this study was to examine the causality and severity of maxillofacial trauma (MFT) among patients referred to a tertiary heath care center in the Southern Aseer region of Saudi Arabia.Materials and methodsThe charts of all MFT patients referred to the tertiary care center from September 2010 to November 2011 were retrospectively reviewed. Pertinent data, including patient age, gender, and cause of injury, were obtained from 101 selected charts.ResultsMale patients comprised 91% of the 101 selected cases. The highest percentage of MFT cases (88.7%) were caused by road traffic accidents (RTAs) while physical altercations and sports injuries accounted for approximately 6% and 2.8% of MFT cases, respectively. A high fracture: patient ratio of 2.4:1 was observed, which was likely due to vehicular speeding (high energy trauma) involved in RTAs in the mountain regions.ConclusionRTAs are a major cause of MFT in the southern region of Saudi. These accidents cause a heavy burden on the health care sector.     

Massive bleeding following maxillofacial trauma. Case report

A case is reported of massive haemorrhage following severe maxillofacial trauma. The various procedures that were used to control the bleeding are discussed with particular reference to therapeutic arterial embolization.     

Impact of the COVID-19 lockdown on the epidemiology of maxillofacial trauma activity: a French multicentre comparative study

The coronavirus disease 2019 (COVID-19) outbreak has had a major impact on medical and surgical activities. A decline in facial trauma incidence was noticed during the lockdown period. The aim of this study was to evaluate the decline in maxillofacial trauma in France during this particular period. A retrospective multicentre comparative study was initiated in 13 major French public hospital centres. The incidence of facial trauma requiring surgery during the first month of lockdown was compared to that during equivalent periods in 2018 and 2019. Differences in the types of trauma were also analysed. Thirteen maxillofacial departments participated in the study. A significant decline in maxillofacial trauma volumes was observed when compared to equivalent periods in 2018 and 2019 (106 patients compared to 318 and 296 patients, respectively), with an average reduction of 65.5% (P = 0.00087). The proportion of trauma due to sports and leisure was reduced when compared to reports in the literature. As a consequence, in the context of a pandemic, the material and human resources related to this activity could be reallocated to the management of other pathologies that cannot be postponed.