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1.
目的 了解老年颌面部骨折患者的临床特征。方法 对2010年7月—2017年10月收治的198例老年颌面部骨折手术患者的临床资料进行回顾,分析创伤原因、骨折部位、合并伤、系统性疾病、治疗方法等临床特征。结果 198例老年颌面部骨折患者,男女比3.95︰1,平均年龄66.15岁;交通事故伤(78例,39.39%)、摔伤(49例,24.75%)、高坠伤(33例,16.67%)是老年人颌面部骨折的主要原因;下颌骨是最常见的骨折部位(120例);60例患者同时伴发颌面部以外的创伤,四肢损伤最多(28例);66例患有系统性疾病,最常见的是心血管疾病(50例)。198例患者的治疗方法主要是小型或微型接骨板切开复位坚强内固定。结论 坠跌伤和交通事故伤是老年颌面部骨折的主要原因,应采取有效的预防和干预措施。  相似文献   

2.
The number of patients older than 65 is increasing in developed societies. The impact of age on injuries and their outcome has been well documented in several fields of traumatology. Data on a broad cohort suffering from oral and maxillofacial injuries are missing. In this study, the data of 12,572 such patients were collected, of which 11,798 were younger and 774 were older than 65 years. With increasing age the risk of a domestic accident increased. The accident mechanism in elderly people was most frequently a fall (72%) or was not reproducible (12%). There was a significant difference between groups regarding concomitant injuries. Additional neurological symptoms occurred in 26% of the older and 15% of the younger patients (P<0.001). Until the age of 65 the risk of concomitant neurological injury increases. Injuries in the older patients mainly affected the soft tissue and midface. No statistical differences in surgical postoperative complications were observed. Due to the changing face of society, the treatment of elderly people is of high relevance. To enable an independent life after trauma, pre- and post-therapeutic care is of major importance. These data support surgical treatment of all patients, regardless of age, driven by general health condition whenever possible.  相似文献   

3.
AIMS: To examine the nature of maxillofacial injuries that presented to the Birmingham Children's Hospital according to aetiology, incidence and characteristics of patients. METHODS: The maxillofacial unit at Diana Princess of Wales Birmingham Children's Hospital serves a catchment area of 5.2 million. We examined all children who presented with maxillofacial trauma from 2002 to 2006. Details including characteristics of patients and aetiology and nature of injury, were entered prospectively into a database. RESULTS: The total number of patients who presented was 1062. The ratio of boys to girls was 2:1. The main reason for attendance was a fall (70%). 149 (17%) patients presented after interpersonal violence. Soft tissue injuries accounted for 70% of injuries and 14% presented with a maxillofacial fracture. CONCLUSIONS: Our data indicate that the range and mechanism of presenting injuries have not changed within the time frame. Despite public perception of increasing interpersonal violence, this was not reflected in our series of patients.  相似文献   

4.
目的:通过对1001例口腔颌面创伤患者回顾分析,了解口腔颌面部创伤患者的流行病学特点。方法:对第四军医大学口腔医院口腔颌面外科2008年8月—2011年3月期间收治的1001例口腔颌面创伤患者的病历资料进行统计分析。结果:1001例口腔颌面创伤患者男女比为2.80∶1;20~29岁(30.07%)为发病的高峰年龄段;交通事故(48.45%)在致伤原因中居首位。在口腔颌面创伤中,下颌骨骨折573例,发生率最高。合并伤以眼部最多见(171例),其次为颅脑伤和四肢创伤。结论:口腔颌面创伤患者以骨折多见。骨折发生的数量、部位等与致伤原因、受力性质及相应部位的解剖结构有关。眼部创伤、颅脑创伤及四肢创伤为最常见的并发症,应予以充分重视,治疗时不可忽视全身状况。  相似文献   

5.
Airway control is critical to the preparation and transport of patients by air medical services. Our experience with an endotracheal tube stabilization device employed in all adult orally intubated patients is described.Details of application, types of injury, and characteristics of patient management were reviewed. The stability of the device was determined on the face and the stability of the endotracheal tube was evaluated.Sixty-three intubated, adult patients transported via our air medical team were included in this study. Indications for intubation included burns, inhalation injury, maxillofacial trauma, upper airway obstruction and thoracic trauma. Maxillofacial injuries included scalp/facial lacerations, craniofacial asymmetry, Le Fort III fractures and electrical burns. Maxillofacial injuries and secretions did not compromise device stability. The device could be placed on all patients regardless of condition or climate at time of device application.Use of a standard endotracheal tube stabilization device is recommended in the air medical setting. It protects against accidental extubation, provides stability regardless of craniofacial trauma or secretions, and allows for easy application and consistent positioning of the endotracheal tube relative to holder.  相似文献   

6.
Since its formation in June 2001, the Royal Centre for Defence Medicine (RCDM) at Birmingham University Hospitals NHS Foundation Trust has treated most of the British military personnel who have sustained serious maxillofacial injuries while serving abroad. We retrospectively analysed all recorded maxillofacial injuries of personnel evacuated to the RCDM between June 2001 and December 2007. We know of no existing papers that describe oral and maxillofacial injuries of military personnel, or workload in the 21st century. During the period 119 personnel with maxillofacial injuries were evacuated to the RCDM for treatment 83% of whom were injured in Iraq or Afghanistan. In total 61% (72/119) of injuries were caused by improvised explosive devices, 9% (11/119) were gun shot wounds, and 1% were caused by aircraft incidents. A further 29% (35/119) of patients had injuries not associated with battle. The most common injuries were facial lacerations (106/119). There were 54 facial fractures of which 17 primarily affected the maxilla, and 15 the mandible. Associated injuries were to the brain (24%), torso (26%), upper limb (39%), and lower limb (31%). The number of maxillofacial injuries has risen over the last 7 years, and has also increased in proportion to the total number of injured soldiers evacuated between 2005 and 2007.  相似文献   

7.

Background

The aim of this study was to analyzed the characteristics and treatment of maxillofacial injuries in the elder patients with maxillofacial injuries in central China.

Material and Methods

We retrospectively analyzed the characteristics and treatment of maxillofacial injuries in the patients over the age of 60 to analyze the trends and clinical characteristics of maxillofacial trauma in elder patients from the First Affiliated Hospital of Zhengzhou University (from 2010 to 2013) in central China and to present recommendations on prevention and management.

Results

Of the 932 patients with maxillofacial injuries, 126 aged over 60 years old accounting for 13.52% of all the patients (male:female, 1.74:1; mean age, 67.08 years old). Approximately 52% of the patients were injured by falls. The most frequently observed type of injuries was soft tissue injuries (100%), followed by facial fractures (83.05%). Of the patients with soft tissue injuries, the abrasions accounted the most, followed by lacerations. The numbers of patients of midface fracture (60 patients) were almost similar to the number of lower face fractures (66 patients). Eighty two patients (65.08%%) demonstrated associated injuries, of which craniocerebral injuries were the most prevalent. One hundred and four patients (82.54%) had other systemic medical conditions, with cardiovascular diseases the most and followed by metabolic diseases and musculoskeletal conditions. Furthermore, the study indicated a relationship between maxillofacial fractures and musculoskeletal conditions. Only 13 patients (10.32%) sustained local infections, of whom had other medical conditions. Most of the facial injuries (85.71%) in older people were operated including debridement, fixing loose teeth, reduction, intermaxillary fixation and open reduction and internal fixation (ORIF).

Conclusions

Our analysis of the characteristics of maxillofacial injuries in the elder patents may help to promote clinical research to develop more effective treatment and possibly prevent such injuries. Key words: Maxillofacial, trauma, elderly, characteristics, treatment.  相似文献   

8.
PURPOSE: The purpose of this study was to identify the contribution of ingested lead particles to elevated blood lead concentrations in victims of gunshot injury to the maxillofacial region. PATIENTS AND METHODS: As part of a larger study of the effects of retained lead bullets on blood lead, a retrospective review of study findings was completed on 5 of 8 patients who sustained injuries to the maxillofacial region. These 5 patients were recruited into the larger study within 11 days of injury and showed a penetration path for the projectile that engaged the upper aerodigestive tract. All subjects were recruited from patients presenting for care of their gunshot injuries to a large inner-city trauma center with a retained bullet resulting from a gunshot injury. An initial blood lead level was measured for all recruited patients and repeated 1 to 17 weeks later. Medical history was taken along with a screening and risk factor questionnaire to determine other potential or actual sources (occupational/recreational) of lead exposure. (109)Cd K-shell x-ray fluorescence determinations of bone lead were completed to determine past lead exposure not revealed by medical history and risk factor questionnaire. Radiographs taken of the abdomen and chest, required as a part of the patient's hospital care, were retrospectively reviewed for signs of metallic fragments along the aerodigestive tract. RESULTS: All 5 patients retained multiple lead pellets or fragments at the site of injury, sustained fractures of the facial bones, and showed increases in blood lead. Three of the 5 study subjects who sustained maxillofacial gunshot injuries involving the mouth, nose, or throat region showed metallic densities along the gastrointestinal tract indicative of ingested bullet fragments. Each patient with ingested bullet fragments showed rapid elevation of blood lead exceeding 25 microg/dL and sustained increases well beyond the time when all ingested fragments were eliminated. A 3-year follow-up on these 3 patients showed significantly sustained elevation of blood lead but less than that observed during the initial 6 months after injury. None of the 5 study subjects showed any evidence of metallic foreign bodies within the tracheobronchial regions indicative of aspiration. CONCLUSION: Ingestion of lead fragments can result from gunshot injuries to the maxillofacial region and may substantially contribute to a rapid increase in blood lead level. Prompt diagnosis and elimination of ingested lead fragments are essential steps necessary to prevent lead being absorbed from the gastrointestinal tract. Increased blood lead in victims after gunshot injuries must be fully evaluated for all potential sources, including recent environmental exposure, absorption of lead from any remaining bullets in body tissues, and the possibility of mobilization of lead from long-term body stores such as bone.  相似文献   

9.
Maxillofacial injuries are usually not life-threatening and do not get priority over other associated injuries. However, some maxillofacial injuries with active oral or nasal bleeding need immediate management due to threatened airway and blood loss. In the case of major active vascular bleeding, measures such as local pressure, anterior nasal packing, posterior nasal packing, and balloon tamponade are ineffective. In these cases, angiography and transcatheter arterial embolisation (TAE) are used to treat life-threatening haemorrhage caused by maxillofacial trauma. We analysed the medical records of 39 patients with severe maxillofacial trauma and life-threatening haemorrhage that was a result of intractable oral or nasal bleeding. These patients were considered for TAE from January 2010 to December 2019. A total of 1668 patients was admitted, out of which 39 (2.3%) had severe maxillofacial injuries with life-threatening oral or nasal bleeding and underwent TAE. Out of a total of 39 patients, 38 were male and one female. Ages ranged from 16 to 65 years. Road traffic injury was the most common cause of injury (79.5%), Lefort I and II were the most common facial fractures, and traumatic brain injury was the most common associated injury. Embolisation and bleeding control were done successfully in all 39 patients with no procedure-related complications. A total of 17 deaths during the study period were due to severe traumatic brain injuries or haemorrhagic shock.  相似文献   

10.
Maxillofacial trauma due to work-related accidents   总被引:2,自引:0,他引:2  
Even though numerous reports on maxillofacial trauma exist, only a few give detailed information about work-related maxillofacial injuries. The purpose of this study was to reveal the significance of maxillofacial injuries related to accidents occurring at work by evaluating a large number of patients with maxillofacial injuries over a 9-year period. Out of the 8704 trauma patients treated between 1991 and 1999 in the Department of Oral and Maxillofacial Surgery at the University of Innsbruck, Austria, 463 (5.4%) were injured at work. All charts were reviewed and analyzed according to age, gender, cause of accident, occupation, type of injury, location and frequency of fractures. The highest incidence of maxillofacial injury was found among construction workers (a total of 124 patients, 26.8%), followed by craftsmen (102 patients, 22.0%) and office employees (69 patients, 14.9%). The sex distribution showed an overall male-to-female ratio of 11.8:1 and those in the age group most affected were between 20 and 29 years of age. The most frequent cause of injury was a blow in 48.4%, followed by falls and falls over obstacles, accounting for 27.9% and 7.1%, respectively. Of all trauma, 45.4% (210 persons) sustained 423 maxillofacial fractures, 31.7% (147 patients) suffered 232 dento-alveolar injuries, and 21.2% (98 people) showed 430 soft-tissue injuries. One-fifth (20.7%) of all patients displayed concomitant injuries with cerebral and cranial trauma being the most common. The probability of sustaining maxillofacial trauma at work is correlated to the nature of the occupation. Individuals (mostly men) using tools or machines at work are exposed to a much higher risk of work-related maxillofacial trauma.  相似文献   

11.
Although cervical spine injury is rarely associated with maxillofacial trauma, it should be suspected when injuries above the clavicle occur, as suggested in the Advanced Trauma Life Support Manual. A retrospective study of 2482 patients with maxillofacial trauma, who were admitted to the Maxillofacial Surgical Division of Turin University between 1996 and 2006, conducted to identify concomitant fractures of the cervical spine and establish a treatment protocol. Twenty-one patients (0.8%), consisting of 17 males and four females ranging in age from 15 to 70 years, had amyelic cervical spine fractures. In 90% of the cases, the cervical spine injury was caused by a road accident. Cervical spine injuries were diagnosed using lateral x-rays in three cases and with computed tomography in the remaining patients. Although an association has been reported between mandibular fracture and cervical spine injury, we did not observe a preferential association between injuries of the upper third of the face and spinal injury. Cervical spine immobilization should never be removed until cervical spine injury has been excluded using a lateral x-ray of the cervical spine. In males with significant blunt craniomaxillofacial trauma caused by high-energy impact accidents such as car and motorcycle accidents, computed tomography is the radiologic examination of first choice to exclude cervical spine injuries. Lastly, the presence of a cervical spine injury did not result in modified or delayed treatment of maxillofacial fractures, with the exception of one patient who had a fracture of the odontoid process.  相似文献   

12.
This study aims to retrospectively analyze the incidence and pattern of cranio-maxillofacial injuries in the developing world in a hope to emphasize on authorities the need of improvising infrastructural facilities, medical and other. Hospital medical records with available radiographs of 6,872 patients treated for cranio-maxillofacial injuries at major trauma centres in Pune, India over a 22 year period (from July 1989 to June 2010) were reviewed. Relevant data pertaining to patients’ age, sex, cause of injury, sites of injury, associated injuries, anaesthesia, various treatment modalities and complications were recorded and analyzed statistically. A total of 6,872 patients sustained maxillofacial injuries of which 5,936 (86.4 %) were caused by road traffic accidents (RTA), followed by fall in 608 cases. Distribution pattern of sex revealed male predominance (M:F-2.5:1) and the third decade age group (2,416) sustained maximum cranio-maxillofacial injuries. Of 12,503 cranio-maxillofacial sites involved, mandible (6,456) predominated, while there was middle third involvement in 5,024 cases. Most of the patients (4,856) were treated with open reduction and internal fixation without maxillo-mandibular fixation and complications were noted in 320 patients. In comparison to similar recent studies reported in the literature, our findings show that RTA remains the most common cause of cranio-maxillofacial injuries with male preponderance. Also RTA remains the major preventable etiological factor of cranio-maxillofacial injuries, which should prompt authorities to take “Herculean effort” to implement rules and educate people.  相似文献   

13.
目的:探讨和总结颌面部骨折的临床特点和治疗方法。方法:对我院2012年6月—2017年6月收治的1264例颌面部骨折住院病例进行回顾分析,包括年龄、性别、致伤原因、损伤部位、全身损伤及治疗方法。结果:男942例(74.53%),女322例(25.47%);20~50岁(59.10%)为好发年龄段;意外摔伤965例(76.35%);276例(21.84%)伴全身损伤,颅脑损伤120例(37.62%);1107例(87.58%)采用坚固内固定。结论:颌面部骨折中男性占大多数,意外摔伤是最主要的原因。颅脑损伤是最常见的并发症,开放复位内固定术是目前最主要的治疗方法:。  相似文献   

14.
Abstract – Trauma, a major public health problem, has been extensively studied. However, characteristics of maxillofacial and dental injuries and their association with socio‐economic position (SEP) have not been thoroughly documented. This study retrospectively investigated the occurrence of maxillofacial, dental and general trauma in Israel, and examined the relationship between socio‐economic status and trauma‐related hospitalizations. Records were obtained for all trauma patients hospitalized and recorded in the National Israel Trauma Registry (ITR) between January 1, 2003 and December 31, 2005. Maxillofacial and dental injuries were separated and further analyzed by residence locality and SEP. The socio‐economic index, developed by the Israel Central Bureau of Statistics, was used to determine the socio‐economic status of 50 selected localities. During the study period, 77 072 trauma patients were hospitalized, of whom 3972 (5%) were diagnosed with maxillofacial or dental injuries. Among the selected localities, 42 303 hospitalizations were recorded, of which 1886 (4.5%) involved maxillofacial or dental injuries. For all traumas, lower injury rates were found among residents living in high socio‐economic localities. The difference in hospitalization rates for maxillofacial and dental injuries was not significant. The cause of injury differed by age, SEP and category of injury. A fall (35%) or road crash (33%) caused most of the maxillofacial injuries, with 50% of dental injuries because of a road crash. Intentional injuries constituted 22% of the maxillofacial‐related hospitalizations and were more prevalent among adults living in low SEP localities. These data should be used to promote injury prevention programs with emphasis directed at high risk populations.  相似文献   

15.
Foreign bodies are often encountered by oral and maxillofacial surgeons and may present a diagnostic challenge to the trauma surgeon due to many factors such as the size of the object, the difficult access, and a close anatomic relationship of the foreign body to vital structures. They are usually a result of injuries or operations. Fragments of broken instruments can be left behind and entire teeth or their fragments can be displaced during extraction. The approach to this kind of injury should be sequential and multidisciplinary, beginning with the trauma unit that will provide maintenance of the airways, hemodynamic stabilization, and, but only if necessary, neurologic, ophthalmologic, and vascular evaluation. With a view to illustrating and discussing the diagnosis and treatment of this kind of injury, this study reports impacted foreign bodies in oral and maxillofacial region. The following data were collected: age, sex, race, etiology, occurrence of fracture, anatomic location of the fracture, daytime of the traumatic event, type of the object, signal and symptoms, type of imaging examination used, type of anesthesia, approach, transoperative complication, period between surgery and hospital liberation, and the occurrence of death. Foreign body injuries in the maxillofacial region can place the patient's life at risk, so a correct initial treatment performed by a multidisciplinary team increases the survival of this kind of patient.  相似文献   

16.
The objective of the current study is to retrospectively evaluate cycling related dental and maxillofacial injuries and to gain insight into the epidemiology and results of these accidents. Data of patients who were admitted due to the maxillofacial injuries between April 2018 and September 2020 were retrospectively evaluated regarding the patients’ characteristics, helmet wearing, type of radiological assessment required for diagnosis and therapy, injury patterns, duration of hospitalization and concomitant injuries. Data of 162 patients were included. 86 (53.08%) patients presented with at least one maxillofacial fracture. A total of 186 maxillofacial bones were fractured. Zygomatico-maxillary complex was the most commonly affected region (n:103, 55,36%). Analysis of the dental traumata revealed that crown fracture without pulp exposure was the most commonly observed entity (n:37, 32.46%) and upper central incisors (n:61, 53.50%) were the most commonly affected teeth. The overall ratio of the number of the fracture line/fracture case was 2.80. However, this ratio was statistically higher in e-bike cases (4.25) compared to non-e-bike riders (2.34) (p:0.014). Bicycle related maxillofacial injuries could correlate with specific morbidity rates and result in severe injuries of the maxillofacial region.  相似文献   

17.
Pediatric maxillofacial trauma is a challenge for surgeons. There are no completely defined protocols, and sometimes, the initial management could be complex. The aim of this research was to perform a retrospective study to analyze the pattern and treatment of maxillofacial fractures in pediatric and adolescent patients. We reviewed the clinical records of 2986 patients treated at the Oral and Maxillofacial Surgery Division of Piracicaba Dental School between 1999 and 2008. Seven hundred fifty-seven patients were younger than 18 years and were divided into 3 groups according to age; the age and sex of the patients, etiology, fractures and associated injury, treatment, and complications were evaluated. Five hundred thirty boys (70.01%) and 227 girls (29.99%) were treated for injuries with major prevalence in adolescents. The most common injury causes were bicycle accidents (29.06%) and falls (28.40%). The mandible was the most fractured bone (44.8%); associated injuries were lacerations of the soft tissue and dental trauma. Surgical treatment was performed in 75 cases (30%) with minor complications (10% of surgical patients). We conclude that maxillofacial trauma in child is associated to fall and bicycle accidents; the mandible is more affected than other maxillofacial structures, and frequently, nonsurgical treatment is performed.  相似文献   

18.

Introduction

India being is a country with different social, cultural, geographical and economic backgrounds; it is also grounds of rapid industrialization, mechanization of farming and increase in vehicular traffic which increases the no. of accidents and issues related to disablement and compensation of maxillofacial injuries.

Need for the study

There is no system available for evaluation for such injuries. The pathological condition states the nature of an illness but not the extent of the remaining health. Since the individual reacts as an integer it is important to include some appraisal of the physical factors influencing his work efficiency. As there is little clarity for disability and impairment, its separate assessment for maxillofacial injury is necessary. There are complex maxillofacial injuries that may cause impairment of sense, esthetic compromises, and functional loss. Epidemiology of craniofacial trauma—approximately 50 % of 12 million annual traumatic wounds treated in emergency rooms involve the head and neck. Being most common along with other injuries but is never considered for compensation. Facial region being the one that is the identity and factor that influences its social and emotional behavioral changes has not been considered. In this article various aspects have been considered for evaluation of compensation and disablement due to maxillofacial injuries.  相似文献   

19.
PURPOSE: We sought to determine the etiology and pattern of motorcycle-related maxillofacial injuries among intracity road users in Nigeria. PATIENTS AND METHODS: We conducted a prospective review of all patients presenting at the maxillofacial surgery units of the Obafemi Awolowo University Teaching Hospital Ile-Ife and Usmanu Dan Fodiyo University Teaching Hospital Sokoto with motorcycle-related injuries. RESULTS: One hundred seven patients were included in the study. A significant male preponderance was observed (P = .002). Overall, the peak age incidence was 20 to 29 years, whereas female patients had a peak age incidence of 10 to 19 years. Victims were mostly riders (50.5%) but none of them was a female. While 8.4% of accidents occurred on motorcycles with more than one pillion passenger, none of the victims reported using a crash helmet. Mechanism of accident was mostly head-on collision (39.2%). The injuries sustained were predominantly soft tissue injuries or in combination with bone injury. Bone and dental injuries were attributed mostly to falls. Facial bone injuries occurred mostly in the mandible (64 of 104). A symmetric distribution of injuries was observed in the upper, middle, and lower thirds of the face, but the middle third had the highest injury sites while the upper third had the least. CONCLUSIONS: Motorcycle-related maxillofacial injuries among Nigerians affect males predominantly. The injuries sustained have a symmetric distribution and were mostly soft tissue injuries in isolation or in combination with bony injuries. The middle third of the face is most vulnerable. Mandatory use of safety helmets and education of cyclists on the appropriate number of pillion passengers are imperative to minimize the morbidity and mortality associated with motorcycle accidents.  相似文献   

20.
The epidemiology of maxillofacial fractures shows considerable regional variation as a result of local demographic and socioeconomic factors. We have assessed the epidemiological characteristics of such fractures at our centre in The Netherlands. The medical records of 394 patients who were treated surgically for maxillofacial fractures between 1 January 2005 and 31 December 2010 were analysed retrospectively. The male:female ratio was 3:1. There was a peak incidence in the second and third decades of life among men. The number of injured patients/year remained stable during the selected period. The incidence was highest in the spring and at weekends. Fractures of the mandible and zygoma were the most common. Road traffic crashes were the most common cause of injury (42%) and mainly involved bicycles. A total of 165 (15%) of the patients were intoxicated, and 142 patients (36%) had other serious injuries. Most patients (n = 248, 63%) were treated within a day of presentation. Two hundred and thirty-two patients (59%) spent 4 days or fewer in hospital. The presence of other injuries was associated with a prolonged stay in hospital. Groups at particular risk of maxillofacial fractures are young men and cyclists. The use of helmets by cyclists could achieve a large reduction in injuries to the brain and upper face.  相似文献   

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