- 期刊
Maxillofacial Fractures - A Review of 417 Cases
上頜顏面骨折：417例回顧
摘要
背景：由於打架互毆及交通事故日漸增加，使得上頜顏面骨折的病例也逐日增多。臺灣都會區像臺南新樓基督教醫院地區的交通工具是以低速摩托車為主，再加上本地騎士多半不願意戴安全帽，使得本院上頜顏面骨折呈現特殊型態。 方法：我們自1989年至1998年總共收集417個上頜顏面骨折的病人，依發生的部位將病患分為7組，討論其治療方式及預後。 結果：上頜顏面骨折病人年齡多集中在20至40歲，發生原因以車禍佔最多，而其中又以摩托車（71%）為主要。鼻骨骨折佔大部份，觀骨骨折及下頜骨骨折次之。而下頜骨骨折中以體部和下頜角為主，下頜骨髁狀突則較少。 結論：病人先控制流血和呼吸暢通及傷口縫合，但有些病人需要處理腦震盪或顱內出血。等待局部水腫消退後，大部的病人在局部麻醉下予以閉鎖式復位。然而，複雜性的骨折往往在2星期內採取開放性的手術復位。另外，本地上頜顏面骨折的型態與國外高速汽車事故為主的上頜顏面骨折型態並不相同。
並列摘要
Background: The incidence of facial injury has significantly increased in Taiwan due to a rising number of traffic accidents in recent years. Otolaryn-gologists may provide emergency care for patients who have sustained facial trauma. Knowledge of the anatomy of the facial skeleton and of the potential injuries associated with each of the various types of facial injuries will facilitate effective management. Methods: The medical records of 417 patients with maxillofacial fractures occurring in the 10-year period from 1989 through 1998 were reviewed. Data collected included patient demographics, causes of injury, treatments, and outcomes. The injuries were classified into seven treatment groups: nasal bone, maxillar, zygomatic arch, zygomatic complex, mandibular, nasofrontal-ethmoidal complex, and multiple fractures. Results: The average age of the study population was 37.6 years old (rang-ing from 5 to 86 years old); most of the cases resulted from motorcycle accidents (71%). Of the 417 patients, nasal bone fracture was the most common injury, affecting 171 patients (41.0%). Almost half of the patients, 192 (46%), were treated with closed reduction under local anes-thesia. Repair in most of the open reduction cases was performed under general anesthesia. Conclusions: Motorcycle accidents were the main cause of nasal bone, zygo-matic complex, zygomatic arch, and mandibular fractures. Our hospital is located in a rural area of Tainan where most traffic accidents are low-speed motorcycle crashes. In this series, the body is the most common site of all mandibular fractures because of the role of motorcycle accidents. In contrast, the condylar fracture is the most common fracture in other stud-ies since most of the injuries in those were due to car accidents.