Management of Windshield Facial Injuries

汽車擋風玻璃之顏面傷害

周治剛(Chih-Kang Chou) ； 林幸道(Sin-Daw Lin) ； 楊錦江(Chin-Chiang Yang) ； 賴春生(Chung-Sheng Lai) ； 蔡經緯(Chin-Wei Tsai) ； 張清旺(Chin-Wang Chang)

《The Kaohsiung Journal of Medical Sciences》 9卷3期 (1993/03) Pp. 153-161

https://doi.org/10.6452/KJMS.199303.0153

摘要

從1986年至1990年，五年間共有99例顏面擋風玻璃傷害之患者，在本院重建整形外科住院治療。其中男性73例，女性26例，年齡分6歲至62歲，平均31歲，其中57例(58%)為汽車駕駛者，42例(42%)為坐於前座之乘客。傷害皆由於車禍意外時，車前舊式之擋風玻璃破裂所造成，所有病人都在顏面有多條典型之U型裂傷，而以顏面的上1/3部份居多。病例中有21例合併顏面骨折，3例有顱骨骨折，2例有輕微腦水腫，1例蜘蛛膜下腔出血，1例額竇被玻璃貫穿，玻璃碎片進入腦組織中。有16例眼球破裂之患者，其中有2例為兩側性，8隻眼球接受摘除，雖然另10隻眼球接受修補手術，但所有受傷眼球皆失明。在99例的患者之中，尚有15例合併其他外，以四肢的傷害居多。
車禍時擋風玻璃破裂雖不會致命，卻可造成相當嚴重的顏面外傷，採用新式之擋風玻璃，而且在汽車行駛中，汽車駕駛者及於前座之乘客一律繫上安全帶，可預防此一嚴重傷害的發生。

並列摘要

Between Jan. 1986 and Dec. 1990, 99 patients with automobile windshield facial injuries were hospitalized in Kaohsiung Medical College hospital. All patients were injured by old type windshields in car accidents. Seventy-three patients (74%) were male and twenty-six (26%) were female. Ages ranged from 6 to 62 years (mean age 31 years). Fifty-seven patients (58%) were car drivers and forty-two (42%) were front seat passengers. All patients had typical multiple U-shaped lacerations on the face. The major injury sites were localized to the upper one third of the face. The wounds were repaired immediately after careful debridement. A total of 21 facial bone fractures were noted. All were open fractures with large, deep avulsion wounds. Displaced and comminuted frctures received reduction and fixation before wound closure. Three patients had cranial bone fracture with no displacement. Brain edema and subarachnoid hemorrhage were found by brain CT scan in two and one patients respectively. They were treated conservatively. In one patient with frontal sinus fracture the glass pieces penetrated into the brain. The forging bodies were removed from the brain and frontal sinus. Eyeball rupture was found in 16 patients, including two patients in whom both eyes were involved. Eight eyeballs needed immediate evisceration and ten eyeballs received reparation. Blindness occurred in all these patients. Of the 99 patients in this study, 15% sustained additional injury. Most were wounds on the extremities.
Because serious injuries can be caused by the old type of windshields, it should be abandoned. Driving with the seat belt fastened is the best way to insure safety.

並列關鍵字

facial injuries ； traffic accidents ； foreign bodies