脑外伤对下颌骨骨折愈合促进作用的临床初步研究

Does Traumatic Brain Injury Result in Accelerated Mandibular Fracture Healing? A Pilot Study

目的:探讨脑外伤是否可促进下颌骨骨折快速愈合。方法:收集本院近6年收治的下颌骨骨折患者,纳入标准为下颌骨骨折在伤后2周进行过CT检查,但未行内固定手术治疗。在CT片上观察骨痂形成情况,采用Cox比例回归模型分析骨痂形成时间与脑外伤,患者年龄、性别和昏迷时间的关系。结果:最终纳入45例下颌骨骨折患者,包括24例合并重型脑外伤和21例非脑外伤。其中有12例脑外伤和6例非脑外伤患者的CT片上可以观察到骨痂形成。统计分析表明脑外伤和非脑外伤两组患者在年龄、性别、CT检查时间及骨折类型上无明显差异。Cox单因素回归分析表明骨痂形成时间与脑外伤及昏迷时间成正相关,而与年龄、性别和骨折类型无相关性。结论:下颌骨骨折合并重型脑外伤患者较非脑外伤患者的骨痂形成提前,表明骨折愈合速度加快。进一步研究阐明该现象具有重要临床意义。

Objective To investigate the occurrence of accelerated bone healing evidenced by early callus formation in patients with mandibular fractures and traumatic brain injury(TBI).Methods A retrospective cohort study on patients presented for mandibular fracture evaluation and management in our unit over a six year period was performed.Subjects eligible for the study included those who had performed a CT examination of the mandible more than 2 weeks after the injury and had not undergone surgery with rigid internal fixation.TBI was used as the predictor variable.The time to callus formation as detected in the CT scans was recorded as the primary outcome variables.Other variables considered included age,gender,coma duration and fracture distribution.Appropriate statistical analyses were performed to determine the influencing factors.Results A total of 45 patients with mandibular fractures-including 24 cases with severe TBI and 21 cases without TBI were retrospectively analyzed,twelve patients with TBI and six without TBI exhibited visible callus in their CT scans.Statistical analysis shows that no significant differences in age,gender,examination time,and fracture distribution between the groups.Cox proportional hazards regression analysis indicates the positive correlation of time to callus formation with TBI and coma duration,but not with age,gender,and fracture distribution.Conclusion Our findings suggest that patients with severe TBI and mandibular fractures exhibit enhanced fracture healing as evidenced by early callus formation.A more exhaustive study is required for further understanding of this phenomenon and provide additional clinical significance.