全面部骨折38例临床分析

A retrospective analysis of 38 panfacial fracture

目的探讨全面部骨折的临床特点及治疗方法。方法收集我院2003年10月-2008年10月收治的38例全面部骨折患者病历资料,对致伤原因、伤情特点、治疗方法进行分析。结果致伤原因以交通伤为主,占全部骨折的86.8%,其中摩托车伤占交通伤比例的57.6%,骨折类型除上下颌骨骨折外,鼻骨是最常见的骨折部位,多成粉碎性,其次为颧骨。下颌骨多呈线形骨折,单处多见,上颌骨以双侧骨折、颧上颌缝分离、上颌窦前壁粉碎性骨折、双侧上颌骨中缝分离为主要的骨折类型。手术方法遵循从下到上,从外到内的骨折复位固定顺序,重建咬合关系和恢复面部外形,手术效果良好。结论目前全面部骨折以上颌骨、鼻骨、颧骨、下颌骨多发骨折为主,遵循建议的治疗方法可获得良好的效果。

Objective To investigate the clinical characteristics and operative effect of panfacial fracture.Methods Totally 38 patients＇ records from Oct.2003 to Oct.2008 were analyzed.Data associated with causes,characteristics,treatment methods were reviewed.Results The most common cause of trauma was traffic accident（33 cases,86.8%）,including 19 cases of motorcycle accident（57.6%）.In relation to fractures,nasal bone was the most common fracture site besides maxilla and mandible,and most of them were comminuted fractures,followed by zygomatic bone.In most cases,linear fractures were found in mandible,and varieties were showed in maxillary,including bilateral fractures,split of medial palate,comminuted fracture in anterior surface of maxillary sinus,separation of zygomaticomaxilla suture line.All the cases received surgical treatment and rigid internal fixation.The sequence of reduction and fixation followed the steps from bottom-to-top-to-middle in the operation.Good clinical results were gained except one,because of severe complications.Conclusion Panfacial fractures are serious injuries because they involve important adjacent structures,and increase difficulties in restoring their functions.Good clinical results can be obtained following the recommended operations.