1452例鼻区不同部位骨折的CT影像分析和临床意义(附一种鼻区骨折新型分类方法)

CT image analysis and clinical value of 1452 cases of nasal fractures in different parts(a new classification method of nasal fracture is attached)

目的采用一种鼻区骨折新型分类方法,以期对骨折复位和预后评估提供更多帮助。方法回顾性分析1452例鼻区骨折成人患者的CT影像资料。从鼻骨最前端到上颌骨额突底部分为前部、中部和后部,包含两个部位及以上称为复合部。骨折类型分为凹陷型、隆起型、轻微型和混合型。结果1452例骨折中,骨折部位占比依次为复合部43.11%、前部41.12%、中部10.06%和后部5.72%;骨折类型占比依次为凹陷型66.25%、轻微型17.98%、隆起型9.23%和混合型6.54%;骨折侧别占比依次为双侧43.53%、左侧33.13%和右侧23.35%,侧别间比较差异有统计学意义(P<0.001),左侧高于右侧;伴发骨折占53.10%,其中鼻中隔骨折占40.50%。结论鼻区骨折的新型分类方法能够细化骨折定位,为复位和预后评估提供更多帮助。

OBJECTIVE To develop a new classification method of nasal fractures for providing more help for fracture reduction and prognosis evaluation.METHODS The CT images of 1452 adult patients with nasal fracture were analyzed retrospectively.Nasal fracture is divided into anterior,middle and posterior parts from the most front of nasal bone to the bottom of frontal process of maxilla.If the fracture involves two or more parts,it is called composite part.Fracture types include depression type,uplift type,slight type and mixed type.RESULTS In 1452 cases of fractures,the proportions of fracture were 43.11%for composite part,41.12%for anterior part,10.06%for middle part and 5.72%for posterior part,respectively.The propor tions of fracturety pes were 66.25%for depression type,17.98%for slight type,9.23%for uplift type and 6.54%for mixed type,respectively.The fracture sides were:43.53%for bilateral,33.13%for left and 23.35%for right,respectively.The incidence of fractures on the left side was significantly higher than that on the right side(P<0.001).Concomitant fractures accounted for 53.10%,of which nasal septal fractures accounted for 40.50%.CONCLUSION The new classification method of nasal fractures can refine the fracture location,provide more help for reduction surgery and prognosis evaluation.