RESUMEN
OBJECTIVE: This study was performed to explore bone remodelling in children with intracapsular condylar fractures after the condylar fracture fragments were fixed using long screws and to offer possible explanations about the underlying mechanism. PATIENT AND METHODS: Records of children (less than 12 y old) who sustained intracapsular condylar fractures and fixed with long screws from May 2012 to January 2015 were retrieved. Age, gender, dates of injury, admission, and discharge, mechanism of trauma, location and pattern of fracture, other mandibular fractures, treatment methods, and time of review were recorded and analyzed. Image dates of pretreatments and posttreatments, including the date of review, were also recorded. RESULTS: A total of 8 patients completed their follow-up, and all patients (n=5) who were followed up after more than 3 months showed serious resorption of the condylar head. The condylar head resorbed until the height (or articular surface) dropped and aligned with the surface of the screw. The shortest time of absorption, as shown by the computed tomography scan was 106 days, and the longest time was 171 days (average time of 141.8 d). CONCLUSIONS: Intracapsular condyle fractures in children should be managed conservatively as much as possible. However, if the height of the fracture fragments drops remarkably, open reduction and rigid internal fixation become possible choices.
Asunto(s)
Cóndilo Mandibular , Fracturas Mandibulares , Humanos , Niño , Cóndilo Mandibular/cirugía , Fracturas Mandibulares/cirugía , Tomografía Computarizada por Rayos X , Fijación Interna de Fracturas/métodos , Tornillos Óseos , Resultado del TratamientoRESUMEN
This study aimed to explore and impart understanding of bone remodelling in children with intracapsular fractures treated conservatively. Records of children (less than 12 years), who sustained intracapsular fractures and treated conservatively, were retrieved consecutively for the period of March 2011 to February 2016. Data about age, gender, date of injury, dates of admission and discharge, mechanism of trauma, location and pattern of fracture, other mandibular fractures, treatment methods and time of review were recorded and analysed. Image dates of pre- and post-treatments, including date of review, were also recorded. A total of 22 patients complete their follow-up and show bone remodelling process. During their follow-up, all the displaced condylar fragments fused with the ramus stump at the displaced position. Regardless of the type of conservative procedure, both treatments cannot promote the spontaneous fracture reduction in patients with intracapsular condylar fractures. During follow-up, the absorption of the lateral process of the condyle after the closed treatment becomes close to the 'horizontal absorption', until the height (or articular surface) of the lateral condylar process dropped and aligned to the articular surface of the medial process. In children with intracapsular condylar fractures, the fracture fragment of the condyle determines the ramus height of the mandible. Closed treatment cannot restore the fracture fragment. If the height of the fracture fragments dropped remarkably, then open reduction and rigid internal fixation become more suitable.
Asunto(s)
Cóndilo Mandibular , Fracturas Mandibulares , Humanos , Niño , Cóndilo Mandibular/cirugía , Fracturas Mandibulares/cirugía , Mandíbula , Fijación Interna de Fracturas , Fijación de FracturaRESUMEN
OBJECTIVE: This study aimed to explore bone remodeling after condylar fracture fragments have been removed from patients with intracapsular condylar fractures. it also evaluated whether condyle fracture removal can be used alternatively when the authors treat patients with comminuted or small pieces of fracture or in extremely difficult operations. METHODS: Records of patients who sustained intracapsular condylar fractures and treated by removal of fragments for the period of February 2013 to September 2019 were retrieved. Data about age, gender, date of injury, dates of admission and discharge, mechanism of trauma, location and pattern of fracture, other mandibular fracture, treatment methods and time of review were recorded and analyzed. Image dates of pre- and post-treatment (including the time of review) were also recorded. RESULTS: The data of a total of 103 patients ranging from 5 to 84 years old were retrieved during this study. A total of 135 sides of condylar fragments were removed. Almost all of the patients with comminuted condyle head fracture or type A fracture presented apparent shortening of the ramus height, and none of them showed osteogenesis (or new bone formation) during their follow-up. Present study only observed osteogenesis in few patients who sustained type B/C intracapsular condylar fractures during their follow-up. The younger the patient was, the longer the follow-up time was, and the higher the possibility of new bone formation was. No correlation was found between the amount of osteogenesis and follow-up time, the amount of osteogenesis was generally small, and no patient could form a new condyle head similar to the normal (or original) condyle head. Condylar hypertrophy only occurred in children. Four patients developed temporomandibular joint ankylosis. CONCLUSIONS: Removal of fracture fragments is an alternative treatment option for patients who sustained comminuted or small pieces of fracture or in extremely difficult operations.
Asunto(s)
Anquilosis , Fracturas Conminutas , Fracturas Mandibulares , Trastornos de la Articulación Temporomandibular , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Fijación Interna de Fracturas , Fracturas Conminutas/diagnóstico por imagen , Fracturas Conminutas/cirugía , Humanos , Cóndilo Mandibular/lesiones , Cóndilo Mandibular/cirugía , Fracturas Mandibulares/diagnóstico por imagen , Fracturas Mandibulares/cirugía , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
OBJECTIVE: This study aims to reveal the reconstruction process in pediatric patients with extracapsular condylar fractures after conservative treatment. We clarify that the "upright" position (or "recontouring" or favorable prognosis) of condyles is not a result of the anatomical reduction of the deviated condylar processes but originates from the remodeling of the skeleton. We also explore the related mechanism. METHODS: The sample consisted of 27 pediatric patients aged less than 12 years who presented with extracapsular condylar fractures and were treated conservatively within an 8-year period (June 2011-April 2019). Data on the age, gender, date of injury, mechanism of trauma, location and pattern of mandibular condylar fracture and associated injuries and treatment methods of the patients were obtained. The process of bone remodeling in condyles was also recorded and analyzed. RESULTS: The 27 children in this study sustained 33 extracapsular condylar fractures over the 8-year period of record retrieval. Amongst these fractures, 8 (24.2%) and 25 (75.8%) were condylar neck and condylar base fractures, respectively. Deviation and green-stick fractures were the predominant types and accounted for over 3 quarters of the condylar neck and base fractures (28, 84.8%), followed by dislocation fracture (3, 9.1%), displacement fracture (1, 3.0%), and non-displaced fracture (1, 3.0%). The period of follow-up ranged from 2 days to 257 days (average, 58.78 days). Only 1 patient with bilateral extracapsular condylar fractures showed vertically reconstructed condyles, which indicates an upright position of the condylar processes. One patient showed less angulation after treatment than before treatment, 1 patient revealed greater angulation after treatment than before treatment and all other patients (20 patients) showed the same angulation pre- and post-treatment. Both patients with only extracapsular condylar fractures showed no obvious deviations in dentition and facial asymmetry after their injury and treatment. The shortest and longest times observed for bone remodeling were 33 and 256 days, respectively. Children whose condylar head remained completely or at least partly inside the glenoid fossa showed satisfactory remodeling results during follow-up. Computed tomography scan during follow-up generally showed bone regeneration in the lateral condyle articular surface and the medial portion of the ascending ramus and bone resorption in the displaced direction (ie, the medial condyle head became sharp). Condylar heads displaced completely outside of the glenoid fossa showed serious shortening of the ascending ramus, and no obvious bone remodeling was observed. Only 1 patient with bilateral extracapsular condylar fractures showed a normal contour (ie, a vertically reconstructed condyle reflecting the upright position of the condylar processes) after 8 months. CONCLUSION: Stress stimulation originating from the glenoid fossa and ascending ramus of the mandible is a prerequisite for good condylar reconstruction. Conservative treatment could be carried out if the condylar head remains completely or at least partly inside the glenoid fossa. When the condylar head is dislocated completely outside the glenoid fossa, the glenoid-condylar relationship ceases to exist, joint function is lost and the height of the ascending ramus is significantly reduced. In this case, open reduction may be suitable.
Asunto(s)
Luxaciones Articulares , Fracturas Mandibulares , Remodelación Ósea , Niño , Humanos , Cóndilo Mandibular/diagnóstico por imagen , Fracturas Mandibulares/diagnóstico por imagen , Fracturas Mandibulares/terapia , Reducción AbiertaRESUMEN
OBJECTIVE: This study aimed to assess whether ramus height is restored in children with extracapsular condylar fractures treated by conservative or surgery procedures. METHODS: The sample consisted of 35 children (collected consecutively) less than 12 years old who presented with extracapsular condylar fractures and treated within an 8-year period (June 2011 to April 2019). Data on the age, gender, date of injury, mechanism of trauma, location and pattern of mandibular condylar fracture, associated injuries and treatment methods were recorded and analyzed. Ramus height restoration is the main evaluation indicator during the follow-up period. RESULTS: Within the 8-year record retrieval, the 35 children sustained 41 extracapsular condylar fractures. For the sample size, 10 (24.4%) and 31 (75.6%) had condylar neck and base fractures, respectively. Deviation and green-stick fracture were the predominant types in condylar neck and base fractures, accounting for more than 3 quarters (31, 75.6%). The majority (33, 80.5%) of patients were treated with nonsurgical treatment, and 8 (19.5%) were treated by open reduction and internal fixation (ORIF). During the follow-up period (1-1419 days, average time of 110.6 days), only 1 patient (with bilateral extracapsular condylar fractures) had their ramus height restored (follow-up period, 256 days). Most members of the ORIF group (5 of 8, 62.5%) postoperatively showed bended ramus (deviated angularly/fragment angulation). CONCLUSION: Conservative treatment could hardly restore the ramus height of children with extracapsular condylar fractures. Anatomically or totally restoring the ramus height is difficult even with the surgical treatment of ORIF; however, surgical treatment of ORIF can substantially restore the ramus height for dislocated fractures or seriously displaced fractures.
Asunto(s)
Luxaciones Articulares , Fracturas Mandibulares , Niño , Fijación Interna de Fracturas , Humanos , Cóndilo Mandibular/cirugía , Fracturas Mandibulares/cirugía , Reducción Abierta , Resultado del TratamientoRESUMEN
PURPOSE: This study aimed to compare the pre-emptive analgesia of oral celecoxib with oral acetaminophen after surgical removal of the mandibular third molars. MATERIALS AND METHODS: A randomized, double-blinded, placebo-controlled clinical trial was conducted to examine patients presenting with a mandibular third molar for extraction under local anesthesia. The participants were randomized to receive a preoperative oral dose of celecoxib or acetaminophen as the predictor variable. The primary outcome variable was postoperative pain measured on a visual analog scale at different time points. The secondary outcome variable was the amount of postoperative analgesic medication taken in both groups. Statistical analyses included descriptive statistics, the t test, and the Pearson χ2 test. Significance was set at P < .05. The overall survival (interval to the first intake of ibuprofen) of the patients in each group was evaluated using Kaplan-Meier curves and log-rank analyses. RESULTS: Sixty participants were randomly divided into either the celecoxib group or acetaminophen group. The postoperative pain scores in the celecoxib group were significantly lower than those in the acetaminophen group at 4, 6, 8, and 12 hours (P = .008, P = .001, P = .021, and P = .011, respectively). The number of patients who did not require analgesics in the celecoxib group was less than that in the acetaminophen group (P = .018). The average amount of rescue analgesic medication in the celecoxib group (0.6 ± 0.8 dose) was significantly lower than that in the acetaminophen group (1.3 ± 1.0 doses) (P = .002). The Kaplan-Meier curve indicated that celecoxib resulted in long-term survival of the patients who did not receive rescue analgesic medication (P = .0055). CONCLUSIONS: Celecoxib exhibits a significant pre-emptive analgesic effect, thereby reducing the use of postoperative analgesics after removal of the third molar.
Asunto(s)
Analgésicos no Narcóticos , Tercer Molar , Acetaminofén , Celecoxib , Método Doble Ciego , Humanos , Dolor Postoperatorio , Extracción DentalRESUMEN
OBJECTIVE: This study aimed to explore and make an understanding of absorption existed in children with intracapsular fractures. METHODS: The sample was composed of all children (less than 12 years) who presented with intracapsular fractures within a 5-year period (January 2011 to April 2016). Data about age, gender, date of injury, dates of admission and discharge, transfer and/or referral by other clinics or local facilities, mechanism of trauma, location and pattern of fracture, associated injuries, centimeter of mouth opening, treatment methods, image date of pre- and post-treatment (including time of review), position of condylar head in pre-treatment or post-treatment, and absorption of condylar head in pre-treatment or post-treatment were recorded and analyzed. Data analysis included the Chi-Square test, the Fisher exact test, and the t-test. Logistic regression analysis was utilized to control the confounding variables. Probabilities of p less than 0.05 were considered statistically significantly different. RESULTS: In the 5 years records retrieved during this study, 93 children patients sustained a total of 140 condylar head fractures. Statistical analysis revealed that abduction of condylar process in post-treatment was highly related to the condylar absorption. Patients associated with other mandibular fractures were highly related to abduction of condylar process. Patients with condylar head fractures, the closer to the medial of the condylar process, the higher the risk of abduction of the condyle. No matter what kind of treatment method is used, it is very difficult to reverse the abduction of condylar process in children patients with intracapsular fractures efficaciously. CONCLUSION: Abduction of condylar process in post-treatment was highly related to the condylar absorption. Patients associated with other mandibular fractures were highly related to abduction of condylar process. Children patients who presented with condylar head fractures, the closer to the medial of the condylar process the higher the risk of abduction of the condyle. Neither surgery nor conservative treatment can recover the abduction of condylar process efficaciously.
Asunto(s)
Resorción Ósea/diagnóstico por imagen , Cóndilo Mandibular/lesiones , Fracturas Mandibulares/diagnóstico por imagen , Fracturas Mandibulares/terapia , Resorción Ósea/epidemiología , Niño , Preescolar , Estudios de Cohortes , Tratamiento Conservador , Femenino , Humanos , Masculino , Fracturas Mandibulares/complicaciones , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: This study aimed to evaluate and compare the demographic characteristics of mandibular condylar fractures between children and adolescents. METHODS: The sample was composed of all children (less than 12 years) and adolescents (between 13 and 18 years old) who presented with mandibular condylar fractures within a 5-year period (January 2011 to April 2016). The age, gender, time of injury, mechanism of trauma, location and pattern of fracture, associated injuries and treatment methods were recorded and analysed. Data analysis included chi-square test and Fisher exact test. Differences at p less than 0.05 were considered significant. RESULTS: A total of 111 children and 39 adolescent patients with condylar fractures were registered and compared. More children than adolescents were involved in falls from a height (pâ¯=â¯0.007), but nearly no relationship was observed between the trauma aetiology and type of condylar fracture in the two patient groups. Condylar head fractures occurred most frequently in the children and adolescents, especially in the children (pâ¯<â¯0.05). Condylar neck fractures were more frequently observed in the adolescent patients (pâ¯<â¯0.001) than in the children. Green-stick fractures occurred only in the child patients (pâ¯=â¯0.005). The patients who fractured other sites of the mandible tended to show a decreased frequency of dislocation (condylar head was out of the glenoid fossa) (pâ¯=â¯0.024). Symphysis/para-symphysis fractures were highly common in the children who sustained unilateral condylar fractures, compared to adolescents (pâ¯<â¯0.05). The patients with bilateral condylar fractures were more frequently associated with other mandibular fractures (children, pâ¯=â¯0.001; adolescents, pâ¯=â¯0.011), especially the fracture of the mandibular body or symphysis. The children who sustained extracapsular fractures were more prone to fractures of other mandibular sites (pâ¯=â¯0.009), especially fracture of the symphysis/para-symphysis (pâ¯=â¯0.014). Intracapsular fractures in children were treated non-surgically more frequently than surgically (pâ¯<â¯0.001). The extracapsular fractures (mild and serious fractures) in children were also treated non-surgically more frequently (pâ¯<â¯0.05). CONCLUSIONS: The trauma mechanisms, incidence, pattern and treatment of condylar fractures in children substantially differ from those in adolescents. This study was conducted to enable the understanding of the differences in condylar fractures between children and adolescents. Accordingly, preventive measures and treatment plans in children or adolescents should be applied differently.
Asunto(s)
Cóndilo Mandibular/lesiones , Fracturas Mandibulares/epidemiología , Fracturas Mandibulares/terapia , Adolescente , Niño , Preescolar , Femenino , Fractura-Luxación/epidemiología , Fractura-Luxación/etiología , Fractura-Luxación/terapia , Fracturas Múltiples , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Fracturas Mandibulares/etiología , Estudios Retrospectivos , Articulación Temporomandibular/lesionesRESUMEN
This study aims to identify and distinguish various factors that may influence the clinical symptoms (limited mouth opening and malocclusion) in patients with maxillofacial fractures. From January 2000 to December 2009, 963 patients with maxillofacial fractures were enrolled in this statistical study to aid in evaluating the association between various risk factors and clinical symptoms. Patients with fractured posterior mandibles tended to experience serious limitation in mouth opening. Patients who sustained coronoid fractures have the highest risk of serious limitation in mouth opening (OR = 9.849), followed by arch fractures, maxilla fractures, condylar fractures, zygomatic complex fractures and symphysis fractures. Meanwhile, the combined fracture of zygomatic arch and condylar process results in normal or mild mouth opening. High risks of sustaining malocclusion are preceded by the fracture of nasal bone (OR = 3.067), mandible, condylar neck/base, combined fracture of zygomatic arch and condylar process, mandibular body, bilateral condylar, dental trauma, mandibular ramus, symphysis, mandibular angle and mid-facial. Patients who experienced serious limitation in mouth opening are treated with surgery more frequently (OR = 2.118). No relationship exists between the treatment options and the patients with malocclusion.
Asunto(s)
Maloclusión/patología , Fracturas Mandibulares/complicaciones , Boca/patología , Rango del Movimiento Articular , Adulto , Fenómenos Biomecánicos , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Maloclusión/etiología , Estudios RetrospectivosRESUMEN
This study aimed to identify and distinguish various factors that may influence the occurrence of mandibular coronoid fractures. From January 2000 to December 2009, a total of 1131 patients with maxillofacial fractures were enrolled in this statistical study to evaluate the association between mandibular coronoid fractures and other risk factors. Among these patients, 869 had mandibular fractures, and 25 sustained a total of 25 coronoid fractures. More than half (13 of 25 patients, 52%) of the coronoid fractures in these patients were caused by motor vehicle accidents. Among these coronoid fractures, seven were associated with other mandibular fractures, and 23 (92.0%) were related to midfacial fractures. The most common site of midfacial fracture was the zygomatic arch (20 patients, 80%). Multivariate logistic regression analysis revealed that the most important influencing factor was the zygomatic arch fracture (odds ratio, 9.033; 95% confidence interval, 1.658, 49.218; p = 0.011). The majority of coronoid fracture fragments (19 of 25, 76%) were removed during operation. The most commonly used incision is hemicoronal or bicoronal approach (16 of 19, 84.2%).
Asunto(s)
Fracturas Mandibulares/epidemiología , Fracturas Mandibulares/etiología , Adolescente , Adulto , Estudios de Casos y Controles , China/epidemiología , Análisis Factorial , Femenino , Humanos , Masculino , Fracturas Mandibulares/diagnóstico , Persona de Mediana Edad , Oportunidad Relativa , Estudios Retrospectivos , Factores de Riesgo , Adulto JovenRESUMEN
The removal of a large number of foreign bodies in the maxillofacial region can be complicated and challenging. In this case report, a specific strategy for removal of multiple foreign bodies in the maxillofacial region is presented. A girl diagnosed with 24 foreign bodies in her left lower face and neck underwent the surgery using a computer-assisted navigation system. A specific strategy was used in this case, which included from one sub-region to the next and from the easiest to the most difficult. This strategy is recommended for the removal of a large number of foreign bodies in the maxillofacial region with a navigation system.
Asunto(s)
Traumatismos Faciales/cirugía , Cuerpos Extraños/cirugía , Traumatismos del Cuello/cirugía , Cirugía Asistida por Computador , Adolescente , Desbridamiento , Traumatismos Faciales/diagnóstico por imagen , Femenino , Cuerpos Extraños/diagnóstico por imagen , Humanos , Traumatismos del Cuello/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: The purpose of this study was to evaluate and compare the demographic characteristics of maxillofacial fractures between women and men in China. PATIENTS AND METHODS: The sample was composed of all patients who sustained maxillofacial fractures during a 10-year period (2000 through 2009). Incidences, age distributions, etiologies, fracture patterns, associated injuries, and occupation distributions were recorded and analyzed. Data analysis included the χ(2) test, the Fisher exact test, and the t test. A P value less than .05 was considered significant. RESULTS: There were 1,131 patients (881 male and 250 female) who sustained maxillofacial fractures, with a male-to-female ratio of 3.5:1. Male patients sustained injuries most frequently during the autumn (P = .048), whereas female patients sustained more maxillofacial injuries during the summer (P = .006). Men sustained motorcycle (P = .023) and assault-related accidents (P = .036) more frequently than women, whereas women were more frequently injured in bicycle-related accidents (P < .001) or falling while at ground level (P = .001) than men. Women presented more frequently with condylar fracture than men (P = .028), whereas men were more prone to symphysis fractures than women (P = .037). For drivers, only men were involved (P = .001). Male workers sustained maxillofacial fractures more frequently than female workers (P < .001). Female children, students, and company staff were more prone to maxillofacial fractures than their male counterparts (P = .010, P = .004, and P = .044 respectively). CONCLUSIONS: The demographic characteristics of maxillofacial fractures in female patients considerably differ from those in male patients.
Asunto(s)
Fracturas Óseas/epidemiología , Traumatismos Maxilofaciales/epidemiología , Accidentes de Tránsito , China , Femenino , Fracturas Óseas/etiología , Humanos , Masculino , Traumatismos Maxilofaciales/etiología , Estudios RetrospectivosRESUMEN
PURPOSE: Computer-assisted navigation has been widely used in oral and maxillofacial surgery. The purpose of this study was to describe the applications of computer-assisted navigation for the minimally invasive reduction of isolated zygomatic arch fractures. PATIENTS AND METHODS: All patients identified as having isolated zygomatic arch fractures presenting to the authors' department from April 2013 through November 2014 were included in this prospective study. Minimally invasive reductions of isolated zygomatic arch fractures were performed on these patients under the guidance of computer-assisted navigation. The reduction status was evaluated by postoperative computed tomography (CT) 1 week after the operation. Postoperative complications and facial contours were evaluated during follow-up. Functional recovery was evaluated by the difference between the preoperative maximum interincisal mouth opening and that at the final follow-up. RESULTS: Twenty-three patients were included in this case series. The operation proceeded well in all patients. Postoperatively, all patients displayed uneventful healing without postoperative complication. Postoperative CT showed exact reduction in all cases. Satisfactory facial contour and functional recovery were observed in all patients. The preoperative maximal mouth opening ranged from 8 to 25 mm, and the maximal mouth opening at the final follow-up ranged from 36 to 42 mm. CONCLUSIONS: Computer-assisted navigation can be used not only for guiding zygomatic arch fracture reduction, but also for assessing reduction. Computer-assisted navigation is an effective and minimally invasive technique that can be applied in the reduction of isolated zygomatic arch fractures.
Asunto(s)
Procedimientos Quirúrgicos Mínimamente Invasivos , Cirugía Asistida por Computador , Fracturas Cigomáticas/cirugía , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
PURPOSE: This study was designed to evaluate the results in isolated mandibular angle fractures treated with resorbable plates and to summarize experiences of the application of resorbable plates. PATIENTS AND METHODS: Ten patients (6 men and 4 women) with isolated displaced mandibular angle fracture were included in this case series. Open reduction by intraoral or extraoral approach was performed, and the fractures were fixed using single or dual resorbable plates. Postoperatively, follow-up was undertaken to evaluate the fracture healing and the degradation of resorbable plates. RESULTS: All the fractures healed without complications during the follow-up period. No screw or plate fractured during the surgery, no dislocation of the fracture segment after the fixation by resorbable plates, and no foreign body reaction related with resorbable plates were observed. CONCLUSIONS: With proper indication, resorbable plates are suitable for the fixation of isolated mandibular angle fractures. Single or dual resorbable plates by intraoral or extraoral approach can be individualized on the basis of the patients' condition.
Asunto(s)
Implantes Absorbibles , Placas Óseas , Fijación Interna de Fracturas/instrumentación , Fracturas Mandibulares/cirugía , Adolescente , Adulto , Tornillos Óseos , Femenino , Estudios de Seguimiento , Curación de Fractura/fisiología , Humanos , Luxaciones Articulares/cirugía , Masculino , Mandíbula/fisiología , Mandíbula/cirugía , Persona de Mediana Edad , Rango del Movimiento Articular/fisiología , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVES: To analyse and evaluate the correlation between traumatic head injuries (THIs) and maxillofacial fractures (MF). Age, gender and trauma mechanism correlated with THI were also investigated. PATIENTS AND METHODS: We conducted a hospital-based retrospective case-control study at Stomatology College and Hospital, Wuhan University. From January 2000 to December 2009, a total of 1131 patients with MF were enrolled in the statistical study to evaluate the association of THI and other risk factors with MF. Among these patients, 86 presented with THI. We utilized binary logistic regression and risk analysis to investigate the associations among MF and other risk factors with HI. RESULTS: Head injuries (103 injuries) were sustained by 86 patients (7.6%), with male-to-female ratio of 4.1:1.0. Most of the patients (52 patients, 50.5%) also exhibited cranial bone fractures. The age group with most patients was the 30-39 years age group (26 patients, 30.2%), followed by the 19-29 years age group (22 patients, 25.6%). Motor vehicle accident (MVA) was the most common mechanism of injury (49 patients, 74.1%). Patients older than 50 years showed the highest risk for head injury (OR, 2.0; 95% confidence interval, 1.1-3.7; P = 0.025). MVA had a sixfold risk of head injury (OR, 6.2; 95% confidence interval, 1.5-26.1; P = 0.013). Head injuries were more prone to occur in patients who had combined fracture of the mid-face and mandible (OR = 4.6, P < 0.001), and only a 0.3-fold risk of multimandible fractures (P < 0.001), 0.5-fold risk of single mandibular fracture (P = 0.017) and 0.3-fold risk of patients who sustained only single mandibular condylar fracture (P = 0.019). CONCLUSIONS: The occurrence of head injuries is significantly related to age, aetiology and the pattern and position of maxillofacial fractures.
Asunto(s)
Fracturas Craneales/epidemiología , Fracturas Craneales/etiología , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Niño , Preescolar , China/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de RiesgoRESUMEN
PURPOSE: This study aims to evaluate the epidemiology of maxillofacial injuries in infants and preschools. PATIENTS AND METHODS: The data from 110 infants and preschools with maxillofacial injuries from October 2010 to March 2013 were analyzed retrospectively. RESULTS: The male-to-female ratio was 1.89:1. The peak age was 1 to 3 years (53.64%). Accident falls (76.36%) were the major cause. A total of 166 soft-tissue injuries were found in 103 patients, 102 dental traumas in 36 patients, and 53 maxillofacial fractures in 33 patients. The most common sites of soft-tissue injuries included the gingiva (17.47%), lower lip (13.86%), upper lip (13.25%), and chin (12.05%), and the majority were lacerations (77.71%). Dental traumas occurred mainly in incisors (81.37%) and the lower arch (60.78%). Of the 53 fractures, the most common sites were the condyle (45.28%), symphysis (22.64%), and mandibular body (16.98%); 28 (52.83%) were treated by operation and 25 (47.17%) by conservative treatment. CONCLUSIONS: Maxillofacial injuries in infants and preschools exhibit specific epidemiological features. These are related to anatomic, physiologic, and psychologic development in infants and preschools.
Asunto(s)
Traumatismos Maxilofaciales/epidemiología , Accidentes por Caídas/estadística & datos numéricos , Distribución por Edad , Niño , Preescolar , China/epidemiología , Femenino , Humanos , Lactante , Fracturas Maxilomandibulares/epidemiología , Masculino , Traumatismos Maxilofaciales/etiología , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Traumatismos de los Tejidos Blandos/epidemiología , Traumatismos de los Dientes/epidemiologíaRESUMEN
PURPOSE: The purpose of this study was to analyze and evaluate ocular injuries in patients with maxillofacial fractures. Correlation of the ocular injury and patients' age, sex, trauma mechanism, and type of maxillofacial fracture was also investigated. MATERIALS AND METHODS: From January 2000 to December 2009, a total of 1131 patients with facial fractures were registered. The information and data collected and analyzed included the following: age, sex, mechanism of injury, type of facial fracture, type of ocular injury, and the relationship between ocular injury and facial fracture. RESULTS: Ocular injury (349 injuries) was sustained by 209 patients (18.5%), with a male/female ratio of 5.33:1 (176 males and 33 females). The age range of the patients associated with ocular trauma was 3 to 68 years (mean [SD], 32.40 [11.27] y). Patients aged 30 to 39 years showed the highest risk for ocular trauma (odds ratio [OR], 1.852; P < 0.001). Children showed the lowest risk for ocular injuries (OR, 0.162; P < 0.001). Motor vehicle accidents were the most common mechanism of injury (97 patients, 46.4%). Motor vehicle accidents also had a 2.243-fold risk for ocular trauma (OR, 2.243; P = 0.021). Ocular traumas were more prone to occur in patients who sustained midfacial fractures (OR, 10.232; P < 0.001), especially the patients with multiple midfacial fractures (OR, 12.389; P < 0.001). Fracture of the mandible had the lowest risk for ocular injuries (multimandibular fractures: OR, 0.035, P < 0.001; single mandibular fracture: OR, 0.151; P < 0.001). CONCLUSIONS: The occurrence of ocular injuries was significantly related to sex, age, etiology, as well as the pattern and position of the maxillofacial fractures.
Asunto(s)
Lesiones Oculares/epidemiología , Traumatismos Maxilofaciales/epidemiología , Fracturas Craneales/epidemiología , Accidentes por Caídas/estadística & datos numéricos , Accidentes de Tránsito/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Anciano , Niño , Preescolar , China/epidemiología , Femenino , Humanos , Masculino , Fracturas Mandibulares/epidemiología , Fracturas Maxilares/epidemiología , Persona de Mediana Edad , Traumatismo Múltiple/epidemiología , Factores de Riesgo , Factores Sexuales , Adulto Joven , Fracturas Cigomáticas/epidemiologíaRESUMEN
PURPOSE: This study was designed to assess the changes in the etiology, incidence, and pattern of maxillofacial fractures during 2 different study periods in our department. PATIENTS AND METHODS: In this retrospective study, patients treated for maxillofacial fractures at our department from January 2000 to December 2009 were included. Data regarding patient's age, sex, etiology of fracture, time of injury, site of fracture, and pattern of fracture were collected and grouped chronologically into two 5-year periods: 2000 to 2004 (period 1) and 2005 to 2009 (period 2); the results of the study during these periods were analyzed and compared. RESULTS: A total of 1131 patients sustained maxillofacial fractures: 422 in the first period and 709 in the second period. During the second period, the male-female ratio increased from 3.35:1 to 3.63:1. Road traffic accidents remained the major etiologic factor, which increased remarkably from 49.3% to 54.6% (P = 0.085), whereas assault-related injuries decreased significantly from 16.8% to 12.4% (P = 0.039). The proportion of patients with mandibular fractures decreased from 59.6% to 55.3% (P = 0.037), whereas the proportion of patients with midfacial fractures increased from 40.4% to 44.7% (P = 0.037). CONCLUSIONS: The changing pattern of maxillofacial fractures in our center is correlated to the socioeconomic status, population mobility, and etiologic factors. Strict enforcement of traffic laws and regulations is still a focal factor in attaining appreciable reduction in maxillofacial fractures associated with road traffic accidents.
Asunto(s)
Traumatismos Maxilofaciales/epidemiología , Fracturas Craneales/epidemiología , Accidentes de Tránsito/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , China/epidemiología , Femenino , Humanos , Incidencia , Lactante , Masculino , Fracturas Mandibulares/epidemiología , Fracturas Maxilares/epidemiología , Persona de Mediana Edad , Fracturas Orbitales/epidemiología , Dinámica Poblacional/estadística & datos numéricos , Estudios Retrospectivos , Factores Sexuales , Clase Social , Violencia/estadística & datos numéricos , Adulto Joven , Fracturas Cigomáticas/epidemiologíaRESUMEN
OBJECTIVE: The purpose of this study was to evaluate and compare the demographic characteristics of maxillofacial fractures between children and adolescents. METHODS: The sample was composed of all children (less than 12 years) and adolescents (between 13 and 18 years old) who presented with maxillofacial fractures during a 10-year period (2000-2009). The age, gender, time of injury, mechanism of trauma, location and pattern of fracture, associated injuries, and treatment methods were recorded and analyzed. Data analysis included Chi-Square test, Fisher exact test. p less than 0.05 was considered significant. RESULTS: Seventy-nine children (male-to-female ratio, 1.63:1) and 113 adolescents (male-to-female ratio, 3.52:1) sustained 389 maxillofacial fractures. Children were more involved in falls compared to adolescents (44.3% versus 23.9%, p=0.003), while adolescents sustained more assault-related injuries (13.3% versus 2.5%, p=0.010) and motorcycle accidents (22.1% versus 8.9%, p=0.015) compared to children. Children suffered mandibular fractures proportionally higher than adolescents (93.1% versus 64.5%, p<0.001). Adolescents sustained mid-facial fractures more frequently than children (35.5% versus 6.9%, p<0.001). Severe facial fractures occurred more in adolescents compared to children (35.4% versus 14.1%, p=0.001). Open reduction was done more in adolescents than in children (92.3% versus 74.6%, p<0.001). CONCLUSIONS: The incidence and pattern of maxillofacial fractures in children were remarkably different from that in adolescents. Preventive measures and treatment plan should be designed with differences between the two groups in mind.
Asunto(s)
Huesos Faciales/lesiones , Fracturas Mandibulares/epidemiología , Traumatismos Maxilofaciales/epidemiología , Fracturas Craneales/epidemiología , Adolescente , Niño , Estudios de Cohortes , Femenino , Humanos , Incidencia , Masculino , Estudios RetrospectivosRESUMEN
PURPOSE: The purpose of this study was to analyze and evaluate the correlation between dental injuries and the pattern of maxillofacial fractures. The correlation with age, gender, trauma mechanism and type of maxillofacial fracture was also investigated. MATERIALS AND METHODS: From January 2000 to December 2009, 1131 patients with facial fractures were registered. Of these, 473 presented with associated dental trauma. The information and data collected and analyzed included: age, gender, mechanism of injury, type of facial fracture, type of dental injury, and the relationship between dental injury and facial fracture. RESULTS: Dental injury was sustained by 473 patients (41.8%), with a total of 2215 injured teeth. Of the 2215 injured teeth, 1191 (53.8%) were in the maxilla and 1024 (46.2%) in the mandible. Fall from a height had the highest risk of dental injuries (OR = 4.145, P = 0.002). The central incisor was the most injured tooth for both the maxilla (388, 36.2%) and mandible (284, 27.7%). The most common type of dental injury was avulsion (1070, 47.4%). More anterior teeth in the maxilla were of crown fracture, avulsion, and intrusion than that in the mandible, whereas more anterior teeth in the mandible were of subluxation and concussion than that in the maxilla. Dental injuries were more prone to occur in patients who sustained only symphysis fractures (OR = 2.817, P < 0.001), only 0.236-fold risk in patients who sustained only mandible angle fracture (P < 0.001). CONCLUSIONS: The occurrence of dental trauma is significantly related to the pattern and position of the maxillofacial fractures.