Causes and effects of zygomatico-orbital and zygomatico-maxillo-orbital fractures managed by open reduction and rigid internal fixation.

Hubert Dziadek, Tadeusz Cieślik
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Abstract

Progressive violence, the quickening pace of life and transport facilities' development have as a consequence an increased number of traumas. Midface fractures involving zygomatic bone fractures take one of the leading positions in the total number of traumas. It seems appropriate to study the causes and the effects of zygomatico-orbital and zygomatico-maxillo-orbital fractures managed by open reduction and rigid internal fixation at the present time of the medical service being reformed and economic rules being included in the treatment. The analysis of the economic consequences of midface traumas and their causes as well as the search for the influence of social and cultural changes on fracture management was the aim of the study. Histories of 61 injured patients treated by open reduction and rigid internal fixation in 1st Department of Maxillofacial Surgery of the Silesian Medical University in Zabrze between 1996 and 2001 were studied. Patients' sex, the most frequent trauma causes and their disposition in different age groups were taken into consideration. It was observed that certain symptoms of the fracture tend to coexist with high energy traumas (traffic accidents, violent assaults). The influence of injury's extension on the prolongation of hospitalization time was emphasized. It was concluded that assaults and traffic accidents are the most frequent and devastating causes of zygomatico-orbital and zygomatico-maxillo-orbital fractures. The fractures usually involve men aged from 21 to 40 years. The rapid growth of violence and the pace of life have in recent times necessitated the general use of advanced and expensive operating techniques in injured patients recently. The break in social and professional activity of injured individuals and the scale of the problem indicate the necessity of change in medical service financing.

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切开复位和刚性内固定治疗颧-眶和颧-上眶骨折的原因和效果。
暴力的加剧、生活节奏的加快和交通设施的发展导致创伤的数量增加。面中骨折合并颧骨骨折在创伤总数中占主导地位。在医疗体制改革和经济规则纳入治疗的今天,研究开放性复位和刚性内固定治疗颧眶骨折和颧上眶骨折的原因和效果似乎是合适的。本研究的目的是分析中面部创伤的经济后果及其原因,以及探讨社会和文化变化对骨折处理的影响。对1996年至2001年在扎布热西里西亚医科大学颌面外科一科接受切开复位和刚性内固定治疗的61例受伤患者的病史进行了研究。考虑了患者的性别、最常见的创伤原因和不同年龄组的倾向。据观察,骨折的某些症状往往与高能量创伤(交通事故、暴力袭击)并存。强调了损伤延长对住院时间延长的影响。结果表明,袭击和交通事故是造成颧-眶骨折和颧-上颌骨-眶骨折最常见和最具破坏性的原因。骨折通常发生在21至40岁的男性身上。近年来,暴力事件的迅速增加和生活节奏的加快,使得对受伤病人普遍使用先进而昂贵的手术技术成为必要。受伤个人的社会和职业活动中断以及问题的规模表明了医疗服务融资改革的必要性。
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