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Matrixmidface Preformed Orbital Implants for Three-Dimensional Reconstruction of Orbital Floor and Medial Wall Fractures: A Prospective Clinical Study. Matrixmidface 预成型眼眶植入物用于眼眶底部和内侧壁骨折的三维重建:前瞻性临床研究
IF 0.9 Pub Date : 2024-06-01 Epub Date: 2023-04-20 DOI: 10.1177/19433875231171749
Neha Umakant Chodankar, Vikas Dhupar, Francis Akkara, Vathsalya Vijay

Study design: Prospective Interventional study.

Objective: To evaluate the efficiency of Matrixmidface preformed Orbital plates for three-dimensional reconstruction of orbital floor and medial wall fractures.

Methods: This prospective institutional clinical study was conducted on a group of 14 patients who underwent repair of orbital floor and medial wall fracture defects using Matrixmidface Preformed Orbital plates and open reduction and internal fixation of associated fractures. The following parameters were studied preoperative and postoperative enophthalmos, hypoglobus, orbital volume; correction of diplopia, intraoperative and postoperative complications.

Results: All 14 patients were males aged between 19 and 42 years. The most common mode of injury was found to be road traffic accidents (RTAs) followed by self-fall and trauma at workplace. Orbital fractures were associated with other concomitant maxillofacial fractures in 12 patients (85.7%) while 2 patients (14.3%) had pure blowout fractures. Significant improvement of enophthalmos was noted from preoperative period to 1 week, 6 weeks, and 6 months postoperatively (P value .02, .01, and .01, respectively). Out of 11 patients with preoperative hypoglobus, 5 patients (45.45%) had persistent hypoglobus in the immediate postoperative period which reduced to 4 patients (36.36%) at 6 weeks postoperatively (p value .00). The postoperative orbital volume of fractured side ranged from 20.3 cm3 to 26.76 cm3 with a mean of 23.50 cm3 ± 1.74. The mean difference between the volumes of the repaired and uninjured sides was found to be .27 cm3 ± .39 (P value .02) denoting that the reconstruction of the orbit closely approximated that of the uninjured side.

Conclusions: The Matrixmidface Preformed Orbital plate provides exceptional reconstruction of the orbital blowout fracture defects and ensures satisfactory results clinically and radiographically. The plate ensures an approximate recreation of topographical anatomy of the orbit and adequately restores the orbital volume. It provides adequate correction of asymmetry, hypoglobus, enophthalmos and attempts to restore eye movements, without causing any significant postoperative complication.

研究设计前瞻性介入研究:评估 Matrixmidface 预成型眶板用于眶底和内侧壁骨折三维重建的效率:这项前瞻性机构临床研究的对象是14名使用Matrixmidface预成型眶板修复眶底和内侧壁骨折缺损,并对相关骨折进行切开复位和内固定的患者。对以下参数进行了研究:术前和术后眼球突出、眼睑下垂、眼眶体积、复视矫正、术中和术后并发症:14 名患者均为男性,年龄在 19 至 42 岁之间。最常见的受伤方式是道路交通事故,其次是自摔和工伤。12名患者(85.7%)的眼眶骨折同时伴有其他颌面部骨折,2名患者(14.3%)为单纯的爆裂性骨折。从术前到术后 1 周、6 周和 6 个月,眼球震颤均有明显改善(P 值分别为 0.02、0.01 和 0.01)。在术前眼球突出的 11 位患者中,有 5 位患者(45.45%)在术后即刻出现持续性眼球突出,而在术后 6 周时减少到 4 位患者(36.36%)(P 值为 0.00)。骨折侧的术后眼眶体积从 20.3 cm3 到 26.76 cm3 不等,平均为 23.50 cm3 ± 1.74。修复侧和未受伤侧的平均体积差为 0.27 cm3 ± 0.39(P 值 0.02),这表明眼眶的重建与未受伤侧的重建非常接近:Matrixmidface 预成型眼眶钢板可为眼眶井喷骨折缺损提供出色的重建效果,并确保在临床和影像学上获得令人满意的结果。该钢板可确保近似再现眼眶的地形解剖结构,并充分恢复眼眶容积。它能充分矫正不对称、眼球过小、眼球凹陷,并尝试恢复眼球运动,而不会引起任何明显的术后并发症。
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引用次数: 0
Objective Photoanalysis of Feminizing Frontal Cranioplasty Outcomes. 女性化额颅成形术效果的客观照片分析。
IF 0.9 Pub Date : 2024-06-01 Epub Date: 2023-02-11 DOI: 10.1177/19433875221143609
Abel P David, Adrian E House, Sonia Targ, W Taylor DeBusk, Andrea Park, P Daniel Knott, Rahul Seth

Study design: Retrospective analysis at a tertiary care center.

Objective: This study describes a method of analyzing postoperative results using lateral view clinical photographs to create normalized projection ratios of the glabella and radix.

Methods: We reviewed preoperative and postoperative photographs of 15 patients. All photographs were in the lateral view Frankfort horizontal plane. We calculated the distances between the (a) tragus and cornea, (b) cornea and radix, (c) cornea and glabella, and the (θ) nasofrontal angle.

Results: Fifteen sets of patient photographs were analyzed and found that there was a favorable 14% reduction at the radix and an even greater reduction (78.9%) at the glabella. The nasofrontal angle was improved to a more feminine range from 131.84° preoperatively to 145.86° postoperatively.

Conclusions: Normalized projection ratios of the glabella and radix, along with the nasofrontal angle, can be used to objectively measure outcomes of frontal feminizing cranioplasty.

研究设计在一家三级医疗中心进行的回顾性分析:本研究描述了一种使用侧视临床照片分析术后结果的方法,该方法可创建正常化的睑板和桡骨投影比:我们查看了 15 名患者的术前和术后照片。所有照片均为法兰克福水平面侧视图。我们计算了(a)外耳道和角膜之间的距离、(b)角膜和桡骨之间的距离、(c)角膜和睑板之间的距离以及(θ)鼻额角之间的距离:对 15 组患者照片进行分析后发现,角膜弧度缩小了 14%,角膜唇部的缩小幅度更大(78.9%)。鼻额角从术前的131.84°改善到术后的145.86°,更加女性化:结论:颅盖和桡骨的归一化投影比以及鼻额角可用于客观衡量额部女性化头颅成形术的效果。
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引用次数: 0
Appropriate Use of Preoperative Imaging in Feminization Cranioplasty. 在女性化颅骨成形术中适当使用术前成像。
IF 0.9 Pub Date : 2024-06-01 Epub Date: 2023-05-12 DOI: 10.1177/19433875231175703
Sabrina Brody-Camp, Jennifer Shehan, Rohith Kariveda, Jeffrey Spiegel

Study design: Retrospective chart review.

Objective: The objective of this study was to determine if proceeding with feminization frontal cranioplasty without preoperative imaging adversely affected patient outcomes.

Methods: This study retrospectively reviewed all patients undergoing frontal cranioplasty for facial feminization at a single tertiary care center between 2013 and 2019. All procedures were performed by a single surgeon (JS), who operated at multiple sites. The site selected is where the majority of these procedures were performed during this time. Type of cranioplasty (I vs III) was recorded. Primary outcomes included postoperative cerebrospinal fluid (CSF) leak, entering the cranium, or dural exposure or injury.

Results: 422 subjects underwent cranioplasty for facial feminization between 2013 and 2019. No preoperative imaging was performed. Zero patients had CSF leak. 334 subjects (79%) had type III cranioplasty, while the remaining 88 subjects (21%) had type I cranioplasty. No subjects had documented episodes of dural injury, or postoperative brain or cranial concerns.

Conclusions: This study demonstrates that frontal cranioplasty for facial feminization does not require routine preoperative imaging. The authors recommend preoperative imaging for patients with a history of congenital cranial abnormality, prior significant head trauma affecting the frontal bone, and in some cases where the patient has had prior surgery or a history of sinus disease or extensive polyposis. Routine preoperative computed tomography is therefore not indicated for patients undergoing feminizing cranioplasty.

研究设计回顾性病历审查:本研究的目的是确定在没有术前成像的情况下进行女性化额颅成形术是否会对患者的预后产生不利影响:本研究回顾性分析了2013年至2019年间在一家三级医疗中心接受额颅成形术进行面部女性化手术的所有患者。所有手术均由一名外科医生(JS)在多个地点进行。所选地点是在此期间进行这些手术的大部分地点。记录了颅骨成形术的类型(I vs III)。主要结果包括术后脑脊液(CSF)漏、进入颅内、硬脑膜暴露或损伤:2013年至2019年期间,422名受试者因面部女性化接受了颅骨成形术。术前未进行影像学检查。零名患者出现 CSF 渗漏。334名受试者(79%)接受了III型开颅整形术,其余88名受试者(21%)接受了I型开颅整形术。没有受试者出现硬脑膜损伤、术后脑部或颅骨问题:这项研究表明,额颅成形术治疗面部女性化并不需要常规的术前成像。作者建议,对于有先天性颅骨畸形病史、曾有影响额骨的重大头部创伤的患者,以及一些曾做过手术或有鼻窦疾病或广泛息肉病史的患者,应进行术前造影。因此,常规术前计算机断层扫描不适用于接受女性化颅成形术的患者。
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引用次数: 0
Trends in Maxillomandibular Fixation Technique at a Single Academic Institution. 一家学术机构的上下颌骨固定技术趋势。
IF 0.9 Pub Date : 2024-06-01 Epub Date: 2023-05-13 DOI: 10.1177/19433875231176339
Heather Schopper, Natalie A Krane, Kevin J Sykes, Katherine Yu, J David Kriet, Clinton D Humphrey

Study design: Retrospective chart review.

Objective: Restoration of premorbid occlusion is a key goal in the treatment of mandibular fractures. Placement of the patient in maxillomandibular fixation (MMF) is performed during mandibular fracture repair to help establish occlusion. A number of techniques are available to achieve MMF. We sought to examine trends in MMF technique at our institution.

Methods: A retrospective chart review was conducted to evaluate patients who underwent surgical treatment of mandibular fractures between January 1, 2011 and March 31, 2021. Data including fracture characteristics, mechanism of injury, patient demographics, complication rates, and MMF technique utilized were collected.

Results: One hundred sixty-three patients underwent MMF (132 males). The most common etiology of fracture was assault (34%). There was an increasing preference for rapid MMF techniques over time, as opposed to standard Erich arch bars. No significant difference in obtaining adequate fracture reduction as determined by postoperative imaging or complications were noted between those who underwent MMF with newer rapid techniques vs traditional MMF techniques.

Conclusions: Our institution has demonstrated changing trends in the technique utilized for establishing occlusion intraoperatively, more recently favoring rapid MMF techniques, with similar rates of complications and ability to adequately reduce fractures.

研究设计回顾性病历审查:恢复骨折前的咬合是下颌骨骨折治疗的关键目标。在下颌骨骨折修复过程中,对患者进行上下颌骨固定术(MMF)有助于建立咬合。目前有多种技术可用于实现上下颌骨固定。我们试图研究本机构 MMF 技术的发展趋势:我们对 2011 年 1 月 1 日至 2021 年 3 月 31 日期间接受下颌骨骨折手术治疗的患者进行了回顾性病历审查。收集的数据包括骨折特征、损伤机制、患者人口统计学特征、并发症发生率以及所使用的 MMF 技术:结果:163 名患者(132 名男性)接受了 MMF 治疗。最常见的骨折病因是袭击(34%)。随着时间的推移,人们越来越倾向于使用快速 MMF 技术,而不是标准的埃里希弓形棒。根据术后影像学或并发症的判断,采用新型快速MMF技术与传统MMF技术的患者在获得充分的骨折复位方面没有明显差异:我院在术中建立闭塞的技术方面呈现出不断变化的趋势,最近更倾向于使用快速 MMF 技术,但并发症发生率和充分缩小骨折的能力相似。
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引用次数: 0
A Review of 13,470 Head and Neck Injuries from Trampoline Jumping. 对 13,470 例因蹦床跳跃造成的头颈部损伤进行回顾。
IF 0.9 Pub Date : 2024-06-01 Epub Date: 2022-09-15 DOI: 10.1177/19433875221125644
Dani Stanbouly, Rami Stanbouly, Michael Baron, Firat Selvi, Raymond Wong Chung Wen, Sung-Kiang Chuang

Study design: The authors designed a 20-year cross-sectional study using the National Electronic Injury Surveillance System (NEISS) database.

Objective: The purpose of the study is to determine the risk factors for hospital admission among individuals who suffer head and neck injuries secondary to trampoline use.

Methods: The primary predictor variables were a set of heterogenous variables that were categorized into the forementioned study variable groups (patient characteristics and injury characteristics). The primary outcome variable was hospital admission. Multivariate logistic regression was used to determine independent risk factors for hospital admission.

Results: The final sample consisted of 13,474 reports of trampoline injuries to the head and neck. Relative to females, males (OR 1.66, P < .05) were at an increased risk for hospital admissions. Fractures (OR 35.23, P < .05) increased the risk for hospital admissions relative to dental injuries. Concerning anatomical region of injury, neck injuries (OR 30.53, P < .05) were at an increased risk for hospital admissions.

Conclusions: Injuries to the neck from trampoline jumping significantly increased the risk for admission. The severity of neck injuries from trampoline jumping is well established in the literature. Additionally, male sex and fractures were each risk factors for hospital admission. Given the rising prevalence of trampoline-related head and neck injuries over the past 2 decades, it is crucial for individuals to take the necessary precautions when jumping on a trampoline.

研究设计:作者利用国家电子伤害监测系统(NEISS)数据库设计了一项为期 20 年的横断面研究:研究目的:确定因使用蹦床而导致头颈部受伤者入院治疗的风险因素:主要预测变量是一组异质变量,这些变量被归类为上述研究变量组(患者特征和损伤特征)。主要结果变量是入院情况。多变量逻辑回归用于确定入院的独立风险因素:最终样本包括 13,474 份蹦床头部和颈部损伤报告。与女性相比,男性入院风险更高(OR 1.66,P < .05)。骨折(OR 35.23,P < .05)相对于牙齿损伤增加了入院风险。就受伤部位而言,颈部受伤(OR 30.53,P < .05)的入院风险更高:结论:蹦床跳跃造成的颈部损伤会显著增加入院风险。蹦床跳跃造成的颈部损伤的严重程度已在文献中得到证实。此外,男性和骨折也是入院的风险因素。鉴于过去二十年中与蹦床相关的头部和颈部损伤的发生率不断上升,因此个人在跳蹦床时采取必要的预防措施至关重要。
{"title":"A Review of 13,470 Head and Neck Injuries from Trampoline Jumping.","authors":"Dani Stanbouly, Rami Stanbouly, Michael Baron, Firat Selvi, Raymond Wong Chung Wen, Sung-Kiang Chuang","doi":"10.1177/19433875221125644","DOIUrl":"10.1177/19433875221125644","url":null,"abstract":"<p><strong>Study design: </strong>The authors designed a 20-year cross-sectional study using the National Electronic Injury Surveillance System (NEISS) database.</p><p><strong>Objective: </strong>The purpose of the study is to determine the risk factors for hospital admission among individuals who suffer head and neck injuries secondary to trampoline use.</p><p><strong>Methods: </strong>The primary predictor variables were a set of heterogenous variables that were categorized into the forementioned study variable groups (patient characteristics and injury characteristics). The primary outcome variable was hospital admission. Multivariate logistic regression was used to determine independent risk factors for hospital admission.</p><p><strong>Results: </strong>The final sample consisted of 13,474 reports of trampoline injuries to the head and neck. Relative to females, males (OR 1.66, <i>P</i> < .05) were at an increased risk for hospital admissions. Fractures (OR 35.23, <i>P</i> < .05) increased the risk for hospital admissions relative to dental injuries. Concerning anatomical region of injury, neck injuries (OR 30.53, <i>P</i> < .05) were at an increased risk for hospital admissions.</p><p><strong>Conclusions: </strong>Injuries to the neck from trampoline jumping significantly increased the risk for admission. The severity of neck injuries from trampoline jumping is well established in the literature. Additionally, male sex and fractures were each risk factors for hospital admission. Given the rising prevalence of trampoline-related head and neck injuries over the past 2 decades, it is crucial for individuals to take the necessary precautions when jumping on a trampoline.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79899602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Corrigendum to "A Review of 13470 Head and Neck Injuries From Trampoline Jumping". 蹦床跳跃造成的 13470 例头颈部损伤回顾 "的更正。
IF 0.9 Pub Date : 2024-06-01 Epub Date: 2023-05-17 DOI: 10.1177/19433875231173469

[This corrects the article DOI: 10.1177/19433875221125644.].

[This corrects the article DOI: 10.1177/19433875221125644.].
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引用次数: 0
Does Alcohol Use Influence Hospitalization Outcomes in Adults Suffering Craniomaxillofacial Fractures From Street Fighting? 饮酒是否会影响因街头斗殴造成颅颌面骨折的成人的住院治疗结果?
IF 0.9 Pub Date : 2024-06-01 Epub Date: 2023-06-02 DOI: 10.1177/19433875231164705
Dani Stanbouly, Sara J Stewart, Jack A Harris, Kevin Arce

Study design: This retrospective cohort study utilized the National Inpatient Sample (NIS) database for the years 2016-2018. Incidences of street fighting were identified using the corresponding ICD-10 codes.

Objective: To determine whether alcohol use (measured by blood alcohol content (BAC)) in patients sustaining maxillofacial trauma from hand-to-hand fighting influence hospitalization outcomes.

Methods: The primary predictor variable was BAC stratified into six categories of increasing magnitude. The primary outcome variable was mean length of hospital stay (days). The secondary outcome variable was total hospital charges (US dollars).

Results: Our final sample consisted of 3038 craniomaxillofacial fractures. Each additional year in age added +$545 in hospital charges (P < .01). Non-elective admissions added $14 210 in hospital charges (P < .05). Patients admitted in 2018 experienced approximately $7537 more in hospital charges (P < .01). Le Fort fractures (+$61 921; P < .01), mandible fractures (+$13 227, P < .01), and skull base fractures (+$22 170; P < .05) were all independently associated with increased hospital charges. Skull base fractures added +7.6 days to the hospital stay (P < .01) and each additional year in patient age added +.1 days to the length of the hospital stay (P < .01).

Conclusions: BAC levels did not increase length of stay or hospitalization charges. Le Fort fractures, mandible fractures, and skull base fracture each independently increased hospital charges. This reflects the necessary care (ie, ICU) and treatment (ie, ORIF) of such fractures. Older adults and elderly patients are associated with increased length of stay and hospital charges-they are likely to struggle in navigating the healthcare system and face socioeconomic barriers to discharge.

研究设计:这项回顾性队列研究利用了2016-2018年全国住院病人抽样(NIS)数据库。使用相应的 ICD-10 编码识别街头斗殴事件:目的:确定因徒手搏斗造成颌面部创伤的患者饮酒(以血液酒精含量(BAC)衡量)是否会影响住院结果:方法:主要预测变量为 BAC,按程度的递增分为六类。主要结果变量是平均住院时间(天数)。次要结果变量是住院总费用(美元):我们的最终样本包括 3038 例颅颌面骨折。年龄每增加一岁,住院费用就会增加 545 美元(P < .01)。非选择性入院增加了14 210美元的住院费用(P < .05)。2018年入院的患者住院费用增加约7537美元(P < .01)。勒堡骨折(+61 921美元;P < .01)、下颌骨骨折(+13 227美元,P < .01)和颅底骨折(+22 170美元;P < .05)均与住院费用增加独立相关。颅底骨折使住院时间增加7.6天(P < .01),患者年龄每增加一岁,住院时间增加1.1天(P < .01):BAC水平不会增加住院时间或住院费用。勒堡骨折、下颌骨骨折和颅底骨折均会增加住院费用。这反映了此类骨折所需的护理(即 ICU)和治疗(即 ORIF)。老年人和老年患者的住院时间和住院费用都会增加--他们很可能难以驾驭医疗系统,并在出院时面临社会经济障碍。
{"title":"Does Alcohol Use Influence Hospitalization Outcomes in Adults Suffering Craniomaxillofacial Fractures From Street Fighting?","authors":"Dani Stanbouly, Sara J Stewart, Jack A Harris, Kevin Arce","doi":"10.1177/19433875231164705","DOIUrl":"10.1177/19433875231164705","url":null,"abstract":"<p><strong>Study design: </strong>This retrospective cohort study utilized the National Inpatient Sample (NIS) database for the years 2016-2018. Incidences of street fighting were identified using the corresponding ICD-10 codes.</p><p><strong>Objective: </strong>To determine whether alcohol use (measured by blood alcohol content (BAC)) in patients sustaining maxillofacial trauma from hand-to-hand fighting influence hospitalization outcomes.</p><p><strong>Methods: </strong>The primary predictor variable was BAC stratified into six categories of increasing magnitude. The primary outcome variable was mean length of hospital stay (days). The secondary outcome variable was total hospital charges (US dollars).</p><p><strong>Results: </strong>Our final sample consisted of 3038 craniomaxillofacial fractures. Each additional year in age added +$545 in hospital charges (<i>P</i> < .01). Non-elective admissions added $14 210 in hospital charges (<i>P</i> < .05). Patients admitted in 2018 experienced approximately $7537 more in hospital charges (<i>P</i> < .01). Le Fort fractures (+$61 921; <i>P</i> < .01), mandible fractures (+$13 227, <i>P</i> < .01), and skull base fractures (+$22 170; <i>P</i> < .05) were all independently associated with increased hospital charges. Skull base fractures added +7.6 days to the hospital stay (<i>P</i> < .01) and each additional year in patient age added +.1 days to the length of the hospital stay (<i>P</i> < .01).</p><p><strong>Conclusions: </strong>BAC levels did not increase length of stay or hospitalization charges. Le Fort fractures, mandible fractures, and skull base fracture each independently increased hospital charges. This reflects the necessary care (ie, ICU) and treatment (ie, ORIF) of such fractures. Older adults and elderly patients are associated with increased length of stay and hospital charges-they are likely to struggle in navigating the healthcare system and face socioeconomic barriers to discharge.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77874823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Corrigendum to "The Impact of Payment Reform on Pediatric Craniofacial Fracture Care in Maryland". 付款改革对马里兰州小儿颅面骨折护理的影响 "的更正。
IF 0.9 Pub Date : 2024-06-01 Epub Date: 2023-07-19 DOI: 10.1177/19433875231189076

[This corrects the article DOI: 10.1177/1943387520983634.].

[此处更正了文章 DOI:10.1177/1943387520983634]。
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引用次数: 0
Evaluation of Different Patterns of Zygomaticoorbital Complex Fractures. 评估颧骨眶骨复合体骨折的不同模式
IF 0.9 Pub Date : 2024-06-01 Epub Date: 2023-03-25 DOI: 10.1177/19433875231161906
Andreas Sakkas, Christel Weiß, Sebastian Pietzka, Frank Wilde, Oliver Christian Thiele, Robert Andreas Mischkowski

Study design: Very few studies exist regarding the fracture pattern variability of the zygomaticoorbital (ZMO) complex. The retrospective evaluation of a large series of surgically treated unilateral ZMO fractures would in certain circumstances help intraoperative predictability and define sensitive indicators for open reduction and internal fixation.

Objective: The aim of this study was to investigate the different fracture patterns after ZMO complex injury regarding the 5 anatomic sutures of the zygoma as well as the concomitance of the paranasal buttress and maxillary sinus wall fracture.

Methods: The medical records of all patients with unilateral ZMO fractures who underwent surgical intervention in a single trauma center department between April 2015 and June 2020 were retrospectively reviewed. Demographic and anamnesis data, radiologic findings, and surgical reports were evaluated. According to the preoperative radiologic evaluation, ZMO fractures were classified as unisutural, bisutural, trisutural, tetrasutural, and complete based on the number of zygomatic sutures. The prevalence of various fracture patterns was analyzed. The impact of patient's age and trauma etiology on the fracture pattern was evaluated using descriptive statistical analysis.

Results: The study included 492 patients with unilateral ZMO fractures, with a mean age of 49.93 years (SD = 20.66) and a male:female ratio of 2.23:1. The most affected age group was 19-44 years (41.67%) and tripping falls were the most common etiology (27.24%). Trisutural (57.32%) and unisutural fractures (23.17%) were the most common, followed by tetrasutural (8.94%), bisutural (8.54%), and complete fractures (2.03%). A trisutural fracture involving the zygomaticomaxillary suture, the infraorbital rim, and the zygomaticosphenoidal suture was the most common fracture pattern (52.03%). Most fractures were observed in the zygomaticosphenoidal suture (86.99%), followed by the infraorbital rim (74.59%) and the zygomaticomaxillary suture (68.29%). Fractures of the maxillary sinus wall and the paranasal buttress co-existed in 9.55% and 31.30% of all cases, respectively. No correlation was detected between age and fracture pattern (P = .4111). Tripping falls and bicycle accidents significantly influenced the fracture pattern (P < .0001).

Conclusions: According to the results, knowledge of the fracture pattern variability of the ZMO complex could in certain circumstances designate CT or CBCT as mandatory before operating on ZMO fractures. Consequently, unnecessary incisions could be avoided. The high concomitance of paranasal buttress fracture also suggests its intraoperative surgical exploration. Further studies should correlate the clinical findings with indication for surgery and postoperative outcome for the different fracture patterns described.

研究设计:有关颧骨-眶骨(ZMO)复合体骨折形态变化的研究很少。在某些情况下,对大量经手术治疗的单侧 ZMO 骨折进行回顾性评估将有助于术中预测,并确定开放复位和内固定的敏感指标:本研究旨在探讨ZMO复合体损伤后,颧骨5条解剖缝以及副鼻托和上颌窦壁骨折的不同骨折模式:回顾性分析2015年4月至2020年6月期间在一家创伤中心接受手术治疗的所有单侧ZMO骨折患者的病历。对患者的人口统计学和病史资料、放射学检查结果以及手术报告进行了评估。根据术前的影像学评估,ZMO骨折根据颧骨缝的数量分为单utural、双utural、三utural、四utural和完全性骨折。对各种骨折形态的发生率进行了分析。使用描述性统计分析评估了患者年龄和创伤病因对骨折模式的影响:研究共纳入 492 例单侧 ZMO 骨折患者,平均年龄为 49.93 岁(SD = 20.66),男女比例为 2.23:1。受影响最大的年龄组为 19-44 岁(41.67%),绊倒是最常见的病因(27.24%)。最常见的是三桡骨骨折(57.32%)和单桡骨骨折(23.17%),其次是四桡骨骨折(8.94%)、双桡骨骨折(8.54%)和完全骨折(2.03%)。涉及颧颌缝、眶下缘和颧蝶骨缝的三utural骨折是最常见的骨折形态(52.03%)。大多数骨折发生在颧骨蝶骨缝(86.99%),其次是眶下缘(74.59%)和颧颌缝(68.29%)。在所有病例中,上颌窦壁和副鼻托同时骨折的比例分别为9.55%和31.30%。年龄与骨折形态之间没有相关性(P = .4111)。绊倒摔伤和自行车事故对骨折模式有明显影响(P < .0001):根据研究结果,在某些情况下,了解 ZMO 复合体骨折形态的可变性可将 CT 或 CBCT 作为 ZMO 骨折手术前的必备条件。因此,可以避免不必要的切口。鼻旁骨折的高并发性也提示术中应进行手术探查。进一步的研究应将临床发现与手术指征和术后结果相关联,以了解所述不同骨折形态的手术指征和术后结果。
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引用次数: 0
Delayed Presentation of Actinomycosis Following Orthognathic Surgery: An Old Nemesis and a Difficult Diagnosis: Case Presentation and Review of the Literature. 正颌外科手术后延迟出现的放线菌病:古老的克星和困难的诊断:病例展示与文献综述。
IF 0.9 Pub Date : 2024-03-01 Epub Date: 2023-02-08 DOI: 10.1177/19433875231155986
Alexander J Krisko, Joseph E Van Sickels

Study design: Review of the literature with report of Case.

Objective: To review the presentation of Actinomycosis specifically as it occurs with mandibular osteotomies.

Methods: A review of the literature and report of an additional case.

Results: While minor infections secondary to local factors are usually seen 2-3 weeks after surgery, late infections are rare. Host factors may play a role. When actinomycosis is diagnosed, long-term antibiotics are necessary.

Conclusions: Actinomycosis is very rare following orthognathic surgery. It usually occurs in the mandible and following a sagittal split. Time of presentation for actinomycosis can vary from 6 weeks to 4 months as in our case. Infections occurring this late after surgery should be treated with suspicion of actinomycosis obtaining both cultures and tissue biopsies. Treatment involves an incision and drainage and long-term antibiotics.

研究设计回顾文献并报告病例:回顾放线菌病的表现形式,特别是下颌骨截骨术时的表现形式:方法:回顾文献并报告一例新增病例:结果:由于局部因素引起的轻微感染通常发生在术后 2-3 周,而晚期感染则很少见。宿主因素可能起一定作用。一旦确诊为放线菌病,必须长期使用抗生素:放线菌病在正颌手术后非常罕见。结论:正颌手术后放线菌病非常罕见,通常发生在下颌骨和矢状劈开术后。像我们的病例一样,放线菌病的发病时间从 6 周到 4 个月不等。术后这么晚发生感染,应怀疑是放线菌病,并进行培养和组织活检。治疗包括切开引流和长期抗生素治疗。
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引用次数: 0
期刊
Craniomaxillofacial Trauma & Reconstruction
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