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題名 | The Internal Fixation in Maxillofacial Bone Fractures--A Clinical Analysis=內固定器應用於顏面骨折之臨床分析 |
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作者姓名(中文) | 陳子瑾; 葉發來; 林進德; 馬旭; 黃志宏; 方榮煌; | 書刊名 | 中華民國重建整形外科醫學會雜誌 |
卷期 | 8:3 1999.09[民88.09] |
頁次 | 頁173-183 |
分類號 | 416.26 |
關鍵詞 | 內固定器; 顏面骨折; Maxillofacial fracture; Internal fixation; |
語文 | 英文(English) |
中文摘要 | 我們回顧且分析由民國76年1月至85年12月,在臺北榮民總醫院因顏面骨折而進行的內固定手術。 對於因顏面骨折而於創傷發生14天之內接受wire或miniplate內固定手術的病人,追蹤一年之久。將這些骨折依手術部位區分為上、中、下部位,來分析骨折發生的原因、頻率、年齡、性別及比較此兩種內固定器手術的效果。 接受內固定器手術的有296個病人,共327個手術:上部位17個,中間部位206個,下部位104個。男性與女性比例為4.4比1。年齡分佈在14歲至84歲之間,平均年齡35.5歲。創傷最常見於20至29歲,佔所有病人的32.1%,與其他論文同。此外,男性另有60歲至69歲的高峰,可能與醫院特性有關。最常見的創傷原因為車禍(佔所有創傷病患的82.8%),其次是墜落意外(佔9.4%)及暴力事件(佔7.8%)。在接受手術的病患中,以中間部份為最多,佔63%。就整體併發症發生率言,miniplate有11.4%;而wire是3.6%。手術的併發症有:感染(佔3.7%)、臉部變形(佔2.4%)、顳額關節活動失調(佔1.5%)及眼瞼外翻(佔1.2%)。有3個病患發生miniplate暴露(佔1.1%)。用wire或miniplate進行內固定手術所發生的併發症並沒有明顯的差異性(p=0.089)。以miniplate用於下部位的內固定手術所產生的感染(p=0.0047)及咬合不正(p=0.0007)併發症機會遠比上部位及中部位還大。目前仍須進一步研究改善併發症的方法。 |
英文摘要 | We review the internal fixation in maxillofacial fractures over he past 10 year period from 1987 Jan. to 1996 Dec. in Veterancs General Hospital-Tiapei, Taiwan, R.O.C. Patients who presented with maxillofacial fractures received titanium miniplate or wire internal fixation treatment within 14 days of injury and were followed for one year. The fractures were divided into superior, middle and inferior portions for evaluations of causes, frequency, age, sex, and the difference between miniplate and wire internal fixation. There were 296 patients who received miniplate or wire internal fixation management. A total of 327 operations were performed: superior portion 17, middle portion 206 and inferior portion 104. The male to female ratio was 4.4:1. The age was ranged from 14 to 84 years with the mean of 35.5. The highest incidence of trauma was in the 20-29 year age group (32.1% of all patients), similar to other reports. In addition, there was another peak incidence in the 60-69 year age group of males (15.4%). The most common cause of fracture was traffic accident (82.8%), which was followed by falling down accident (9.4%) and assault (7.8%). Of all operative patients, the middle portion was the most common fracture site (63%). The overall complication rate was 11.4% for miniplate and 3.6% for wire. The complications of operation were infection (3.7%), facial deformity (2.4%), malocclusion (2.4%), temporomandibular joint dysfunction (1.5%), and ectropion (1.2%). Miniplate exposure was noted in 3 cases (1.1% of miniplate patients). There was no difference in complication rate between miniplate and wire fixations (p=0.089). Using miniplate for internal fixation, there were significant infection (p=0.0047) and malocclusion (p=0.007) rates in the inferior portion, compared to the middle and superior portions. Further investigation is required for improvement of complications. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。