殴打による顎顔面骨骨折の様相
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Clarifying the features of maxillofacial fractures from a particular cause is very important not only from the therapeutical point of view but also from the aspect of prevention of such fractures; however, no detailed clinical, radiographical or statistical information, except fragmentary, on the maxillofacial fractures from assault and battery seems to be available. Hence we attempted to characterize maxillofacial fractures resulting from assault and battery by clinical, radiographical and statistical observations of 130 such patients with maxillofacial fractures at the oral surgery clinic of the Ryukyu University Hospital during a ten year period from January, 1978 to December, 1987.<BR>In 22.1% of all the 130 cases investigated, the fractures had resulted from assault and battery with the number of such patients showing a slight increase in recent years. The ratio of males to females was five times greater for males. For both sexes, those in their twenties most frequently sustained such injuries. The greatest number of patients had been injured by fist blows to the maxillofacial regions sustained in street fights after drinking alcohol late at night, occurring slightly more frequently in summer.<BR>About one third of the patients were referred to the Ryukyu University Hospital from private dental clinics.<BR>Fractures of the mandible showed a very high rate of occurrence and were seen in 123 cases or 94.6% of all the maxillofacial fractures. Fracture of the maxilla occurred in 3 cases (2.3%) and fracture of the zygomatic in 15 cases (11.5%).<BR>In the mandible, 42% of the fractures (most usual) were seen in the molar and angle area. However, very few fractures were related to the first and second molar. The fracture in the molar and angle area occurred very often in conjunction with the third molar and impaction of the third molar greatly increased the risk of fracture of the mandide. It is suggested that prior extraction of an impacted third molar would reduce the number of maxillofacial fractures sustained in cases of assault and battery.<BR>A total of 264 complications were observed: facial hypaesthesia, 46 cases (17.5%); injury of oral mucosa, 46 cases (16. 4%); fracture of tooth, 38 cases (14. 4%); unconciousness, 33 cases (12.6%); injury of facial skin, 28 cases (10.6%); infection, 11 cases (4.2%); injury of skin or fracture other than facial, 7 cases (2.7%) and 5 cases (1.9%), respectively; and other miscellaneous symptoms, 52 cases (19.7%).
- 社団法人 日本口腔外科学会の論文
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