顔面骨骨折104例の臨床統計的検討

抄録

One hundred and four cases (79 males and 25 females) with facial bone fractures treated at Himeji Medical Center between June 2000 and May 2004 were reviewed. Patient ages ranged from 2 to 78 years with an average of 30.8 years. There were 127 sites of facial bone fractures, which were the nasal bone (54 cases), the orbit (37 cases), the maxilla (11 cases), the mandible (6 cases), the zygoma (17 cases), and the frontal bone (2 cases). Orbital bone fractures consisted of 19 orbital floor fractures, 16 medial orbital wall fractures, and 2 lateral orbital wall fractures with 4 cases showing combined fractures of the floor and median wall. The causes of fractures were 1) traffic accidents (32.3%), 2) accidents or falls (24.4%), 3) sports (23.6%), and 4) violence or fights (19.7%).
Surgical treatments were performed for 61 (48.0%) of 127 sites and the remaining cases were treated conservatively. There were 32 cases (59.3%) undergoing reduction of the nasal bone, 19 cases (51.4%) reduction of the orbit, one case (9.1%) reduction of the maxilla, 6 cases (100%) reduction of the mandible, and 3 cases (17.6%) reduction of the zygoma. Nasal fractures were reduced under local anesthesia in 29 (90.6%) patients. We used the transorbital approach with sub-ciliary incision for 14 cases of the orbital floor fracture and the endonasal approach with an endoscope for 5 cases of medial orbital wall fracture. Eleven (84.6%) of 13 orbital floor fractures needed orbital floor reconstruction with iliac bone grafts.
Seventeen cases (16.3%) had additional fracture sites or injuries in the body and needed treatment provided by staff from several different departments. For 6 cases, the facial bone fracture was repaired at the same time as other orthopedic procedures under general anesthesia.