FREQUENCY AND STRUCTURE OF MAN-DIBULAR FRACTURES
DOI:
https://doi.org/10.35220/2078-8916-2020-38-4-53-60Keywords:
retrospective analysis, traumatic fractures of the mandible, etiology, structure, frequency, combined trauma, concomitant pathologyAbstract
Recently, despite scientific and technological progress, there has been a worldwide increase in traumatic injuries to the head and neck. Their complexity and the presence of complications. All this is an important medical, social and economic problem.
Materials and methods. A retrospective analysis of medi-cal histories of patients treated in the maxillofacial de-partment of the city clinical hospital of Vinnytsia, on the basis of the Department of Surgical Dentistry and Maxil-lofacial Surgery of VNMU named after MI Pirogov, in the period from 2010 to 2019, showed the frequency and structure fractures of the mandible, their causes, com-plexity and presence of combined trauma and concomi-tant pathology. During the reporting period, only 23,735 patients with various maxillofacial pathologies were treated in the maxillofacial department.
Results. Among the maxillofacial pathology with non-gunshot fractures of the mandible were 2127 patients, which was about 8.96 %, fractures of the zygomatic-orbital complex of 275 patients – 1.16 %, fractures of the upper jaw – 115 injured – 0.5 %, fractures of the frontal bone – 57 patients – 0.2 %, fractures of the nasal bones – 211 patients – 0.8 %. That is, among all the pathology of the maxillofacial area, about 11.7 % belongs to traumatic injuries of the bones of the facial skeleton. Of the man-dibular fractures, unilateral mandibular fractures oc-curred in 1,294 patients, accounting for 60.8 % of cases, and bilateral fractures occurred in 785 (36.9 %) injured, and multiple mandibular fractures occurred in 48 (2.3 %) cases. Among the fractures of the mandible there were angular, articular, mental, middle, in the body of the mandible. The largest proportion were patients with mandibular fractures in the mandibular angle – 872 pa-tients, their percentage was equal to 67.4 %, and the smallest number of unilateral fractures were median frac-tures, which occurred in 41 patients, which amounted to 3.2 %. Among bilateral fractures of the mandible, which occurred in 785 cases (36.9 %), the most common were combinations of angular and articular fractures of the mandible, as well as combinations of angular and mental, mental and articular, middle and angular, in the area of the body and of the angle of the mandible . The largest share were patients with fractures of the mandible in the angle of the mandible and articular- 328 patients, their percentage was equal – 41.8 %, and the smallest number were fractures in the body of the mandible and mental – 23 injured (2.9 %).
Conclusion. Over the past 10 years, there has been a ten-dency to increase the number of mandibular fractures. The structure of mandibular fractures is dominated by angular fractures – 67.4 %, as well as their combination with mental – 41.8 % or articular – 36.1 %. The increase in the number of fractures is due to bilateral and more complex fractures, which requires more attention when choosing treatment tactics. In the structure of fractures of the mandible quite a large number are combined frac-tures – 35.5 %. Of which the most common was traumatic brain injury in patients with mandibular fractures – 24.1 %. Patients with mandibular fractures in 43.5 % were di-agnosed with concomitant pathology. Most often, such patients were diagnosed with pathology of the hepatobiliary system – 67.4 %. When drawing up a treat-ment plan should take into account the possibility of com-bined trauma in the fracture of the mandible, as well as the presence of concomitant pathology. All this requires finding ways to prevent fractures of the mandible and fa-cial injuries.
References
Безруков С. Г. Профілактика травматичного осте-омієліту нижньої щелепи / С. Г. Безруков, Г. Г. Роганов // Вісник стоматології. – 2012. – №4. – С. 67–71
Бернадский Ю. И. Травматология и восстанови-тельная хирургия челюстно-лицевой области / Бернадский Ю. И. – М.: Медицинская литература, 1999. – 444 с.
Гулюк А. Г. Профилактика осложнений консоли-дации при переломах нижней челюсти у больных со струк-турно-метаболическими изменениями костной ткани / А. Г. Гулюк, А. Э. Тащян, Л. Н. Гулюк // Вісник стоматології. – 2012. – № 2. – С. 65–71.
Нагірний Я. П. Якісний та кількісний склад мік-рофлори порожнини рота у хворих з травматичними пере-ломами нижньої щелепи / Я. П. Нагірний // Вісник проблем біології і медицини. – 2014. – Т. 1, вип. 3. – С. 242–247.
Переломи нижньої щелепи: аналіз частоти виник-нення, локалізації та ускладнень / Д. С. Аветіков, К. П. Ло-кес, С. О. Ставицький [та ін.] // Вісник проблем біології і медицини. – 2014. – Вип. 3(3). – С. 62–64. 6. Поліщук С. С. Експериментальне дослідження впливу квертуліну на загоєння травматичних пошкоджень нижньої щелепи щурів / С. С. Поліщук // Вісник стоматоло-гії. – 2016. – № 3. – С. 17–22. 7. Поліщук С. С. Корекція психоемоційного стану у хворих з травмами щелепно-лицевої ділянки/ С. С. Поліщук // Вісник стоматології. – 2005. – № 1. – С. 50-56.
Рузін Г. П. Сучасні принципи медикаментозного лікування переломів нижної щелепи / Г. П. Рузін, О. І. Чи-рик // Український стоматологічний альманах. – 2013. – № 6. – С. 109–112.
Тимофєєв О.О. Щелепно-лицева хірургія / О.О.Тимофєєв. – К.: ВСВ «Медицина», 2011. –752 с.
Травматичні переломи нижньої щелепи з 1995 по 2009 рр. : матеріали клініки кафедри / В. О. Маланчук, А. В. Копчак, М. А. Городійчук [та ін.] // Вісник стоматології. – 2015. – № 1. – С. 69–73.
Хірургічна стоматологія та щелепно-лицева хірур-гія ; у 2 т. – Т.2. / [Маланчук В. О., Логвіненко І. П., Малан-чук Т. О. та ін.] – К., ЛОГОС. – 2011. – 606 с.
Polishchuk S.S. Histological changes of bone tissue in the perforation defect site of the rat mandibule when using hepatoprotector in odstructive hepatitis / S.S. Polishchuk, V.Ya. Skyba, I.S. Davydenko [et al.] // World of medicine and biology. – 2020. – Vol. 16, № 2 (72). – P. 193-198.
Skyba V.Ya. Dynamics of morphometric bone changes in the site of mandibular perforation defect in rats with toxic hepatitis and use of hepatoprotector / V.Ya. Skyba, S.S. Polishchuk, I.S. Davydenko [et al.] // World of medicine and biology. – 2020. – Vol. 16, № 2 (72). – P. 198-203.
Van den Bergh B. Treatment and complications of mandibular fractures: a 10-year analysis / Van den Bergh B., Heymans M. W., Duvekot F. [et al.] // J. Craniomaxillofac. Surg. – 2012. – Vol. 40, № 4. – P. 108–111.
Verma S. Update on patterns of mandibular fracture in Tasmania, Australia / S. Verma, I. Chambers // Br. J. Oral Maxillofac. Surg. – 2015. – Vol. 53, № 1. – P. 74–77.
A study of mandibular fractures over a 5-year period of time: A retrospective study / A. Vyas, U. Mazumdar, F. Khan [et al.] // Contemp. Clin. Dent. – 2014. – Vol. 5, № 4. – P. 452–455.
Management of pediatric mandible fractures / E. M. Wolfswinkel, W. M. Weathers, J. O. Wirthlin [et al.] // Otolaryngol. Clin. North. Am. – 2013. – Vol. 46, № 5. – P. 791–806.
Yamamoto M. K. Evaluation of surgical retreatment of mandibular fractures / M. K. Yamamoto, R. P. D’Avila, J. G. Luz // J. Cranio maxillofac. Surg. – 2013. – Vol. 41, № 1. – P. 42–46.
