Journal of Trauma and Injury

  • 제19권2호
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  • Pages.150-158
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  • 2006
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  • 2799-4317(pISSN)
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  • 2287-1683(eISSN)
대한외상학회 (The Korean Society of Traumatology)
권호 표지

안면부 골절 환자와 두부 손상의 연관성

Correlation Between Facial Fracture and Cranial Injury

  • 이승원 (인제대학교 상계백병원 응급의학과) ;
  • 조석진 (인제대학교 상계백병원 응급의학과) ;
  • 류석용 (인제대학교 상계백병원 응급의학과) ;
  • 이상래 (인제대학교 상계백병원 응급의학과) ;
  • 김성은 (인제대학교 상계백병원 응급의학과) ;
  • 김성준 (인제대학교 상계백병원 예방의학과) ;
  • 안지영 (인제대학교 서울백병원 응급의학과)
  • Lee, Seung Won (Department of Emergency Medicine, Sanggye Paik Hospital, College of Medicine, Inje University) ;
  • Cho, Suk Jin (Department of Emergency Medicine, Sanggye Paik Hospital, College of Medicine, Inje University) ;
  • Ryu, Seok Yong (Department of Emergency Medicine, Sanggye Paik Hospital, College of Medicine, Inje University) ;
  • Lee, Sang Lae (Department of Emergency Medicine, Sanggye Paik Hospital, College of Medicine, Inje University) ;
  • Kim, Sung Eun (Department of Emergency Medicine, Sanggye Paik Hospital, College of Medicine, Inje University) ;
  • Kim, Sung Jun (Department of Preventive Medicine, Sanggye Paik Hospital, College of Medicine, Inje University) ;
  • Ahn, Ji Young (Department of Emergency Medicine, Seoul Paik Hospital, College of Medicine, Inje University)
  • 투고 : 2006.10.31
  • 심사 : 2006.12.05
  • 발행 : 2006.12.30
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초록

Purpose: There are two theories about the relationships between facial fractures and cranial injuries. One is that facial bones act as a protective cushion for the brain, and the other is that facial fractures are the marker for increased risk of cranial injury. They have been debated on for many years. The purpose of this study is to identify the relationship between facial fractures and cranial injuries. Methods: A retrospective study was performed on 242 patients with facial fractures. The data were analyzed based on the medical records of the patients: age, gender, cause of injury, Injury Severity Score (ISS), alcohol intake, type of facial fractures, and type of cranial injury. The patients were divided into two groups: facial fractures with cranial injury and facial fractures without cranial injury. We compared the general characteristics between the two groups and evaluated the relationship between each type of facial fracture and each type of cranial injury. Results: Among the 242 patients with facial bone fractures, 96 (39.7%) patients had a combination of facial fractures and cranial injuries. Gender predilection was demonstrated to favor males: the ratio was 3:1. The mean age was $36.51{\pm}19.63$. As to the injury mechanism, traffic accidents (in car, out of car, motorcycle) were statistically significant in the group of facial fractures with cranial injury (p=0.038, p=0.000, p=0.003). The ISS was significant, but alcohol intake was not significant. No significant relationship between facial fractures and skull fractures was found. Only maxilla fractures, zygoma fractures, and cerebral concussion had a significant difference in cranial injury (p=0.039, p=0.025). Conclusion: There is a no correlation between facial fractures and skull fractures, which suggests that the cushion effect is the predominent relationship between facial fractures and cranial injuries.

키워드

참고문헌

  1. Maynard EJ, Doge JS. Introducing a community health center at Mosgiel, Newzeland:Effects on use of the hospital accident and emergency department. Med Care 1983;21:379-88 https://doi.org/10.1097/00005650-198304000-00001
  2. Yoo JH, Lee JK, Choi JP, Park JS. A study of Facial Fracture and Associated injuries. J Korean Soc Emerg Med. 2004;15:88-94
  3. Turvey TA. Midfacial fractures. a retrospective analysis of 593 cases. J Oral Surg. 1997;35:887-91
  4. Lee KF, Wagner LK, Lee YE, Suh JH, Lee SR. The impact-absorbing effects of facial fractures in closed-head injuries: An analysis of 210 patients. J Neurosurg 1987;66:542-7 https://doi.org/10.3171/jns.1987.66.4.0542
  5. Baek EH, Ko SO, Shin HK. A Clinical study of infraorbital wall fractures. J Korean Asso Maxillofacial Plast and Reconstr Surg. 2000;3: 288- 93
  6. Rimel RW, Giordani B, Barth JT, Boll TJ, Jane JA. Disability caused by minor head injury. Neurosurgery 1981;9:221-8 https://doi.org/10.1227/00006123-198109000-00001
  7. Dacey RG Jr, Alves WM, Rimel RW, Winn HR, Jana JA. Neurosurgical complications after apparently minor head injury: Assessment of risk in a series of 610 patients. J Neurosurg 1986;65:203-10 https://doi.org/10.3171/jns.1986.65.2.0203
  8. Davidoff G, Jakubowski M, Thomas D, Alpert M. The spectrum of closed head injuries in facial trauma victims: Incidence and impact. Ann Emerg Med 1988;17:6-9 https://doi.org/10.1016/S0196-0644(88)80232-4
  9. Max W, Mackenzie E, Rice D. Head injuries: Costs and consequences. J Head Trauma Rehabil. 1991; 27:332-43
  10. Schultz RC. One thousand consecutive cases of major facial injury. Rev Surg 1970;27:394-410
  11. Sastry SM, Sastry CM, Paul BK, Bain L. Leading cause of facial trauma in the major trauma outcome study. Plast Reconstr Surg. 1995;95:196-7 https://doi.org/10.1097/00006534-199501000-00039
  12. McCabe JB, Angelos MG. Injury to head and face in patients with cervical spine injury. am J Emerg Med 1984;2:333-5 https://doi.org/10.1016/0735-6757(84)90130-X
  13. Haug RH, Prather J, Indresano AT. An epidemiologic survey of facial fractures and concomitant injury. J Oral Maxillofacial Surg. 1991;48:926-32 https://doi.org/10.1016/0278-2391(90)90004-L
  14. Gautam V, Leonard EM. Bony injuries in association with minor head injury: Lessons for improving the diagnosis of facial fracture. Injury 1994;25:47-9 https://doi.org/10.1016/0020-1383(94)90184-8
  15. Gwyn PP, Carraway JH, Horton CH, Adamson JE, Madick RA. Fractures associated injuries and complications. Plast Reconstr Surg 1971;47:225-30 https://doi.org/10.1097/00006534-197103000-00004
  16. Frable MA, Hong K, Jang JH, Park YW. Facial fracture at an urban hospital: A review continued. Va Med 1978;105:700-1
  17. Lamberg MA. Maxillofacial fractures. An epidemiological and clinical study on hospitalized patients. Proc Finn Dent Soc 1979;75:20-5
  18. Kim JD, Kim TY, Chun CY. A Clinical and Statistical Analysis of the facial bone fracture. J Korean Assoc of Plast and Reconstr Surg 1992: 19:38-42
  19. Martin RC, Spain DA, Richardson JD. Do facial fractures protect the brain or are they a marker for severe head injury. Am Surg 2002;68:477-81
  20. Keenan HT, Brundage SI, Thomson DC, Maier RV, Rivara FP. Does the face protect the brain- A case control study of traumatic brain injury and facial factures. Arch Surg 1999;134:14-7 https://doi.org/10.1001/archsurg.134.1.14
  21. Jess FK, Thomas MR, Corinne P, David LM. Facial trauma and the risk of intracranial injury in motocycle riders. Ann Emerg Med 2003;41:18-26 https://doi.org/10.1067/mem.2003.1
  22. Pappacban B, Alexander M. Correlating facial fractures and cranial injuries. J Oral Maxillofac Surg 2006;64:1023-9 https://doi.org/10.1016/j.joms.2006.03.021
  23. Slupcgtnskyj OS, Berkower AS, Byrne DW, Cayten CG. Association of skull base and facial fractures. Laryngoscope 1992;102:1247-50 https://doi.org/10.1288/00005537-199211000-00008