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Analysis of radiographically confirmed blunt-mechanism facial fractures.
- Source :
-
The Journal of craniofacial surgery [J Craniofac Surg] 2014 Jan; Vol. 25 (1), pp. 321-7. - Publication Year :
- 2014
-
Abstract
- Facial fractures resulting from blunt-mechanism trauma, although common, have been infrequently evaluated in large studies that do not include confirmation of fractures based on author review of available patient radiographic studies. An 8-year review (1998-2006) of the R Adams Cowley Shock Trauma Registry was performed with institutional review board approval. Patients diagnosed with blunt-mechanism facial fractures were identified by the International Classification of Diseases, Ninth Revision (ICD-9) codes and their facial fractures confirmed by author review of computed tomographic scans. Individual fractures were classified and grouped according to the facial thirds. Intra- and interreader variability was calculated, and confirmed fracture patterns were compared to fracture patterns listed by ICD-9 codes. Concomitant injuries and demographic data were additionally evaluated. Four thousand three hundred ninety-eight patients with 8127 fractures were identified. Intra- and interreader variability was 2% and 7%, respectively. ICD-9 coding misdiagnosed 12.5% of all fractures. Eighty-two percent of patients sustained associated injuries, including basilar skull fractures (7.6%) and cervical spine fractures (6.6%). 1.1% had at least one fracture in each facial third (panfacial fracture pattern). Significant relationships were found between demographic parameters, concomitant injuries, specific fractures, and fracture patterns. Studies investigating facial fractures should report fracture patterns confirmed by author review of available radiographic imaging. Large retrospective data sets containing confirmed fractures and capable of addressing rare fracture patterns can be compiled with low inter- and intrauser variability, and are useful for generating mechanistic hypotheses suitable for evaluation in prospective series or by directed biomechanical studies.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Cervical Vertebrae injuries
Child
Child, Preschool
Female
Frontal Bone injuries
Humans
Infant
Infant, Newborn
Male
Mandibular Fractures epidemiology
Maryland epidemiology
Maxillary Fractures epidemiology
Middle Aged
Nasal Bone injuries
Orbital Fractures epidemiology
Registries
Retrospective Studies
Skull Fractures diagnostic imaging
Spinal Fractures epidemiology
Tomography, X-Ray Computed methods
Wounds, Nonpenetrating diagnostic imaging
Young Adult
Zygomatic Fractures epidemiology
Facial Bones injuries
Skull Fractures epidemiology
Wounds, Nonpenetrating epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1536-3732
- Volume :
- 25
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The Journal of craniofacial surgery
- Publication Type :
- Academic Journal
- Accession number :
- 24406598
- Full Text :
- https://doi.org/10.1097/SCS.0b013e3182a2e979