摘要
目的 探讨上颌骨骨折LeFort分类的改良原则和方案。方法 以 193例上颌骨骨折为研究样本。按LeFort分类的Ⅰ型、Ⅱ型、Ⅲ型骨折,增加Manson分类的矢状骨折和牙槽突骨折,列出诊断条目。根据华特位X线片和CT片显示的骨折部位和骨折线走行,对研究样本进行条目诊断和统计分析,比较LeFort分类和增加分类条目后的诊断覆盖率与未覆盖率。依据分析要素,提出对LeFort分类的改良补充方案。结果 185例被纳入诊断条目的样本按例统计,符合LeFort分类条目的单处骨折和多处骨折诊断率分别为 30 81%和 34 06%,增加条目后的单处骨折和多处骨折诊断率分别提高 13 51%和 21 61%,总体覆盖率达 95 86%。193例样本中被纳入诊断条目的 344处骨折按骨折处统计,符合LeFort分类条目者 279处(81 10% )。其中LeFortⅢ型骨折 65处, 98 46% (64处)与LeFortⅡ型合并,或与LeFortⅠ型和Ⅱ型同时合并发生。结论 LeFort分类的缺陷在于缺少矢状骨折和牙槽突骨折诊断条目,LeFortⅢ型骨折很少单独发生。建议上颌骨骨折做如下改良分类:低位水平骨折;高位水平骨折;矢状骨折;牙槽突骨折。
Objective To put forward a revised scheme on LeFort classification for the upper jaw fractures.Methods 193 consecutive cases with the primary diagnoses of upper jaw fractures were involved in this study, for each one of which water′s and CT scan were available to decide the fracture site and pattern. Data were filed in term of classification items as LeFort Ⅰ, Ⅱ and Ⅲ fracture , as well as sagittal fracture and alveolar fracture. Statistical analysis was done to validate the meliorating thought on and revised scheme on LeFort classification. Results It was validated that of 185 cases with upper jaw fractures only 30 81% which presented single line fracture and 34 06% which presented multiple line fracture were covered with LeFort classification. Additional 13 51% with single line fracture and 21 61% with multiple line fracture could be included when LeFort classification was extended with increase of items of sagittal fracture and alveolar fracture. Further results revealed that among total 344 sites or fracture lines included in 193 cases, 81 10% could be diagnosed fracture pattern of LeFort classification. Of 65 fracture sites presenting LeFort Ⅲ type, 92 31%were concomitant with LeFort Ⅱ type or LeFort Ⅰ and Ⅱ type , very few being alone.Conclusions A revised classification was proposeded that upper jaw fractures could be classified into four types as follows: ①high horizontal fracture (corresponding to LeFort Ⅱ and Ⅲ type), ②low horizontal fracture (corresponding to LeFort Ⅰ type), ③sagittal fracture (including midline and para midline fracture) and ④ alveolar fracture.
出处
《中华口腔医学杂志》
CAS
CSCD
北大核心
2005年第2期134-136,共3页
Chinese Journal of Stomatology
