COVID-19 大流行之前和期间颌面部创伤病例的单一研究所审计。

IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE
Mithilesh Kadanthode, Zainab Chaudhary, Pankaj Sharma, Sujata Mohanty, Chayanika Sharma
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引用次数: 0

摘要

研究设计:2020 年,严重急性呼吸系统综合征冠状病毒 2 导致 COVID-19 全面流行。这导致医疗资源紧张,人们将注意力转移到减少交叉感染和防止传播事件上。颌面部创伤护理也同样受到影响,大多数病例都尽可能采用闭合复位法进行处理。我们进行了一项回顾性研究,记录了印度 COVID-19 大流行导致全国封锁前后我们治疗颌面外伤病例的经验:该研究的目的是比较大流行对下颌骨创伤报告模式的影响,以及在此期间处理下颌骨单发或多发骨折的闭合复位术的结果:研究在德里毛拉纳-阿扎德牙科学院口腔颌面外科进行,为期 20 个月,即 COVID-19 大流行导致全国封锁(2020 年 3 月 23 日起生效)前后各 10 个月。病例被分为 A 组(2019 年 6 月 1 日至 2020 年 3 月 31 日报告的病例)和 B 组(2020 年 4 月 1 日至 2021 年 1 月 31 日报告的病例)。根据病因、性别、下颌骨骨折位置和治疗方法对主要目标进行评估和比较。作为次要目标,B组在2个月后使用口腔健康综合评估指数(GOHAI)评估了与闭合复位治疗结果相关的生活质量(QoL):共有 798 名下颌骨骨折患者寻求治疗,其中 A 组 476 人,B 组 322 人。病例数在大流行病的第一波期间急剧下降,大多数病例是由于道路交通意外造成的,其次是坠落和袭击。在封锁期间,跌倒和袭击导致的骨折明显增加。718例(89.97%)患者仅有下颌骨骨折,80例(10.03%)患者下颌骨和上颌骨同时受累。A 组和 B 组分别有 110 例(23.11%)和 58 例(18.01%)下颌骨骨折。各组中分别有 324 名患者(68.07%)和 226 名患者(70.19%)下颌骨多处骨折。下颌骨副干骺端最常见(24.31%),紧随其后的是单侧髁状突(23.48%),然后是下颌骨角和横突(20.71%),冠状突骨折最少。在锁定后的最初 6 个月中,所有病例均采用闭合复位法成功治疗。对下颌骨完全骨折的病例(210例多发骨折,48例单发骨折)进行的GOHAI QoL评估结果显示,单发骨折和多发骨折的疗效显著(P < .05):经过一年半的时间,我们从第二波疫情中恢复过来,对 COVID-19 有了更深入的了解,并采用了更好的管理方案。研究表明,在大流行病情况下,IMF 仍是治疗大多数面部骨折的金标准。从 QoL 数据中可以明显看出,大多数患者都能充分履行其日常职能。随着我国准备迎接第三波大流行,除非另有说明,否则闭合复位术仍将是大多数颌面部创伤的常规处理方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Single Institute Audit of Maxillofacial Trauma Cases Before and During COVID-19 Pandemic.

Study design: In the year 2020, we saw the emergence of severe acute respiratory syndrome coronavirus 2 causing COVID-19 into a full blown pandemic. This resulted in constraints on healthcare resources, and the attention was shifted to reduce cross contamination and prevent spreader events. Maxillofacial trauma care was also affected similarly, and most of the cases were managed by closed reduction whenever possible. A retrospective study was conducted to document our experience in treating maxillofacial trauma cases before and after nationwide lockdown due to COVID-19 pandemic in India.

Objective: The objective of the study was to compare the effect of pandemic in reported pattern of mandibular trauma and the result of closed reduction procedures in the management of single or multiple fractures in mandible during this time period.

Methods: The study was conducted in the Department of Oral and Maxillofacial Surgery, Maulana Azad institute of Dental Sciences, Delhi, for a period of 20 months, that is, 10 months before and after nationwide lock down which was effective from 23rd March 2020 due to COVID-19 pandemic. The cases were grouped into Group A (those reporting from 1st June 2019 to 31st March 2020) and Group B (those reporting from 1st April 2020 to 31st January 2021). Primary objectives were assessed and compared according to etiology, gender, location of the mandibular fractures, and treatment provided. Quality of life (QoL) associated with the treatment outcome by closed reduction was assessed after 2 months as a secondary objective using General Oral Health Assessment Index (GOHAI) in Group B.

Results: A total of 798 patients sought treatment for mandibular fractures and included 476 patients in Group A and 322 in Group B. The groups showed similar age and male: female ratio. Cases showed a steep fall during first wave of pandemic, and most of the cases occurred as result of RTA followed by fall and assault. The fractures due to fall and assault showed an obvious rise during the lockdown period. There were 718 (89.97%) patients having exclusive mandibular fractures and 80 (10.03%) patients having involvement of both mandible and maxilla. Single fractures of mandible constituted 110 (23.11%) and 58 (18.01%) in Group A and B, respectively. 324 patients (68.07%) and 226 patients (70.19%) had multiple fractures involving mandible in respective groups. Parasymphysis of mandible was most commonly involved (24.31%) followed closely by unilateral condyle (23.48%) then Angle and Ramus of mandible (20.71%) with coronoid being the least fractured. During the initial 6 months after lockdown, all the cases were treated successfully using closed reduction. GOHAI QoL assessment conducted in cases having exclusive mandibular fracture (210 Multiple, 48 Single) showed favorable results with significant (P < .05) difference between the single and multiple fractures.

Conclusions: After one and half years and recovering from the second wave of pandemic that hit the country, we have come to understand COVID-19 better and embraced better management protocol. The study reveals that IMF remains the gold standard for the management of most of the facial fractures in pandemic situations. It was evident from the QoL data that most of the patients were able to carry out their day-to-day functions adequately. As the country prepares for a third wave of pandemic, management of maxillofacial trauma by closed reduction will remain the norm for most unless indicated otherwise.

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Craniomaxillofacial Trauma & Reconstruction
Craniomaxillofacial Trauma & Reconstruction DENTISTRY, ORAL SURGERY & MEDICINE-
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