Uticaj karakteristika traume i izbora hirurškog pristupa na rezultate lečenja bolesnika sa prelomom kostiju lica

Abstract

Due to its anatomical structure and exposure to external factors ,the facial region is subjected to trauma. There are no studies that compare the results of two surgical approaches: transcutaneous and transmucosal, as well as the results of conservative methods of treatments. Lot of studies are based on examining the quality of life of patients with facial fractures, but there are no studies that compare the patient quality of life having different types of treatments. The aim is to determine the significance of injury, treatment modality (in terms of choice of surgical technique and approach), following complications and the influence of these factors on the treatment outcome . In this prospective clinical study, 90 patients with facial bone fractures were observed. The highest incidence of facial fractures is recorded in the third and fourth decades of life, both genders. Infections were more common in patients with transmucosal approach,compared to transcutaneous approach, as well as in comparison to conservatively treated patients. Moreover, a significant association between oral health care and postoperative infection was observed. Statistically significant differences in the appearance of infection were found between the patients with mandible fracture treated by transmucosal approach, more specifficaly by the operative procedure through the mucous membrane of mandibule and another way of treatment. Statistically significant negative correlation between preoperative intensity of pain and degree of mouth opening was observed, while positive association existed with infection and paraesthesia. Most patients with facial fracture had an anxiety disorder in all three groups. The quality health is much poorer in patients with transcutaneous approach than in patients with conservative treatment. During the past seven days following the injury,total health quality of life was poor in 50% of patients with facial fracture, regardless of the type of the treatment.