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本文报告贝鲁特美国大学医学中心,1975～1984年间收治1021例战伤,共1357处头颈部损伤的处理经验。致伤物以子弹,炮弹片及碎玻璃片最常见。伤及部位(％)数为:头部895(66),上颌骨325(24),下颌骨244(18),鼻部136(10),口腔108(8),眼眶82(6),颈部462(34),肌骨和软组织伤326(24),喉气管伤54(4),咽部伤48(3.5),血管伤34(2.5)。颅脑、眼球及附属器损伤未列入,颈部损伤的处理将另文报告。作者介绍了各部战伤的处理原则和效果。上颌骨以粉碎性骨折常见,初期以清创为主,尽可能使缺损区闭合而覆盖暴露的骨面;二期用皮瓣或其他移植物成形,宜间隔足够时间使创面缩小以利于整复。本组41％一期修复获满意效果,59％需二期手术。并发症(24.5％)有感染,骨折对位不良和瘘管形成。下颌骨骨折54％用闭合复位。46％切开复位。74％愈合良好,其余因感染或骨髓炎再次手术。鼻部软组织断裂
This article reports from Beirut's American University Medical Center, from 1975 to 1984, 1021 cases of war injuries, a total of 1357 head and neck injuries experience. Injuries to bullets, artillery shells and broken glass most common. The number of injuries is: head 895 (66), maxilla 325 (24), mandible 244 (18), nose 136 (10), mouth 108 (8), orbit 82 462 (34), musculoskeletal and soft tissue injuries 326 (24), laryngeal tracheal injury 54 (4), pharyngeal injury 48 (3.5) and vascular injury 34 (2.5). Brain, eye and appendage injuries were not included and neck injuries were dealt with separately. The author introduces the handling principles and effects of various war wounded. The maxillary common to comminuted fracture, initial debridement, as far as possible to close the defect area covered the exposed bone surface; two flap or other graft formation, should be enough time to reduce the wound in order to facilitate the restoration . 41% of the first phase of this group were satisfactory results, 59% required two surgery. Complications (24.5%) were infections, poorly positioned fractures and fistula formation. 54% of mandibular fractures with closed reduction. 46% open reduction. 74% healed well, the rest due to infection or osteomyelitis again surgery. Nasal soft tissue breaks