Avtor/Urednik		Aljinović-Ratković, Naranđa; Virag, Mišo
Naslov		Nova razvrstitev vojnih poškodb srednjega dela obraza
Prevedeni naslov		A new classification of the midface war injuries
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 39, št. Suppl 3
Leto izdaje		2000
Obseg		str. 157-60
Jezik		cro
Abstrakt		Missile wounds caused by bullets and fragments are different from other wounds not only by the patterns of injury but also in resulting bone damage. Therefore maxillofacial war wounds can hardly be classified according to the standard peacetime classifications which are primarily defined for blunt trauma. The precise evaluation of war injuries, treated during the war in Croatia, was presumed to be an adequate base for the development of a proper classification of maxillofacial war injuries. The differences between peacetime and war time aetiology, the basic surgical anatomy of the facial bones and the standard classifications of facial bone fractures are reviewed. The wound ballistics, especially the characteristics of the maxillofacial wound ballistics are discussed. The evaluation of the war wounds was performed in 262 casualties, treated in the Department of Maxillofacial Surgery in Zagreb, from 1st August 1991 till 30th November 1995. All of them were wounded by either bullet or fragments from various explosive devices. The analysis has proved that all of the midface injuries can be classified in five groups. This five groups are proposed as a new classification: transorbital, transmaxillar, palatoalveolar, central and tangential injuries. Comparing the standard classifications for midface fractures, the results have shown that only 20%, can be properly classified according to the standard clasification, and 100% according to the proposed new one. The main advantages of the new classification are that it can be applied in all maxillofacial war injuries, it is simple and based on the clinical and radiological findings. War injuries classified according to the new classification can be compared and evaluated, and also recognized and reconstructed without clinical and radiological documentation for each casualty.
Izvleček		Poškodbe kosti obraza z delci eksploziva ali naboji so drugačne od poškodb v mirnem času, ne le po vzorcih poškodb, ampak tudi po posledičnih poškodbah kosti. Zato jih je težko razvrščati po standardnih razvrstitvah, ki veljajo za mirni čas in veljajo predvsem za tope poškodbe. Natančno ovrednotenje vojnih poškodb, ki smo jih zdravili med vojno na Hrvaškem, je primerna osnova za razvrstitev maksilofacialnih vojnih poškodb. Članek podaja pregled razlik med mirnodobno in vojno etiologijo, osnovno kirurško anatomijo obraznih kosti in standardne razvrstitve zlomov obraznih kosti ter razpravlja o balistiki rane, zlasti značilnosti balistike maksilofacialnih ran. Avtorji so ocenili 262 primerov vojnih poškodb, zdravljenih na oddelku maksilofacialne kirurgije v Zagrebu med 1. 8.1991 in 30.11. 1995. Vse so bile posledica poškodbe z nabojem ali različnih eksplozivnih teles. Analiza je pokazala, da je vse poškodbe srednjega dela obraza mogoče razvrstiti na pet skupin, ki tvorijo predlagano novo razvrstitev: transorbitalne, transmaksilarne, palatoalveolarne, centralne in tangencialne poškodbe. Pri primerjavi s standardno razvrstitvijo zlomov obraznih kosti se je pokazalo, da je po njej mogoče razvrstiti le 20% vojnih poškodb, po predlagani novi razvrstitvi pa 100%. Glavne prednosti nove razvrstitve so, da jo je mogoče uporabljati za vse maksilofacialne vojne poškodbe, da je preprosta in da temelji na kliničnih in radioloških ugotovitvah. Vojne poškodbe, razvrščene po novi razvrstitvi, je mogoče primerjati in ocenjevati ter tudi prepoznati in rekonstruirati brez klinične in radiološke dokumentacije vsakega posameznega primera.
Deskriptorji		FACIAL BONES SKULL FRACTURES WAR WOUNDS, GUNSHOT CROATIA