광산사고로 인한 악안면 손상의 기전 및 1차처치에 관한 고찰

The study on mechanism & primary care of maxillofacial injuries occurring in mines

This is a practical & retrospective study on the maxillofacial injuries occurring in mines. The study was based on a series of 74 patients with maxillofacial injuries of miners which had been treated at Wonju Christian Hospital from 1982 to 1986 after the reviewing of mechanism of experimental maxillofacial injures & examination about injury factors in miners. The results obtained were as follows; 1. The most common cause was the abrupt falling down of variable minerals (37%). And minecar accidents (22%), machine work errors (19%) & explosion accidents (18%) were next in orders. 2. The frequency was increased every year. There were most occurred in 1985 during 5 years & November was the highest incidence during a year. 3. The most common type of soft tissue injuries was multiple lacerations (40%), tatooing & foreign body (27%), avulsion (26%) were next in orders. Primary care methods were primary closure (51%), Brushing or Dermabrasion (29%) & S.T.S.G. (14%). 4. The most common location of facial bone fracture was mandible (49%), especially parasymphysis. And LeFort Ⅱ fx was noted 13 cases (17%) because of impact in broad area of face. 5. The types of facial bone fracture were compound fx (39%), simple fx (35%) & comminuted fx (26%) in orders. The primary care methods were closed reduction (29%), open reduction (55%) & immediate emergency operation (16%) in orders. 6. The most common time relapse in arrival at E-R of Wonju Christian Hospital was three to twelve hours (43%) after accident in mines. There were complications in patients which arrived beyond three days after accident. 7. The good prognosis was resulted from immediate bone graft, split-thickness skin graft & microneurosurgery in patients which arrived in 12 hours after accident. 8. The seven patients (8%) had the chronic occupational diseases, such as, pneumoconiosis & pulmonary tuberculosis that prevented wound healing. 9. The other combined injury sites with maxillofacial injury were head (26%), nose (19%), eye (15%), neck (10%), lower extremities (10%) & upper extremities (8%) in orders. 10. The authors would like to propose the improvement of working environment & safe facilities, skillful working techniques & rapid transfer system on industrial accident.