An assessment of maxillofacial fractures treated in a suburban tertiary health facility: a 2-year study of 167 patients (original) (raw)
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The Pattern of Maxillofacial Trauma & its Management
Purpose: The descriptive study was undertaken to determine the pattern and different methods of treatment of maxillofacial fractures. Materials and Methods: Three hundred and twenty consecutive patients with maxillofacial trauma were treated in a tertiary care hospital in last three years. A review of patients' records and radiographs was conducted. Data regarding age, gender, cause of fracture, anatomic site and treatment modalities were reviewed. Results: The age range was 2-76 years (25±8) with peak frequency occurring in age group 21-30 years. The male to female ratio was 5.4: 1. The study indicated that (n=206; 64.7%) resulted from road traffic accidents (rtas) followed by fall (n=60; 18.8%), assault (n=26; 8.1%), sports (n=17; 5.3%), firearm injury [FAI (n=3; 0.9%)], industrial trauma (n=2; 0.6%) while 5cases (1.65%) were associated with other causes such as bomb blast, animal injury etc. The mandible was the most commonly involved (69.7%) followed by zygomatic complex [ZC (8.4%)], maxilla (5.3%), nasal bone (1.3%) and nasoethmoidal fractures (0.9%); in 14.4% of cases, more than one facial bone fracture occurred. Of mandibular fractures, body (30.3%) was the most common site followed by condylar region (24.2%). In midface fractures the ZC was the most susceptible area (48.2% of midface); of maxillary fractures, Le Fort I was the most common fracture (34.5%); the frequency of nasal (7.1%) & nasoethmoidal (5.4%) remained low. Most patients with mandibular fractures were treated by closed reduction surgery [eyelet wiring, arch bars with inter maxillary fixation (IMF) &splint fixation], only 18.9% of patients were treated with open reduction surgery (Interosseous &miniplates fixation). The maxillary fractures were mostly treated with suspension wiring while in ZC fractures Gillies' approach (37.9%) was the common method of management. Conclusion: This study reflects trauma patterns within the community and, as such, can provide a guide to the design of programs geared toward prevention and treatment.
Maxillofacial Fractures: A Three-Year Survey
Journal of Current Surgery
Background: Maxillofacial fractures constitute a substantial proportion of trauma globally. The main causes worldwide are road traffic accidents (RTAs), falls, assaults, sports, firearm injuries and industrial trauma. The highest incidence is commonly seen in the young age group with majority being male. The most common site in maxillofacial injuries is the mandible followed by the zygomatic complex, maxilla, and alveolar process. Maxillofacial trauma also poses a significant socioeconomic burden on affected individuals. Hence appropriate treatment and prevention of these morbidities and possible mortality is necessary. This study is therefore aimed at analyzing the prevalence, pattern of presentation of maxillofacial injuries at Lagos State University Teaching Hospital (LASUTH) in Western Nigeria. Methods: A retrospective review of 182 patients diagnosed and treated for maxillofacial injuries at the Oral and Maxillofacial Department of the LASUTH was conducted. Data were obtained from clinical notes and records of radiological findings noting patient's age, gender, etiologic factors (RTA, assault, sport, and fall), anatomic site of injury and different definitive treatment modalities. The data were analyzed by SPSS version 20 using various descriptive statistical tools. Mean and standard deviation were calculated for quantitative variable like age while frequency and percentage were calculated for qualitative variables like gender and site of fracture. Results: Majority of patients were male (72.0%) with a male to female ratio of 1:0.4. Most patients were between 31 and 40 (34.1%) years of age. RTA accounting for 73.1% of the injuries was the most common cause for maxillofacial injury followed by assault (19.2%). Majority of injuries due to RTA were of motorcycles accidents (33.6%). The most common sites of fracture out of 226 sites were in the mandible (62.8%, P = 0.003). Among the mandibular fracture sites, 28.2% affected the body of the mandible. Majority (31.9%) of the studied patients presented within 24 h (≤ 1 day). Out of the 182 patients, 68.1% were treated by close reduction. Conclusions: RTA represented the major etiological factor of maxillofacial injuries. The mandible remains the most affected bone of the facial skeleton. Closed reduction is the most common approach used for treatment.
Incidence of Maxillofacial Trauma and Its Management -A Retrospective Study Research Article
SciDoc Publishers, 2020
Injury to the facial structures is disastrous and it affects the quality of life; which increases the demand for esthetics [1, 2]. Management of injuries in this region presents one of the most challenging procedures, as fractures are invariably associated with morbidity, disfigurement, functional problem and expensive treatment [3,4]. Maxillofacial injury can be an isolated injury or can occur in combination with other injuries as well [5, 6]. Road traffic accidents (RTA) are the common cause for the injury [7, 8]. The aim of this retrospective study was to evaluate the incidence, gender prevalence, etiology, site of maxillofacial fractures and their management.
A retrospective study on the epidemiology and treatment of maxillofacial fractures
Ulusal Travma Ve Acil Cerrahi Dergisi Turkish Journal of Trauma Emergency Surgery Tjtes, 2009
Background: Maxillofacial injuries constitute a substantial proportion of cases of trauma. This descriptive analytical study assesses the cause, type, incidence, and demographic and treatment data of maxillofacial fractures. Methods: A retrospective study on maxillofacial traumas was carried out in the Department of Plastic and Reconstructive Surgery at Sişli Etfal Hospital (Istanbul, Turkey) between January 1, 2000 and December 31, 2005. The study included 216 patients with a mean age of 29.8 years. Sex and age distribution of patients, etiology of trauma, localization of the fractures, treatment modalities, time to treatment after the trauma, and postoperative complications were recorded. Results: The male predilection was 75.5%. Road traffic accident was the most common causative factor (67.1%), followed by interpersonal violence (19.4%), falls (12.5%), and work- and sport-related accidents (0.9%). A total of 50% of the patients suffered isolated mandibular fractures, 23.6% had isolated midface fractures, and 26.3% had combined midface and mandibular fractures. Regarding distribution of mandibular fractures, the majority (26.8%) occurred in the parasymphysis, 14.8% in the angulus, and 11.1% each in the symphysis and corpus. Complications occurred in 6% of patients, and the most common was malocclusion followed by infection and nonunion. Conclusion: The causes and pattern of maxillofacial fractures reflect trauma patterns within the community and, as such, can provide a guide for the design of programs geared toward prevention and treatment.
British Journal of Oral and Maxillofacial Surgery, 2013
The epidemiology of maxillofacial fractures shows considerable regional variation as a result of local demographic and socioeconomic factors. We have assessed the epidemiological characteristics of such fractures at our centre in The Netherlands. The medical records of 394 patients who were treated surgically for maxillofacial fractures between 1 January 2005 and 31 December 2010 were analysed retrospectively. The male:female ratio was 3:1. There was a peak incidence in the second and third decades of life among men. The number of injured patients/year remained stable during the selected period. The incidence was highest in the spring and at weekends. Fractures of the mandible and zygoma were the most common. Road traffic crashes were the most common cause of injury (42%) and mainly involved bicycles. A total of 165 (15%) of the patients were intoxicated, and 142 patients (36%) had other serious injuries. Most patients (n = 248, 63%) were treated within a day of presentation. Two hundred and thirty-two patients (59%) spent 4 days or fewer in hospital. The presence of other injuries was associated with a prolonged stay in hospital. Groups at particular risk of maxillofacial fractures are young men and cyclists. The use of helmets by cyclists could achieve a large reduction in injuries to the brain and upper face.
Epidemiologic analysis and evaluation of complications in 1266 cases with maxillofacial trauma
Turkish Journal of Plastic Surgery, 2018
IntroductIon Many studies conducted in various countries report different incidences for maxillofacial trauma, these cases nevertheless represent a major group among the emergency cases in plastic surgery practice after hand injuries. [1] These traumas can vary etiologically based on age and gender; most often, however, they are caused by road accidents involving both in-car and noncar road accidents. Its etiology varies widely based on geographical region, cultural status, and lifestyle differences, as well as on socioeconomic status. [2,3] The treatment of maxillofacial traumas involves facial bone fractures in the head and neck region, dentoalveolar trauma, and soft-tissue damage. [4] Because these traumas often accompany multiple traumas such as traumas of the head, the spine, and the lower or upper extremities, increased morbidity and longer treatment times are seen in this patient group. Epidemiologic studies have an important part in the prevention of this process. [5] The gold standard imaging modalities for diagnosis are computerized tomography and orthopantomography. The rigid fixation technique using plates as developed by Michelet and modified by Champy et al. is the most widely used repair approach in treatment. [6] The purpose of this study is to present the occurrence mechanism of maxillofacial traumas, the most affected bone structures, distribution of these variables by patient's age, treatment methods used, and the resulting complications in comparison to the reports in the literature. MaterIals and Methods In this study, data of 1266 patients who had either directly applied or were referred by the ER to our clinic between the years of 2003 and 2017 were retrospectively analyzed. All age groups were included in the study, the fractures were diagnosed Introduction: Patients with maxillofacial trauma represent a major group of patients in plastic surgery practice. These traumas are often caused by in-car and noncar road accidents and can result in permanent damages. This study aims at providing an epidemiologic analysis of such cases together with their diagnostic procedures, treatment methods, and postoperative complications. Materials and Methods: A total of 1266 maxillofacial trauma cases that were operated on between 2003 and 2017 were studied, and analyzed for fractured bones, etiology, diagnosis and treatment principles, and complications. Results: The major etiologic factor causing maxillofacial trauma in our study is noncar road accidents (25.5%). Mandible fractures were seen to be the most common type of bone fracture (52.2%). Together with physical examination, computerized tomography and orthopantomography are the diagnostic procedures we effectively use in our clinic. Rigid and semi-rigid fixation with plate and screws are the most frequently used treatment methods, and complication rates are seen to be lower (by 6.6%) than those reported in the literature. Conclusion: Careful and meticulous processes, as well as effective follow-up of the patient are required to achieve optimal esthetic and functional results in maxillofacial trauma cases. Such approach can help to reduce the possibility of complications and allow for their early identification, hence early intervention.
Evaluation of maxillofacial fracture cases: A retrospective study
Yeditepe Dental Journal
The purpose of this study is to characterize the fractures in relation to age, gender, mechanism of injury, and anatomic location of fractures. Materials and Method: Seventy-nine patients admitted to the Department of Oral and Maxillofacial Surgery of Kocaeli University Faculty of Dentistry between July 2013 and June 2018 with the diagnosis of the maxilla or mandible fracture and who have been treated, were included in our study. Data were collected regarding age, sex, etiology, time distribution, site of the fracture, treatment protocol and evaluated. Results: A total of 79 patients with 101 fractures were included in this study. The results were achieved from 58 (73.4%) males and 21 (26.6%) females, whose ages ranged from 7 to 65 years and the mean age was 31.36±13.07. Traffic accidents (30.4%) were the major cause of etiology of the trauma and followed by violence (27.8%) and falls (17.7%). The most common fractured anatomic sites were angulus (34.6%) and parasymphyseal regions (17.8%). Conclusion: Maxillofacial fractures result from various types of facial trauma. Traffic accident and violence are the most common etiological factors for these fractures. A deeper understanding of preventive actions to reduce falls, traffic accidents and aggression in the population can be beneficial to people in terms of quality of life.
Assessment of maxillofacial trauma in emergency department
World Journal of Emergency Surgery, 2014
Introduction: The incidence and epidemiological causes of maxillofacial (MF) trauma varies widely. The objective of this study is to point out maxillofacial trauma patients' epidemiological properties and trauma patterns with simultaneous injuries in different areas of the body that may help emergency physicians to deliver more accurate diagnosis and decisions. Methods: In this study we analyze etiology and pattern of MF trauma and coexisting injuries if any, in patients whose maxillofacial CT scans was obtained in a three year period, retrospectively. Results: 754 patients included in the study consisting of 73.7% male and 26.3% female, and the male-to-female ratio was 2.8:1. Mean age was 40.3 ± 17.2 years with a range of 18 to 97. 57.4% of the patients were between the ages of 18-39 years and predominantly male. Above 60 years of age, referrals were mostly woman. The most common cause of injuries were violence, accounting for 39.7% of the sample, followed by falls 27.9% and road traffic accidents 27.2%. The primary cause of injuries were violence between ages 20 and 49 and falls after 50. Bone fractures found in 56,0% of individuals. Of the total of 701 fractured bones in 422 patients the most frequent was maxillary bone 28,0% followed by nasal bone 25,3%, zygoma 20,2%, mandible 8,4%, frontal bone 8,1% and nasoethmoidoorbital bone 3,1%. Fractures to maxillary bone were uppermost in each age group. 8, 9% of the patients had brain injury and only frontal fractures is significantly associated to TBI (p < 0.05) if coexisting facial bone fracture occurred. Male gender has statistically stronger association for suffering TBI than female (p < 0, 05). Most common cause of TBI in MF trauma patients was violence (47, 8%). 158 of the 754 patients had consumed alcohol before trauma. No statistically significant data were revealed between alcohol consumption gender and presence of fracture. Violence is statistically significant (p < 0.05) in these patients.
Maxillofacial fractures: A retrospective study
IP innovative publication pvt. ltd, 2019
Abstract Introduction: Aim of the retrospective study is to determine the type and frequency of the maxillofacial fractures and to assess their sex, age, site distribution, and treatment accordingly. Materials and Methods: Study was conducted based on year-wise data collected from 2015 to 2018, with 280 cases recorded. Results: Study group consists of total 280 patients, out of which 28(10%) were females and rest 252(90%) were males. The most common maxillofacial fractures are mandibular fractures in which body of the mandible have the highest occurrence rate and among 280 cases, 187(66.78%) were treated by open reduction and fixation. Conclusion: Results of the study shows the majority of injuries were in males and Mandible was the most commonly fractured bone with the body of the mandible region as the most frequent site. Open reduction and fixation remain the choice of treatment. Keywords: Mandibular fractures, Maxillary fractures, Closed reduction, Open reduction, Fixation.
Frequency of Maxillofacial Trauma and Accompanying Types of Maxillofacial Fractures
Acibadem Universitesi Saglik Bilimleri Dergisi, 2021
Objective: In this study, it was aimed to examine the characteristics, causes of trauma, and age distribution of maxillofacial fractures in patients admitted to the emergency department as a result of blunt maxillofacial trauma. Materials and Methods: Between 01.01.2015 and 31.12.2019, 1248 patients who were admitted to the emergency department with maxillofacial trauma were evaluated retrospectively. Patients who underwent CT examination and were diagnosed with fracture were included in our study. Results: The median age of the patients was 32 years, and 71.2 % of them were male. Trauma-related fractures were detected in 239 (19.2%) of 1248 patients with maxillofacial trauma. The affected group of participants comprised of individuals of younger age and male gender. The main mechanisms of trauma were traffic accidents and falls from height. Orbital fractures were the most common, followed by maxillary bone fractures. Severe maxillofacial fractures were often accompanied by traumatic brain injuries. The mortality rate was low (0.4%) in patients with isolated maxillofacial trauma compared to patients with polytrauma (16%) (p= 0.001). In our study, it has been shown that face AIS (Odds ratio: 2.79) and Glasgow coma score (Odds ratio: 0.98) can predict mortality in trauma patients with multivariable regression analysis. Conclusion: As a result of this study, we determined the relationship between variables associated with common traumatic injury in the maxillofacial region. Age, gender, and injury mechanism are of great clinical importance in the identification and prediction of traumatic maxillofacial fractures.