Major dog attack injuries in children

Children are frequently admitted to a hospital with injuries sustained as a result of being attacked by a dog. Over a 5-year period (1977 to 1981), 57 such patients have been treated at the Winnipeg Children's Hospital. Half of the dog attack victims were 5 years or younger with injuries occurring more often in boys (55%). The majority of patients (95%) sustained puncture wounds and lacerations to the face (77%) and extremities (23%). In three of the cases, the dog attack victims presented with peritonitis secondary to bowel perforation and were treated successfully. A fourth child died as a result of his injuries prior to reaching the hospital. In the past, much attention has been focused on soft tissue injuries and their cosmetic repair. It is also important to recognize that the small child is particularly vulnerable to dog maulings from which the injuries sustained may be life threatening or lethal. Prevention seems to be the only rational approach to solving this problem.

Aetiology and incidence of facial fractures in adults

The incidence, aetiology and trends in fractures of the facial bones occurring in the years 1965, 1970, 1975 and 1980 in the Grampian Region of Scotland are reported. A 2.7 fold increase in incidence occurred during this period. Males are seen to be most at risk and an increase in assault and sports-related trauma is seen. Offshore oil exploration developed during this period and its effects are discussed. Attention is drawn to the differences in the aetiology of right and left malar fractures.

Fractures of the zygomatic complex in Nigerian patients

A survey of 337 Nigerian patients with fractures of the zygomatic complex disclosed that almost 96% involved males, more than 80% were between 21 and 40 years old, and 82.2% were caused by traffic accidents. The incidence of fractures caused by traffic accidents, falls, and sports was not significantly higher on the left side of the face than on the right, but those resulting from fights occurred significantly more often on the left side of the face. The highest incidence of fractures occurred during the rainy season and the month of December. Delay in reporting for treatment contributed considerably to the problems of management and to complications. About 47% of the patients required no active treatment, whereas approximately 41% had simple elevation; the overall complication rate was 8.9%.

Facial fractures. A review of 368 cases

The medical records of 368 patients, hospitalized for facial fractures, were analyzed according to sex, age, etiology, etc. To get the long-term results, the patients were given a questionnaire which was answered by 271 patients (73.6%). In the total material there is an overrepresentation for younger males and the main reasons for the fractures are traffic accidents (34.8%) and fights (27.1%). The most common fracture is the zygomaticomaxillary one (202 cases), followed by the fractures of the mandible (121 cases). The results 1 week postoperatively were good from a clinical point of view. The results from the X-ray examination with its exact demands were poorer. This discrepancy is discussed. The questionnaire covers a postoperative period of 6--99 months. Altogether, 40.1% of the patients operated on and 57.1% of those not operated on were satisfied and considered themselves as good as before the lesion. The results improve in the course of time, especially the functional ones. The reactivation of the function in the infraorbital nerve seems to be a more drawn-out process than previously supposed.

An analysis of the pattern of facial injuries in a general accident department

Over a period of one year 20 549 new patients attended an accident and emergency department. Of these patients, 15 555 were victims of accidents, including 875 who had sustained facial injuries. This latter group comprised 609 patients with soft tissue trauma and 266 with skeletal injury. The frequency, aetiology, age and sex distribution of the facial injuries were analysed and compared with other published statistical surveys of facial injury. It is concluded that facial injuries constitute a significant proportion of the work of a civilian accident unit and that any accident service must have adequate facilities for the management of these injuries.

[Etiology and occurrence of lateral midfacial fractures]

The present paper deals with 198 cases of isolated lateral midfacial fracture treated at the Clinic and Policlinic of Stomatology of the Magdeburg Medical Academy during the years 1966-1975. In view of a comparison with data from the literature, these cases were statistically analysed with regard to the frequency and the causes of this type of fracture and with regard to treatment.

Fractures of the zygomatic complex in the south-east region of Scotland

With the ever increasing of facial trauma, a study has been carried out on some aspects of zygomatic complex fractures in a part of Scotland. The results were different in some aspects from those reported in the literature, but they endorse the findings of a similar study which was carried out in the Eastern regions of Scotland (Hitchen & Shuker, 1973).

Zygomatic fractures. II. A follow-up study of 137 patients

Out of a total of 137 patients with zygomatic fractures, 87 with post-reductively stable fractures were treated solely with Gillies' procedure. Twenty-eight patients with unstable fractures were treated with transosseous wiring. In 22 patients, in whom the fracture was considered undisplaced, no fracture treatment was given. At the follow-up only 2 of the patients treated by Gillies' procedure presented malunited fractures, and these only minor ones,this reductive method thus being satisfactory in 64% of all cases. Malunion was seen in one-third of the patients treated with transosseous wiring, this treatment thus appearing frequently insufficient. Consequently, accomplishment with Kirschner-pin fixation is proposed. Finally, a schedule for treatment of zygomatic fractures is given.

The biomechanics of facial bone fracture

Selected facial bone locations were impacted to simulate clinical trauma conditions. Locations selected included the nose, zygoma, mandible, maxilla, and frontal bone. The experiment clearly delineate tolerance bands for the facial bones for both sexes. These data should permit the improved design of injury producing structures.

The biomechanics of maxillofacial trauma

Current advances in vehicle design include nonlacerative windshields and energy-absorbing instrument panels and interior structures. In order to prevent more severe injuries, it may be necessary to accept minor soft tissue trauma and nasal fractures, but it should be possible to prevent almost all other facial trauma at reasonable impact speeds.

Patterns, causes and prevention of facial injury in car occupants

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