Three-year review of facial fractures at a teaching hospital in northern Iran

The facial-bone fractures among fatally injured car occupants in frontal collisions

The retrospective study was performed of all deceased car-occupants in frontal car collisions in order to identify persons with facial-bone fractures. The sample consisted of 482 cases: 378 males and 104 females, average age of 39.59+/-16.01 years. There were 239 car-drivers, 194 front-seat passengers, and 49 rear-seat passengers. In 46 of 482 cases, single fracture of upper facial bones was established: nasal fractures were the most common, followed by zygomatic. In 118 of 482 cases, fracture of upper facial bones was established, as well as 70 cases of jawbone. The fractured facial bones either of the upper or lower face could not be a factor that predicts the position of the deceased in the motor vehicle at the moment of injury (lambda=0.989, p>0.05). The multi-fractured facial-bones were very often associated with the multi-fractured cranial bones - 85 cases (chi(2) =138.75, df=8, p<0.001), as well as jawbone fracture - 35 cases (chi(2) =20.52, df=4, p<0.001). Brain injuries were more present and more severe (coup and contrecoup-contusion and brain laceration) if more facial-bone fractures were involved (chi(2) =147.99, df=8, p<0.001). Cases with only contrecoup brain contusions, associated with multi-fractured facial-bones, were rare - 6 of 118. These fractures are very often associated with cranial fractures, as well as with brain injuries and were caused by intensive contact of the deceased's head with the car's pillar.

[Epidemiology of maxillofacial traumatology in Tunis]

INTRODUCTION

The aim of this study was to assess the epidemiology of maxillofacial trauma in Tunisia over a 10-year period.

METHODS

This retrospective study was carried out between 1995 and 2004 on patients admitted for maxillofacial trauma in the department of maxillofacial and plastic surgery of the Charles-Nicolle Hospital in Tunis. The selected relevant parameters were: age, gender, etiology, time of trauma, type of fracture and associated lesions.

RESULTS

A total of 1100 patient files were analyzed. The average age was 29 years and the sex-ratio was 6:1 in favor of men. The most common etiologies were: car crashes (39%), fights (28%) and domestic trauma (19%), occurred in the evening, on weekends and in the summer. The frequency increased in the evening, on weekends and in the summer. Mandibular fractures (62%) and zygomatic fractures (32%) were the most common trauma. Polytrauma occurred in 18% of the patients and cranial trauma in 10% of the cases.

DISCUSSION

Epidemiological investigations results vary according to demographic and cultural regional specificities. Long-term collection of epidemiological data in maxillofacial surgery is a major issue to plan educational campaigns and therapeutic strategies. In Tunisia, driver education and observance of traffic regulations should be improved.

A four year retrospective study of 1,062 patients presenting with maxillofacial emergencies at a specialist paediatric hospital

AIMS

To examine the nature of maxillofacial injuries that presented to the Birmingham Children's Hospital according to aetiology, incidence and characteristics of patients.

METHODS

The maxillofacial unit at Diana Princess of Wales Birmingham Children's Hospital serves a catchment area of 5.2 million. We examined all children who presented with maxillofacial trauma from 2002 to 2006. Details including characteristics of patients and aetiology and nature of injury, were entered prospectively into a database.

RESULTS

The total number of patients who presented was 1062. The ratio of boys to girls was 2:1. The main reason for attendance was a fall (70%). 149 (17%) patients presented after interpersonal violence. Soft tissue injuries accounted for 70% of injuries and 14% presented with a maxillofacial fracture.

CONCLUSIONS

Our data indicate that the range and mechanism of presenting injuries have not changed within the time frame. Despite public perception of increasing interpersonal violence, this was not reflected in our series of patients.

Maxillofacial fractures in Southern Bulgaria – A retrospective study of 1706 cases

The present retrospective study investigated various types, aetiology, complications and methods of treatment of maxillofacial fractures managed in the Department of Maxillofacial Surgery, Medical University, Plovdiv, Bulgaria.

PATIENTS AND METHODS

A total of 1706 patients were studied with 2534 fractures treated between 1994 and 2003. The analysis included data on age and gender of patients, causes and types of fractures (mean number of fractures per patient - 1.48) as well as the treatments used and the associated complications.

RESULTS

Most maxillofacial fractures were sustained by 574 men (age range 21-30 years). The ratio of males to females was 4.6:1. Most fractures were caused by violent assault - 1040 (61%), followed by motor vehicle accidents - 264 (15.5%), fall - 213 (12.5%) and bites from animals - 72 (4%). Fractures of the mandible were sustained by 1261 patients (74%), fractures of the maxilla by 97 (6%), fractures of the zygomatic bone by 277 (16%), nasal fractures by 63 (4%) and multiple fractures by 8 (0.5%). In 1330 (77%) patients the fractures were treated by closed reduction; in 264 patients (16%) by open reduction and fixation, and for the remaining 112 patients (7%) were managed with combined closed and open reduction. The mortality rate was 0.2%, the lethal cases being a result of a combination of severe fractures in the maxillofacial region and trauma to other organs/systems.

CONCLUSION

The most common cause of traumatic injury in the maxillofacial region in this study sample was assault, predominantly affecting men. The fractures were treated using various methods but mostly by closed reduction plus fixation.