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Costello L, Ogunbowale A, Ekanayake K. Maxillofacial fractures among non-indigenous ethnic groups in the Irish national maxillofacial unit: a review. Ir J Med Sci 2024; 193:1995-2000. [PMID: 38676900 PMCID: PMC11294398 DOI: 10.1007/s11845-024-03681-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/27/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND This study investigates maxillofacial fractures in non-indigenous ethnic groups who were reviewed in the national maxillofacial unit in Ireland. The aim of this study was to highlight any potential trends in presentation of facial fractures in non-indigenous groups in comparison to previous reports which have included all ethnicities. This unique study is based on the fact that Ireland has only recently transformed into a diverse, multi-cultural country. This is unlike countries such as the UK and USA which have a long history of multicultural integration. MATERIALS AND METHODS This retrospective study evaluated the trauma database of 4761 patients with 5038 fractures who attended the national maxillofacial unit over a 5-year period from 2015 to 2019. Parameters included age, gender, mechanism of injury, fracture sustained, time of the day, day of the week, month of injury, and the referral source were obtained from patient records. RESULTS The study identified 456 patients who did not identify as being born in Ireland, with 384 males and 72 females. The most common fracture seen was of the zygomatic bone, and the most common mechanism of injury was alleged assault for this cohort. Most injuries occurred in late afternoon with Friday being the most common day of the week. CONCLUSION This study shows how maxillofacial units need to adapt to the changing trends in Irish demographics with increased demand for resources such as translation services. A further study could evaluate the rapidly changing demographic with mass migration of people currently seeking refuge in Western Europe.
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Affiliation(s)
- Liam Costello
- National Oral and Maxillofacial Unit, St. James' Hospital Dublin, Dublin, Ireland
| | - Akinsola Ogunbowale
- Dept. of Oral and Maxillofacial Surgery, University Hospital Limerick, Limerick, Ireland.
| | - Kumara Ekanayake
- National Oral and Maxillofacial Unit, St. James' Hospital Dublin, Dublin, Ireland
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Hesham A, Geiger J, Alshamrani Y, Sawatari Y. Can the Mechanism of Injury Impact the Location of a Mandibular Fracture? A Systematic Review. J Maxillofac Oral Surg 2024; 23:363-370. [PMID: 38601229 PMCID: PMC11001800 DOI: 10.1007/s12663-022-01750-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 06/05/2022] [Indexed: 10/16/2022] Open
Abstract
Purpose Mandible fractures are the second most common fractures of the facial skeleton because of the prominent position of the lower jaw. The purpose of this study was to calculate the prevalence of mandibular fractures based on their causes and locations. Materials and Method A systematic search of 3 electronic databases from January 2010 and January 2020 was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. There were 359 articles identified for screening against selection criteria. The search identified 39 articles to be included in our analysis. Results A total of 20,135 patients with 31,468 mandible fractures in this review. There was a 76% male predominance. The third decade was the most common age group (21-30). Motor vehicle accidents (39.89%) were the leading cause of mandible fractures, followed by falls (27.72%) and violence (25.35%). Condylar fractures are the most common cause of MVA and fall (33.11%, 50% respectively). Mandible body fractures are the second most common type of MVA injury (17.06%). When it came to violence, the angle of the mandible was the most common site (31.73%). Conclusions The prevalence of mandible fractures was higher in male patients in the current study, particularly in the second and third decades of life. Road traffic accidents were the most common cause, and the condylar process of the mandible was the most frequently affected region. Demographic data such as age, gender, and mechanism of injury can help surgeons predict and identify specific areas of mandibular fracture.
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Affiliation(s)
- Abdulrahman Hesham
- Department of Oral and Maxillofacial Surgery, University of Miami and Jackson Memorial Hospital, Miami, FL USA
| | - Joseph Geiger
- Department of Oral and Maxillofacial Surgery, University of Miami and Jackson Memorial Hospital, Miami, FL USA
| | - Yousef Alshamrani
- Department of Oral and Maxillofacial Surgery, University of Miami and Jackson Memorial Hospital, Miami, FL USA
| | - Yoh Sawatari
- Department of Oral and Maxillofacial Surgery, University of Miami and Jackson Memorial Hospital, Miami, FL USA
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Mao J, Li X, Cao K, Xue J, Wang M, Yan D, Zhou Z. Epidemiology of maxillofacial fractures in northwest China: an 11-year retrospective study of 2240 patients. BMC Oral Health 2023; 23:313. [PMID: 37221520 DOI: 10.1186/s12903-023-03006-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 05/02/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND The aim of this study was to determine the epidemiological pattern of maxillofacial fractures in northwestern China by retrospectively analysing the demographics, aetiologies, concomitant injuries, fracture sites, and management. METHODS A 10-year retrospective analysis of 2240 patients with maxillofacial fractures admitted to the General Hospital of Ningxia Medical University was conducted. The extracted data included sex, age, aetiology, fracture site, concomitant injuries, time of treatment, therapeutic approaches and complications. Statistical analyses were performed, including descriptive analysis and the chi-square test. Logistic regression was used to determine the impact factors of maxillofacial fractures and concomitant injuries. P values < 0.05 were considered statistically significant. RESULTS The age of the included patients ranged from 1 to 85 years, and the mean age was 35.88 ± 15.69 years. The male-to-female ratio was 3.9:1. The most frequent aetiology of maxillofacial fractures was road traffic accidents (RTAs) (56.3%), and the most common fracture sites were the anterior wall of the maxillary sinus, arcus zygomaticus and mandibular body. A total of 1147 patients (51.2%) were affected by concomitant injuries, with craniocerebral injury being the most common. Logistic regression analyses revealed increased risks of mid-facial fractures in elderly individuals (odds ratio (OR) = 1.029, P < 0.001) and females (OR = 0.719, P = 0.005). Younger patients had a higher risk of mandibular fractures (OR = 0.973, P < 0.001). RTAs increased the risk for mid-facial fractures and high falls increased the risk for mandibular fractures. CONCLUSIONS The maxillofacial fracture pattern is correlated with sex, age and aetiology. Patients were mainly young and middle-aged males, and the main cause of injury was RTAs, mostly causing compound fractures. Medical staff must be systematically educated to comprehensively examine patients with injuries resulting from RTAs. The management of patients with fractures requires thorough consideration of the patient's age, aetiology, fracture site, and concomitant injuries.
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Affiliation(s)
- Jingjing Mao
- Ningxia Medical University, No. 1160, Sheng Li South Road, Yinchuan, 750004, Ningxia, P.R. China
| | - Xiaojie Li
- Department of Dental and Endodontic Diseases, General Hospital of Ningxia Medical University, No. 804, Sheng Li South Road, Yinchuan, 750004, Ningxia, P.R. China
| | - Kun Cao
- Department of Oral and Maxillofacial Surgery, General Hospital of Ningxia Medical University, No. 804, Sheng Li South Road, Yinchuan, 750004, Ningxia, P.R. China
| | - Jiawen Xue
- Ningxia Medical University, No. 1160, Sheng Li South Road, Yinchuan, 750004, Ningxia, P.R. China
| | - Min Wang
- Department of Stomatology, The Eighth People's Hospital of Jinan, No. 68, Xin Xing Road, Jinan, 271100, Shandong, P.R. China
| | - Di Yan
- Institute of Medical Sciences, General Hospital of Ningxia Medical University, No. 804, Sheng Li South Road, Yinchuan, 750004, Ningxia, P.R. China
| | - Zhongwei Zhou
- Department of Oral and Maxillofacial Surgery, General Hospital of Ningxia Medical University, No. 804, Sheng Li South Road, Yinchuan, 750004, Ningxia, P.R. China.
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Tang A, Wong A, Khurana B. Imaging of Intimate Partner Violence, From the AJR Special Series on Emergency Radiology. AJR Am J Roentgenol 2023; 220:476-485. [PMID: 36069484 DOI: 10.2214/ajr.22.27973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Intimate partner violence (IPV) is a highly prevalent public health issue with multiple adverse health effects. Radiologists are well suited to assessing a patient's likelihood of IPV. Recognition of common IPV injury mechanisms and resulting target and defensive injury patterns on imaging and understanding of differences between patients who have experienced IPV and those who have not with respect to use of imaging will aid radiologists in accurate IPV diagnosis. Target injuries often involve the face and neck as a result of blunt trauma or strangulation; defensive injuries often involve an extremity. Awareness of differences in injury patterns resulting from IPV-related and accidental trauma can aid radiologists in detecting a mismatch between the provided clinical history and imaging findings to support suspicion of IPV. Radiologists should consider all available current and prior imaging in assessing the likelihood of IPV; this process may be aided by machine learning methods. Even if correctly suspecting IPV on the basis of imaging, radiologists face challenges in acting on that suspicion, including appropriately documenting the findings, without compromising the patient's confidentiality and safety. However, through a multidisciplinary approach with appropriate support mechanisms, radiologists may serve as effective frontline physicians for raising suspicion of IPV.
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Affiliation(s)
- Anji Tang
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115
- Trauma Imaging Research and Innovation Center, Brigham and Women's Health, Boston, MA
| | - Andrew Wong
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115
| | - Bharti Khurana
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115
- Trauma Imaging Research and Innovation Center, Brigham and Women's Health, Boston, MA
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Romeo I, Sobrero F, Roccia F, Dolan S, Laverick S, Carlaw K, Aquilina P, Bojino A, Ramieri G, Duran‐Valles F, Bescos C, Segura‐Pallerès I, Ganasouli D, Zanakis SN, de Oliveira Gorla LF, Pereira‐Filho VA, Gallafassi D, Leonardo Perez F, Alalawy H, Kamel M, Samieirad S, Jaisani MR, Rahman SA, Rahman T, Aladelusi T, Hassanein AG, Goetzinger M, Bottini GB. A multicentric, prospective study on oral and maxillofacial trauma in the female population around the world. Dent Traumatol 2022; 38:196-205. [PMID: 35390219 PMCID: PMC9321108 DOI: 10.1111/edt.12750] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND/AIMS Approximately 20% of patients with maxillofacial trauma are women, but few articles have analysed this. The aim of this multicentric, prospective, epidemiological study was to analyse the characteristics of maxillofacial fractures in the female population managed in 14 maxillofacial surgery departments on five continents over a 1-year period. METHODS The following data were collected: age (0-18, 19-64, or ≥65 years), cause and mechanism of the maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injury, day of trauma, timing and type of treatment, and length of hospitalization. RESULTS Between 30 September 2019 and 4 October 2020, 562 of 2387 patients hospitalized with maxillofacial trauma were females (24%; M: F ratio, 3.2:1) aged between 1 and 96 years (median age, 37 years). Most fractures occurred in patients aged 20-39 years. The main causes were falls (43% [median age, 60.5 years]), which were more common in Australian, European and American units (p < .001). They were followed by road traffic accidents (35% [median age, 29.5 years]). Assaults (15% [median age, 31.5 years]) were statistically associated with alcohol and/or drug abuse (p < .001). Of all patients, 39% underwent open reduction and internal fixation, 36% did not receive surgical treatment, and 25% underwent closed reduction. CONCLUSION Falls were the main cause of maxillofacial injury in the female population in countries with ageing populations, while road traffic accidents were the main cause in African and some Asian centres, especially in patients ≤65 years. Assaults remain a significant cause of trauma, primarily in patients aged 19-64 years, and they are related to alcohol use.
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Affiliation(s)
- Irene Romeo
- Division of Maxillofacial SurgeryCittà della Salute e della ScienzaUniversity of TurinTurinItaly
| | - Federica Sobrero
- Division of Maxillofacial SurgeryCittà della Salute e della ScienzaUniversity of TurinTurinItaly
| | - Fabio Roccia
- Division of Maxillofacial SurgeryCittà della Salute e della ScienzaUniversity of TurinTurinItaly
| | - Sean Dolan
- Department Oral and Maxillofacial SurgeryUniversity of DundeeDundeeUK
| | - Sean Laverick
- Department Oral and Maxillofacial SurgeryUniversity of DundeeDundeeUK
| | - Kirsten Carlaw
- Department Plastic, Reconstructive and Maxillofacial SurgeryNepean HospitalSydneyNew South WalesAustralia
| | - Peter Aquilina
- Department Plastic, Reconstructive and Maxillofacial SurgeryNepean HospitalSydneyNew South WalesAustralia
| | - Alessandro Bojino
- Division of Maxillofacial SurgeryCittà della Salute e della ScienzaUniversity of TurinTurinItaly
| | - Guglielmo Ramieri
- Division of Maxillofacial SurgeryCittà della Salute e della ScienzaUniversity of TurinTurinItaly
| | - Francesc Duran‐Valles
- Department Oral and Maxillofacial SurgeryHospital Universitario Vall D’HebronBarcelonaSpain
| | - Coro Bescos
- Department Oral and Maxillofacial SurgeryHospital Universitario Vall D’HebronBarcelonaSpain
| | - Ignasi Segura‐Pallerès
- Division of Maxillofacial SurgeryCittà della Salute e della ScienzaUniversity of TurinTurinItaly
| | - Dimitra Ganasouli
- Department Oral and Maxillofacial SurgeryHippokration General HospitalAthensGreece
| | - Stelios N. Zanakis
- Department Oral and Maxillofacial SurgeryHippokration General HospitalAthensGreece
| | | | | | - Daniel Gallafassi
- Division of Oral and Maxillofacial SurgeryDepartment of Diagnosis and SurgerySão Paulo State UniversityUNESPAraçatuba, São PauloBrazil
| | - Faverani Leonardo Perez
- Division of Oral and Maxillofacial SurgeryDepartment of Diagnosis and SurgerySão Paulo State UniversityUNESPAraçatuba, São PauloBrazil
| | - Haider Alalawy
- Department Oral and Maxillofacial SurgeryGazi Alhariri HospitalMedical CityBaghdadIraq
| | - Mohammed Kamel
- Department Oral and Maxillofacial SurgeryGazi Alhariri HospitalMedical CityBaghdadIraq
| | - Sahand Samieirad
- Oral and Maxillofacial Diseases Research CenterMashhad University of Medical SciencesMashhadIran
| | | | - Sajjad Abdur Rahman
- Department Oral and Maxillofacial SurgeryAligarh Muslim UniversityAligarhIndia
| | - Tabishur Rahman
- Department Oral and Maxillofacial SurgeryAligarh Muslim UniversityAligarhIndia
| | - Timothy Aladelusi
- Department Oral and Maxillofacial SurgeryCollege of MedicineUniversity of IbadanIbadanNigeria
| | - Ahmed Gaber Hassanein
- Maxillofacial Surgery UnitFaculty of MedicineGeneral Surgery DepartmentSohag UniversitySohagEgypt
| | - Maximilian Goetzinger
- Department Oral and Maxillofacial SurgeryParacelsus Medical UniversitySalzburgAustria
| | - Gian Battista Bottini
- Department Oral and Maxillofacial SurgeryParacelsus Medical UniversitySalzburgAustria
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Cavalcanti AL, de Sousa FJC, Laureano ICC, Cavalcanti AFC. Head and Face Injuries in Brazilian Homicide Victims - A Retrospective Study. Ann Maxillofac Surg 2021; 11:103-107. [PMID: 34522663 PMCID: PMC8407615 DOI: 10.4103/ams.ams_158_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 02/01/2021] [Accepted: 02/08/2021] [Indexed: 11/07/2022] Open
Abstract
Introduction: Violence is a serious problem in view of its magnitude and impact on the health of the population in several countries. The aim of the study was to evaluate the occurrence of head and face injuries among homicide victims in a municipality in the Northeastern region of Brazil. Materials and Methods: A cross-sectional study carried out at the Police Station for Crimes against Persons of the Civil Police, which evaluated 168 police inquiries of homicide victims notified from January 2015 to December 2018. Variables analyzed were related to the Victim's sociodemographic profile, homicide characteristics and body region involved. Descriptive data analysis and Pearson's Chi-square test (P < 0.05) were performed. Results: There was greater involvement of men (92.9%) aged 20–29 years (36.3%), drug users (70.7%) and with a criminal record (65.9%). There was a predominance of simple homicides (92.3%), with greater occurrence on Sundays (16.7%), in the night shift (40.1%), revenge was the main reason for the crime (32%), and firearms as the main means used (89.2%). Regarding the number of body regions affected, victims were more frequently affected in 2 regions (36.5%). Head injuries were identified in 68.3% of victims, while face injuries represented 35.3%. There was an association between the presence of head injuries and number of injuries (P < 0.05). Discussion: The prevalence of head and face injuries resulting from homicide was high and victims are predominantly young men, drug users and those with a criminal record. The association was found between the presence of head injuries and number of injuries.
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Maxillofacial fractures in females: a 5-year retrospective review. Ir J Med Sci 2021; 191:367-374. [PMID: 33616845 DOI: 10.1007/s11845-021-02534-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 01/28/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND This retrospective study reviews the maxillofacial fractures (MF) over a 5-year period at the National Maxillofacial Unit, St James Hospital Dublin, with an emphasis on female patients. MATERIALS AND METHODS The trauma database was analysed from January 2015 to December 2019. The following demographic details were recorded: patient age and gender, mechanism of injury, and facial fracture sites. This retrospective study did not require approval from the local IRB. RESULTS A total of 4761 patients had facial fractures during the study: 1125 (24%) female, 3636, (76%) male. Females had 1190 facial fractures, with two fracture peaks: 20-39 years and 70-89 years. In males, the majority of fractures occurred between 20 and 39 peaking at 20-29 years and tailed off thereafter. In the females the most common fracture sites were zygomatic 402 (34%), nasal 311(26%), orbital (22%), and mandibular 141(12%). There were also smaller percentages of frontal (0.8%), maxillary (4%), and Le Fort fractures (1%). Two hundred and sixty-two (23%) females were managed surgically and 853 (77%) non-surgically. CONCLUSION This study confirms maxillofacial fractures are less common in females. The female age distribution demonstrates two peaks, one in early adult and a second in old age. This may be explained by females living longer and independently and at risk for falls. The most commonly reported fracture aetiology in females was "falls." This raises concerns as to whether "falls" are used to explain an assault. There is an informal concern amongst maxillofacial surgeons that females presenting with facial trauma may be the victims of domestic violence, which may be denied by the victims.
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Carvalho Laureano IC, Farias L, de Souza Abreu Alencar G, Cabral Cavalcanti AF, Barros de Alencar CR, Cavalcanti A. Injuries in the Maxillofacial Complex and Associated Factors in Brazilian Victims of Violence: A Cross-sectional Study. CUMHURIYET DENTAL JOURNAL 2019. [DOI: 10.7126/cumudj.467382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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