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Noorali IS, Attyia MA, Alsunbuli MMB. Patterns of Maxillofacial Injures Caused by Motorcycle Accidents. Int Arch Otorhinolaryngol 2023; 27:e309-e315. [PMID: 37125365 PMCID: PMC10147459 DOI: 10.1055/s-0042-1744256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 01/31/2022] [Indexed: 05/02/2023] Open
Abstract
Introduction Motorcycles are used as a common means of transportation, and motorcycle accidents are responsible for a major portion of trauma injuries. Objectives The purpose of this study was to analyze the patterns of facial injuries in motorcyclists, to evaluate the types of injuries, and to investigate if the accident-related factors had any impact on the characteristics of the injuries. Methods This retrospective observational study included 74 patients with maxillofacial injuries following motorcycle-related accidents. Investigated data were divided into four main categories: sociodemographic, accident-related, injury-related, and treatment-related. Results All the patients were males with a mean age (±SD) of 25.03 (±9.986) years. Most accidents ( n = 44, 59.4%) occurred in the evening. Most of the patients ( n = 40, 54%) were traveling on motorcycle models that had maximum speed of over 120 km/h. Furthermore, 15 patients (18.9%) were under the influence of alcohol during the crashes and only one patient was wearing a helmet. Fractures of the maxillofacial bones were observed in 50 (67.5%) crash victims; 24 of them (48%) had middle third fractures, 11 (22%) had mandibular fractures, and 15 patients (30%) presented with a combination of lower, middle, and upper third fractures. Conclusion Almost all patients were not wearing helmets at the moment of the crash. The most common fractured site was the maxilla. The majority of the patients received surgical treatment. Increased enforcement of safety measures for riders and raising awareness about the dangers of motorcycle crashes are required measures to improve traffic safety and, ultimately, population health.
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Affiliation(s)
- Imad S. Noorali
- Oral and Maxillofacial Surgery Unit, Al-Yarmouk Teaching Hospital, Baghdad, Iraq
| | - Marwa A. Attyia
- Oral and Maxillofacial Surgery Unit, Al-Yarmouk Teaching Hospital, Baghdad, Iraq
- Address for correspondence Marwa A. Attyia, BDS, FIBMS Oral and Maxillofacial Surgery Unit, Al-Yarmouk Teaching HospitalBaghdadIraq
| | - Mudher M. B. Alsunbuli
- Oral and Maxillofacial Surgery Department, College of Dentistry, Al-Bayan University, Baghdad, Iraq
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Uppada UK, Sinha R, Susmitha M, Praseedha B, Kiran BR. Mandibular Fracture Patterns in a Rural Setup: A 7-Year Retrospective Study. J Maxillofac Oral Surg 2022; 21:1349-1354. [PMID: 36896075 PMCID: PMC9989092 DOI: 10.1007/s12663-020-01358-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/28/2020] [Indexed: 10/24/2022] Open
Abstract
Aim This study is designed to outline the probable patterns of mandibular fracture based on patient demographics and mechanism of injury in a rural setup. Materials and Methods The data from the record section in our unit belonging to patients who sustained fractures in the maxillofacial skeleton and were treated in our unit between the period June 2012-May 2019 were collected and analyzed. The variables analyzed for the study were etiology, gender, age, and type of fracture. All cases were treated by open reduction and rigid internal fixation. Results A total of 224 patients with maxillofacial fractures were diagnosed, of which 195 were male and 29 were female. The ages ranged from 7 to 70 years. Road traffic accidents are noted to be the most common cause of mandibular fractures. The maximum cases were in the age group of 21-30 years with 85 (38%) patients. In a total of 224 patients, there were 278 mandibular fractures. The maximum incidence of fractures was in the mandibular parasymphysis region with 90 fractures accounting for 32.3% of the mandibular fractures. Males were more susceptible to mandibular fractures. Majority of them sustained mandibular fracture at more than one anatomical area. Conclusion It can be concluded that mandibular fractures are seen predominantly in the second and third decades of life due to road traffic accidents with high-speed vehicles and lack of protective safety accessories. Mandible when it fractured, it usually involved more than one anatomical location.
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Affiliation(s)
- Uday Kiran Uppada
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, India
| | - Ramen Sinha
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, India
| | - M. Susmitha
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, India
| | - B. Praseedha
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, India
| | - B. Ravi Kiran
- Department of Oral and Maxillofacial Surgery, Sri Sai College of Dental Surgery, Vikarabad, India
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Essobiyou TB, Adam S, Dargani MF, Boko SUR, Ananidjin G, Keheou AP, Issa M, Bissa H. Mandibular fracture in a regional area: About 109 cases in Togo. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2022.100365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Stanford-Moore GB, Niyigaba G, Tuyishimire G, Yau J, Kulkrani A, Nyabyenda V, Ncogoza I, Shaye DA. Effect of Delay of Care for Patients with Craniomaxillofacial Trauma in Rwanda. OTO Open 2022; 6:2473974X221096032. [PMID: 35480144 PMCID: PMC9036345 DOI: 10.1177/2473974x221096032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/22/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives Craniomaxillofacial (CMF) trauma represents a significant proportion of global surgical disease burden, disproportionally affecting low- and middle-income countries where care is often delayed. We investigated risk factors for delays to care for patients with CMF trauma presenting to the highest-volume trauma hospital in Rwanda and the impact on complication rates. Study Design This prospective cohort study comprised all patients with CMF trauma presenting to the University Teaching Hospital of Kigali, Rwanda, between June 1 and October 1, 2020. Setting Urban referral center in resource-limited setting. Methods Epidemiologic data were collected, and logistic regression analysis was undertaken to explore risk factors for delays in care and complications. Results Fifty-four patients (94.4% men) met criteria for inclusion. The mean age was 30 years. A majority of patients presented from a rural setting (n = 34, 63%); the most common cause of trauma was motor vehicle accident (n = 18, 33%); and the most common injury was mandibular fracture (n = 28, 35%). An overall 78% of patients had delayed treatment of the fracture after arrival to the hospital, and 81% of these patients experienced a complication (n = 34, P = .03). Delay in treatment was associated with 4-times greater likelihood of complication (odds ratio, 4.25 [95% CI, 1.08-16.70]; P = .038). Conclusion Delay in treatment of CMF traumatic injuries correlates with higher rates of complications. Delays most commonly resulted from a lack of surgeon and/or operating room availability or were related to transfers from rural districts. Expansion of the CMF trauma surgical workforce, increased operative capacity, and coordinated transfer care efforts may improve trauma care.
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Affiliation(s)
- Gaelen B. Stanford-Moore
- Department of Otolaryngology–Head and Neck Surgery, University of California–San Francisco, San Francisco, California, USA
| | - Gilbert Niyigaba
- Department of ENT, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Gratien Tuyishimire
- Department of Surgery, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Jenny Yau
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye & Ear, Harvard Medical School, Boston, Massachusetts, USA
| | - Amol Kulkrani
- Department of Surgery, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Victor Nyabyenda
- Department of Surgery, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Isaie Ncogoza
- Department of ENT, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Department of Surgery, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - David A. Shaye
- Department of Surgery, University Teaching Hospital of Kigali, Kigali, Rwanda
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, Massachusetts Eye & Ear, Harvard Medical School, Boston, Massachusetts, USA
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Pandey S, Yadav P, Roychoudhury A, Bhutia O, Goswami D. A randomized controlled trial to compare functional, combined rigid and functional and rigid fixation in double mandibular fractures. J Oral Biol Craniofac Res 2022; 12:233-237. [DOI: 10.1016/j.jobcr.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 02/18/2022] [Indexed: 10/19/2022] Open
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Seol YJ, Kim YJ, Kim YS, Cheon YW, Kim KG. A Study on 3D Deep Learning-Based Automatic Diagnosis of Nasal Fractures. SENSORS 2022; 22:s22020506. [PMID: 35062465 PMCID: PMC8780993 DOI: 10.3390/s22020506] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 12/11/2022]
Abstract
This paper reported a study on the 3-dimensional deep-learning-based automatic diagnosis of nasal fractures. (1) Background: The nasal bone is the most protuberant feature of the face; therefore, it is highly vulnerable to facial trauma and its fractures are known as the most common facial fractures worldwide. In addition, its adhesion causes rapid deformation, so a clear diagnosis is needed early after fracture onset. (2) Methods: The collected computed tomography images were reconstructed to isotropic voxel data including the whole region of the nasal bone, which are represented in a fixed cubic volume. The configured 3-dimensional input data were then automatically classified by the deep learning of residual neural networks (3D-ResNet34 and ResNet50) with the spatial context information using a single network, whose performance was evaluated by 5-fold cross-validation. (3) Results: The classification of nasal fractures with simple 3D-ResNet34 and ResNet50 networks achieved areas under the receiver operating characteristic curve of 94.5% and 93.4% for binary classification, respectively, both indicating unprecedented high performance in the task. (4) Conclusions: In this paper, it is presented the possibility of automatic nasal bone fracture diagnosis using a 3-dimensional Resnet-based single classification network and it will improve the diagnostic environment with future research.
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Affiliation(s)
- Yu Jin Seol
- Department of Biomedical Engineering, Gachon University, 191, Hambangmoe-ro, Yeonsu-gu, Incheon 21936, Korea;
| | - Young Jae Kim
- Department of Biomedical Engineering, Gachon University College of Medicine, 38-13 Docjeom-ro 3 beon-gil, Namdong-gu, Incheon 21565, Korea;
| | - Yoon Sang Kim
- Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, College of Medicine, Incheon 21565, Korea;
| | - Young Woo Cheon
- Department of Plastic and Reconstructive Surgery, Gachon University Gil Medical Center, College of Medicine, Incheon 21565, Korea;
- Correspondence: (Y.W.C.); (K.G.K.)
| | - Kwang Gi Kim
- Department of Biomedical Engineering, Gachon University College of Medicine, 38-13 Docjeom-ro 3 beon-gil, Namdong-gu, Incheon 21565, Korea;
- Department of Health Sciences and Technology, Gachon Advanced Institute for Health Sciences and Technology (GAIHST), Gachon University, Seongnam-si 13120, Korea
- Correspondence: (Y.W.C.); (K.G.K.)
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Kim MJ, Yang KM, Lim H. Epidemiology of Facial Bone Fractures During the Coronavirus Disease 2019 Pandemic: A Single Korean Level I Trauma Center Study. JOURNAL OF TRAUMA AND INJURY 2021. [DOI: 10.20408/jti.2021.0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose The medical community has been heavily impacted by the coronavirus disease 2019 pandemic. The management of facial trauma patients has been affected by the patient capacity of emergency rooms. In this study, we share our experiences of facial trauma management during the social lockdown period and investigate the epidemiological changes in facial bone fractures. Methods A total of 997 patients who presented to Ajou University Hospital Emergency Center and were evaluated by plastic or maxillofacial surgeons for facial trauma were included in this retrospective study. Our study design was a comparative study of two groups: the 2019 group (control) and the 2020 group (the experimental group that experienced social lockdown). Results The total number of emergency room inpatients reflected the national pandemic trends with three peaks in patient numbers. According to these trends, facial bone fractures had two different low points in August 2020 and December 2020. A comparison of the 2019 and 2020 facial bone fractures did not show a statistically significant difference in the total number of patients. An analysis of the causes of trauma showed that domestic accidents increased in 2020 (30.92%; p<0.001). Among the anatomical sites of facial injury in surgical patients, the frontozygomatic complex fracture increased the most in 2020 (p=0.018). Facial injuries with two separate sites of injury or with three or more involved sites also showed a significant increase in 2020 (p<0.001). Conclusions We demonstrated that the incidence of facial trauma patients correlated with the incidence of patients presenting to the emergency department and that facial trauma is inextricably related to multi-trauma cases. Domestic accidents and facial trauma with multiple anatomically involved sites are increasing trends that need more attention.
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Frimpong P, Nguyen TTH, Sodnom-Ish B, Nimatu ES, Dampare NYA, Rockson R, Awuah SB, Amponsah EK, Newton C, Kim SM. Incidence and management of mandibular fractures in a low-resource health facility in Ghana. J Korean Assoc Oral Maxillofac Surg 2021; 47:432-437. [PMID: 34969016 PMCID: PMC8721415 DOI: 10.5125/jkaoms.2021.47.6.432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/14/2021] [Accepted: 01/21/2021] [Indexed: 11/07/2022] Open
Abstract
Objectives The mandible and other parts of the maxillofacial region suffer significant morbid injuries following road traffic accidents. Our study gives epidemiological description of mandibular fractures in Ghana and also evaluates the relevance of closed reduction and indirect fixation for managing mandibular fractures in low-resource health facilities in low-income countries like Ghana. Patients and Methods This is a retrospective study involving 268 patients who reported to the Department of Oral and Maxillofacial Surgery of the Sunyani Regional Hospital with mandibular fractures from January 2010 to December 2019. Patient medical records were assessed for information on age, sex, fracture etiology, anatomic location of fracture, time of day of road traffic accident, and other associated injuries. Results A total of 268 patients were included in this study (males, 216 [80.6%]; females, 52 [19.4%]). Motor vehicular accident (MVA) was the leading cause of mandibular fractures (202 injuries, 75.4%). Other etiologies included assault (39, 14.6%), gunshot (13, 4.9%), falls (12, 4.5%), and industrial accidents (2, 0.7%). Of the 161 male cases caused by MVA, 121 (75.2%) occurred at night and in the evening while the remaining 40 (24.8%) occurred in the morning and afternoon. Among all managed 222 patients, 212 (79.1%) were treated with closed reduction and indirect fixation technique while 10 (3.7%) were treated with open reduction and direct fixation. Conclusion Closed reduction with indirect fixation could successfully be used to manage mandibular fractures in low resourced health facilities, especially in low-income countries. The poor lightening system on roads in Ghana is a major contributory factor to motor vehicular accidents.
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Affiliation(s)
- Paul Frimpong
- Oral and Maxillofacial Microvascular Reconstruction LAB, Sunyani, Ghana
| | - Truc Thi Hoang Nguyen
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Buyanbileg Sodnom-Ish
- Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | | | | | - Roberta Rockson
- Oral and Maxillofacial Microvascular Reconstruction LAB, Sunyani, Ghana
| | | | | | - Cardinal Newton
- Department of Restorative Dentistry, Brong Ahafo Regional Hospital, Sunyani, Ghana
| | - Soung Min Kim
- Oral and Maxillofacial Microvascular Reconstruction LAB, Sunyani, Ghana.,Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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Rejeb MB, Daldoul M, Ben Cheikh A, Tabka F, Ayachi S, Khochtali H. Facial fractures in post-revolution Tunisia as violence indicator: About 476 cases. ANN CHIR PLAST ESTH 2021; 67:14-19. [PMID: 34848099 DOI: 10.1016/j.anplas.2021.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/17/2021] [Accepted: 10/25/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION On January 2011, Tunisia had known a revolution. To move from dictatorship to democraty project, the country suddenly fell into political instability, which was accompanied by a wave of social violence. Traumatology, and, particularly, maxilla-facial traumatology, is usually a reliable indicator of the degree of violence. AIM The aim of this study was to establish the epidemiological profile of facial fractures during the various phases of political transition through which Tunisia has passed since revolution (2012-2016). PATIENTS AND METHODS A retrospective cross-sectional study was conducted among all patients with facial fractures admitted to the department of Oral and Maxillo facial Surgery of University Hospital of Sahloul during five years (2012-2016). Fractures diagnosed late at the sequelae stage were excluded. Data of patients were recorded according to medical files, including cause of injury, age and gender, injury mechanisms and type of facial fracture. RESULTS During the period of the study, a total of 476 patients were identified, with a sex-ratio of 7.2 to 1, patients ranged in age from 1 year to 76-years-old with a mean age of 27 years. Assaults were the most common cause of injury (39.1%). Mandible was fractured in 257 cases (54.2%) followed by zygoma (116 cases, 24.4%), nasal bone (99 cases, 20.8%) and Orbital walls (98 cases, 20.6%). DISCUSSION The epidemiological profile of facial fractures in Tunisia has been changed since 2011. Facial fractures occur mainly after assaults, which are an indicator of increased social violence accompanying political instability present in our country.
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Affiliation(s)
- M B Rejeb
- Maxillofacial surgery department, Sahloul Hospital, Sousse university, Sousse, Tunisia.
| | - M Daldoul
- Maxillofacial surgery department, Sahloul Hospital, Sousse university, Sousse, Tunisia.
| | - A Ben Cheikh
- Prevention and safety care department, Sahloul hospital, Sousse university, Sousse, Tunisia.
| | - F Tabka
- Maxillofacial surgery department, Sahloul Hospital, Sousse university, Sousse, Tunisia.
| | - S Ayachi
- Maxillofacial surgery department, Sahloul Hospital, Sousse university, Sousse, Tunisia.
| | - H Khochtali
- Maxillofacial surgery department, Sahloul Hospital, Sousse university, Sousse, Tunisia.
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The Epidemiology and Management of Maxillofacial Fractures at a Tertiary Care Hospital in a Conflict-Torn Region in Somalia. J Craniofac Surg 2021; 32:2330-2334. [PMID: 34351730 DOI: 10.1097/scs.0000000000007671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The etiology of maxillofacial fractures (MFFs) varies according to the geographical location and density of the population. This study aimed to analyze the etiology, pattern, and treatment of MFFs. Epidemiological characteristics and treatment modalities of MFFs have never been evaluated in Somalia. The study included 45 patients who were operated on for MFFs at a tertiary care hospital in Somalia (2018-2019). Patient demographics, fracture causes, types, associated non-facial injuries, treatment modalities, and hospitalization-time were evaluated. The most common etiological factors of the MFFs were explosion (24.4%) and assault (24.4%), followed by gunshot (22.2%), sports accident (15.6%), motor vehicle accident (11.1%), and fall from height (2.2%) patients, respectively. The main site of injury was the mandible bone (64.4%) followed by nasal bone, maxilla, zygomatic, and orbital region. The most common non-facial injuries of the MFFs were soft tissue laceration (37.8%) followed by femoral fracture (6.7%), clavicle fracture (4.4%), and femoral fracture with chest injuries (2.2%). The most applied treatment was open reduction microplate +/- intermaxillary fixation (77.8%). Due to the size of the mandible fractures, an iliac autograft (6.7%) was performed. The mean length of the hospital stay was 11.8 +/- 8.4 days (range, 1-45 days), and some patients (15.6%) needed intensive care due to severe injuries. This will be the first study aiming to analyze the etiology, pattern, and treatment of MFFs in Somalia. This study deals with the social aspects of Somalia, and it shows that MFFs develop as a result of highly interpersonal violence in a young man.
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AlMofreh AlQahtani F, Bishawi K, Jaber M, Thomas S. Maxillofacial trauma in the gulf countries: a systematic review. Eur J Trauma Emerg Surg 2021; 47:397-406. [PMID: 32572511 DOI: 10.1007/s00068-020-01417-x] [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: 02/10/2020] [Accepted: 06/15/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE The objective of this review was to determine the prevalence, major causative factors and the most common sites of Maxillofacial Trauma in the Gulf Cooperation Council (GCC) Countries. METHODS All articles that were published in the English language in the databases such as Google Scholar, EBSCO, PubMed, NCBI, Medline, COCHRANE, ELSEVIER and SCOPUS were reviewed for MFT from GCC during the last 23 years. RESULTS A total of 19,151 patients (16,567 males and 2584 females) (86-14%) with an age range between 0 and 97 years were included in the study. In all of the Gulf countries males outnumber females in terms of maxillofacial injuries with a ratio of 6.4:1. The mandible was the most common site of trauma followed by the maxilla. Road Traffic Accidents (RTA) was the most common cause of injury in the GCC followed by falls. CONCLUSION Maxillofacial injuries are highly prevalent, distributed among the Gulf countries, and is mainly caused by RTAs especially among males who are highly prone to MFT in the gulf. The reasons are due to lack of road safety culture and weak enactment of traffic legislation, other possible factors include intrinsic car safety features, high speed driving and the amount/use of highways in these societies.
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Affiliation(s)
| | - Khaled Bishawi
- College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Mohamed Jaber
- College of Dentistry, Ajman University, Ajman, United Arab Emirates. .,Department of Oral Surgery, College of Dentistry, Ajman University, P.O. Box 346, Ajman, United Arab Emirates.
| | - Sam Thomas
- College of Dentistry, Ajman University, Ajman, United Arab Emirates
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Fomete B, Adebayo ET, Agbara R, Osunde DO, Abah ER. Pattern of Ocular Involvement in Midface Injuries Seen at a Tertiary Care Hospital in Northern Nigeria. Niger J Surg 2021; 27:33-37. [PMID: 34012239 PMCID: PMC8112374 DOI: 10.4103/njs.njs_21_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/19/2020] [Accepted: 07/23/2020] [Indexed: 11/13/2022] Open
Abstract
Aim: The aim of the study was to report the etiology, pattern, and spectrum of ocular injuries in patients with maxillofacial injuries seen at a tertiary care hospital in northern Nigeria. Patients and Methods: This is a retrospective evaluation of the etiology, spectrum, and treatment of ocular injures seen in patients with midfacial fractures, who presented at Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria, a tertiary care hospital in northern Nigeria. Cases were seen at the oral and maxillofacial clinic for those presenting with midfacial fractures, whereas those presenting with ocular injuries due to midfacial injuries were referred from the ophthalmology department. Data were collected on their demographics, etiology of injuries, body part(s) involved, and treatment. Results: A total of 256 patients had midfacial injuries during the period, of which 219 patients had 357 associated ocular injuries. The age range was between 3 and 76 years. There were more males (83.8%) than females (16.2%), giving a male-to-female ratio of 5.2:1; the 21–30 years' age bracket was most frequently affected (38.4%). The predominant etiology of injuries was road traffic accidents (RTAs) (90.1%), followed by assault (4.9%). Zygomatic complex fractures (38.6%) and orbital wall fractures (24.7%) were the common midfacial injuries. There were 357 ocular injuries, giving a patient: injury ratio of 1:1.6, with subconjunctival hemorrhage (32.5%) and ruptured globe (20.0%) being common. Treatments performed were reduction and immobilization of midfacial fractures plus evisceration (32.0%), followed by reduction and immobilization of fractures alone (23.9%) and reduction and immobilization plus grafting of soft tissues (21.2%). Conclusion: Ocular injuries are quite common in patients with midfacial injuries, with a ratio of 1.6:1. RTA was the most common etiology, with zygomatic complex fractures as the most common midfacial injury. Subconjunctival hemorrhage was the most common ocular injury manifestation, with young adults (21–30 years of age) being most affected. Treatment often involved reduction and immobilization of midface fractures with evisceration and grafting of ocular tissues.
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Affiliation(s)
- Benjamin Fomete
- Department of Maxillofacial Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
| | - Ezekiel Taiwo Adebayo
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Medical Sciences, Ondo, Nigeria
| | - Rowlan Agbara
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Jos, Jos, Nigeria
| | - Daniel Otasowie Osunde
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Calabar, Calabar, Nigeria
| | - Emmanuel R Abah
- Department of Ophthalmology, Ahmadu Bello University Teaching Hospital, Zaria, Kaduna, Nigeria
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Al-Qattan YM, Al-Qattan MM. The use of interosseous dental wires and sutures for internal fixation in a patient with multiple comminuted middle facial fractures and facial nerve injury: A demonstrative case report. Int J Surg Case Rep 2021; 79:188-192. [PMID: 33482446 PMCID: PMC7819820 DOI: 10.1016/j.ijscr.2021.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/10/2021] [Accepted: 01/10/2021] [Indexed: 11/21/2022] Open
Abstract
We report on a case of multiple comminuted middle facial fractures. There was concurrent facial nerve injury. Fracture fixation was done with wires which is considered obsolete. Wire fixation was preferred to protect the facial nerve repair. The outcome was satisfactory.
Introduction The use of plates and screws for facial fractures is considered the gold standard; providing accurate reduction and rigid fixation. Case report We report on a case with multiple comminuted middle facial fractures and concurrent facial nerve injury. The fractures were fixed with a combination of interosseous dental wires and polypropylene sutures with a satisfactory outcome. Discussion We aim to demonstrate two main advantages of wire/suture fixation in such cases when compared to plates and screws. Wire/suture fixation does not require periosteal dissection for fixation; and hence there is more preservation of the blood supply of the bony fragments. Furthermore, in the setting of concurrent facial nerve repair, the use of plates may risk re-injury of the repaired nerve during the late removal of the hardware. Interosseous wires/sutures do not require late removal and this is another advantage in these cases. Conclusion Interosseous dental wires and polypropylene sutures may be considered for fixation of multiple comminuted middle facial fractures and concurrent facial nerve injury.
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Affiliation(s)
| | - Mohammad M Al-Qattan
- Department of Surgery, Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia.
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Devarakonda V, Navakoti P, Sungal RP, Sakleshpur Mruthyunjaya C, Karanam AK, Sanobar A. Trends in mandibular fracture patterns in central Telangana - A retrospective overview and analysis. Dent Traumatol 2021; 37:436-439. [PMID: 33427375 DOI: 10.1111/edt.12649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIM Socio-economic, environmental and cultural influences may lead to discrepancies in the distribution and occurrence of orofacial injuries. The aim of this study was to analyze the patient demographics and current patterns of mandibular fractures within a geographic population. MATERIAL AND METHODS The medical records of patients with facial trauma treated over a period of 3 years were retrieved and reviewed. Their data were analyzed based on the following parameters-age, gender, mechanism of trauma, seasonal variation, drug/alcohol abuse at the time of trauma, number, and anatomic location of fractures. RESULTS Of all the patients with maxillofacial injuries, 56% had mandibular fractures and 80% of these were sustained in road traffic accidents. Nearly 44% of patients had multiple mandibular fractures giving an average of about 1.6 fractures per mandible. Alcohol abuse was seen in 39% of patients. Seasonal influence indicated that the monsoon season had the highest incidence of trauma. CONCLUSION Fracture patterns vary according to the etiology of the fracture and direction of the impact force. This information can help in the diagnosis and as a guide to future funding of preventive public health programs.
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Affiliation(s)
- Visalakshi Devarakonda
- Department of Oral & Maxillofacial Surgery, Government Dental College & Hospital, Hyderabad, India
| | - Prasad Navakoti
- Department of Oral & Maxillofacial Surgery, Government Dental College & Hospital, Hyderabad, India
| | | | | | - Anil Kumar Karanam
- Department of Oral & Maxillofacial Surgery, Government Dental College & Hospital, Kadapa, India
| | - Arshiya Sanobar
- Department of Oral & Maxillofacial Surgery, Government Dental College & Hospital, Hyderabad, India
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Juncar RI, Tent PA, Juncar M, Arghir IA, Arghir OC, Rivis M. Interrelation between facial soft tissue lessions, underlying fracture patterns and treatment of zygomatic bone trauma: a 10 year retrospective study. Head Face Med 2020; 16:30. [PMID: 33243244 PMCID: PMC7690189 DOI: 10.1186/s13005-020-00246-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 11/18/2020] [Indexed: 12/03/2022] Open
Abstract
Background The pattern of zygomatic bone fractures varies in the literature, their features being frequently masked by the presence of associated soft tissue lesions. In this context the clinical diagnosis and the therapeutic indications can be difficult. The aim of this study was to evaluate the clinical features of zygomatic bone fractures and their interrelation with concomitant overlying soft tissue injuries, as well as to assess the type of treatment methods applied depending on the fracture pattern and the results achieved depending on the incidence rate of postoperative complications. We will use these results in order to improve the diagnosis and the establishment of correct treatment of this pathology. Methods A 10-year retrospective evaluation of midface fractures was performed in patients diagnosed and treated in a tertiary Clinic of Oral and Maxillofacial Surgery. Statistical analysis was performed with the MedCalc Statistical Software version 19.2 (MedCalc Software bvba, Ostend, Belgium; 53 https://www.medcalc.org; 2020). Nominal data were expressed as frequency and percentage. The comparisons of the frequencies of a nominal variable among the categories of another nominal variable were made using the chi-square test. Multivariate logistic regressions were used in order to establish the independent association between variables and lacerations/excoriations. After using the Bonferroni correction for multiple comparisons, a value of p < 0.025 was considered statistically significant. Results The study included 242 patients with zygomatic bone fractures. The majority of the fractures were displaced n = 179 (73.9%), closed n = 179 (73.9%) and complete n = 219 (90.5%). Hematoma was the most frequent associated soft tissue lesion n = 102 (42.1%) regardless of the fracture pattern (p = 1.000). Complete zygomatic fracture (OR – 2.68; p = 0.035) and fractures with displacement (OR – 3.66; p = 0.012) were independently associated with the presence of laceration. Fractures with displacement (OR – 7.1; p = 0.003) were independently associated with the presence of excoriation. The most frequent type of treatment applied was Gillies reduction (61.9%), followed by ORIF (30.9%). The most frequent postoperative complication was malunion secondary to Gillies treatment (4,6%). Conclusions Patients presenting lacerations and excoriations on clinical soft tissue examination will most frequently have an underlying complete, displaced or comminuted zygomatic fracture. In the case of displaced, open or comminuted fractures we achieved the best results secondary to ORIF treatment method, while in the case of non-displaced and closed fractures, the best results achieved were secondary to conservative treatment.
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Affiliation(s)
- Raluca Iulia Juncar
- Department of Oral and Maxillofacial Surgery, University of Oradea, Str. Piața 1 Decembrie, no.10, 410073, Oradea, Romania
| | - Paul Andrei Tent
- Department of Oral and Maxillofacial Surgery, University of Oradea, Str. Piața 1 Decembrie, no.10, 410073, Oradea, Romania.
| | - Mihai Juncar
- Department of Oral and Maxillofacial Surgery, University of Oradea, Str. Piața 1 Decembrie, no.10, 410073, Oradea, Romania
| | - Ioan Anton Arghir
- Pulmonology Department, Faculty of Medicine, Ovidius University of Constanta, Consteanta, Romania
| | - Oana Cristina Arghir
- Pulmonology Department, Faculty of Medicine, Ovidius University of Constanta, Consteanta, Romania
| | - Mircea Rivis
- Discipline of Oral Surgery, 2nd Department of Dental Medicine, "Victor Babeş" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041, Timisoara, Romania
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Kanala S, Gudipalli S, Perumalla P, Jagalanki K, Polamarasetty PV, Guntaka S, Gudala A, Boyapati RP. Aetiology, prevalence, fracture site and management of maxillofacial trauma. Ann R Coll Surg Engl 2020; 103:18-22. [PMID: 32808805 DOI: 10.1308/rcsann.2020.0171] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Maxillofacial fractures are often associated with severe morbidity, functional deficit, disfigurement and significant financial implications. The aim of this review was to investigate whether the aetiology, prevalence and management modalities of facial trauma can identify the common causes of facial trauma with a view to recommending measures to the appropriate governing bodies to change the current practice wherever possible. METHODS The records of 1,112 patients referred to our oral and maxillofacial unit in Andhra Pradesh, India, between February 2008 and October 2017 were analysed retrospectively. Data including age, sex, aetiology, fracture site and treatment were evaluated. RESULTS Men aged 20-40 years were the most common victims of facial trauma. Road traffic accidents (RTAs) were responsible in 70% of cases. Mandibular fractures constituted 47% of the overall fractures, and 55% of the total fractures were treated with open reduction and internal fixation. CONCLUSIONS The main cause of maxillofacial injury among patients reporting to our hospital was RTAs. Mandibular fractures were the most common, accounting for almost half of the cases. Over half (55%) of all maxillofacial fractures were treated with open reduction and internal fixation. Reasons for this high frequency may include the large number of poorly maintained, overloaded vehicles on unsuitable roads, violation of traffic regulations (particularly by inexperienced young drivers), abuse of alcohol or other intoxicating agents and the sociocultural behaviours of some drivers.
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Affiliation(s)
- S Kanala
- Government Dental College and Hospital, Vijayawada, India
| | - S Gudipalli
- Government Dental College and Hospital, Vijayawada, India
| | - P Perumalla
- Government Dental College and Hospital, Vijayawada, India
| | - K Jagalanki
- Government Dental College and Hospital, Vijayawada, India
| | | | - S Guntaka
- Government Dental College and Hospital, Vijayawada, India
| | - A Gudala
- Government Dental College and Hospital, Vijayawada, India
| | - R P Boyapati
- Queen Victoria Hospital NHS Foundation Trust, UK
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Saluja H, Sachdeva S, Shah S, Dadhich A, Singh M, Mishra S. Ten-year review of facial bone fractures in rural population at a teaching institute in Central India (Maharashtra). JOURNAL OF HEAD & NECK PHYSICIANS AND SURGEONS 2020. [DOI: 10.4103/jhnps.jhnps_22_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Clinical Signs and Intraocular Pressure Changes in Patients with Orbitozygomatic Complex Fractures. J Maxillofac Oral Surg 2019; 19:585-590. [PMID: 33071507 DOI: 10.1007/s12663-019-01299-6] [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: 09/19/2018] [Accepted: 10/12/2019] [Indexed: 10/25/2022] Open
Abstract
Objectives The study investigated the association between intraocular pressure changes and clinical ocular signs in 51 patients with orbitozygomatic complex fractures. Diplopia, chemosis, enophthalmos, subconjunctival haemorrhage, periorbital ecchymosis and extraocular muscles entrapment were assessed. Study Design Intraocular pressure was measured in mmHg at different time intervals with Perkins and Goldman tonometers; within first 3 days of injury (T1), 24 h post-elevation within 3-14 days of injury (T2), 1 month after initial treatment assessment (T3), 2 months after initial treatment assessment (T4), and 3 months after initial treatment assessment (T5). Intraocular pressure changes between T2/T1 and T3/T1 were analysed as change 1 and change 2, respectively, with paired t test. Significance was set at p < 0.05. Results Minimum intraocular pressure recorded in the affected eye was 5 mmHg at T1 and T2, while maximum intraocular pressure was 28 mmHg at T1. Mean intraocular pressure at T1 and T2 was 15.90 ± 4.73 mmHg and 16.80 ± 4.43 mmHg, respectively. All eye signs had completely resolved at T3 except enophthalmos, which persisted till T5. Statistical significant relationship exist between orbitozygomatic complex fracture and enophthalmos (T1: p = 0.04). subconjunctival haemorrhage (T2: p = 0.003), periorbital ecchymosis (T2: p = 0.005),and T3: p = 0.001). Conclusion Chemosis, diplopia, enophthalmos, periorbital ecchymosis and subconjunctival haemorrhage showed positive contributory effect to intraocular pressure elevation in orbitozygomatic complex fracture.
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Wubulihasimu Z, Tuerhong M, Zhang Z, Li H, Kadir N, Xie M, Abulaiti M, Abulaiti A, Tulamaiti N, Maimaitiming B, Aili W, Ni Y. Clinical Analysis and CT 3D-Mediated Precise Internal Fixation in Maxillofacial Fracture. EAR, NOSE & THROAT JOURNAL 2019; 100:420S-426S. [PMID: 31619078 DOI: 10.1177/0145561319882114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND/PURPOSE To retrospectively analyze the epidemiological features, clinical diagnosis, and treatment of 610 patients with maxillofacial fractures, while providing a reference for the prevention and optimized treatment of maxillofacial fractures. METHODS Data of patients with maxillofacial fractures who were treated and followed up at the Second People's Hospital of Kashi Prefecture from June 2012 to April 2018 were summarized. The epidemiological features, clinical manifestations, fracture sites, treatment methods, and results were analyzed. RESULTS The highest incidence was in the age range of 20 to 49 years. The main cause of fracture was traffic injury. Mandibular fractures accounted for 37.77%, zygoma and zygomatic arch fractures for 37.00%, and maxillary fractures for 21.19%. Atypical zygomatic arch fractures were more common in the maxilla, followed by Le Fort I and II fractures. Closed fractures accounted for 85.97%. Many (73.39%) patients were treated with computed tomography 3-dimensional (3D)-mediated precision modified incision internal fixation with satisfactory results. CONCLUSIONS There is a high incidence of maxillofacial fractures among young men, especially in summer, with the most common injuries being traffic-related injuries. The most common site is the mandible, followed by the zygomatic arch, zygomatic complex, and maxilla. Computed tomography 3D-mediated precision modified incision internal fixation can achieve satisfactory results.
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Affiliation(s)
| | - Meiheriban Tuerhong
- Otorhinolaryngology Head and Neck Surgery, Fudan University, Shanghai, China
| | - Zhifei Zhang
- Otorhinolaryngology Head and Neck Surgery, Fudan University, Shanghai, China
| | - Huilin Li
- Otorhinolaryngology Head and Neck Surgery, Fudan University, Shanghai, China
| | - Nurahmat Kadir
- Otorhinolaryngology Head and Neck Surgery, Fudan University, Shanghai, China
| | - Maxian Xie
- Otorhinolaryngology Head and Neck Surgery, Fudan University, Shanghai, China
| | - Maiheba Abulaiti
- Otorhinolaryngology Head and Neck Surgery, Fudan University, Shanghai, China
| | - Aerzigu Abulaiti
- Otorhinolaryngology Head and Neck Surgery, Fudan University, Shanghai, China
| | | | | | - Wurelika Aili
- Department of Radiology, Second People's Hospital of Kashi Prefecture, Fudan University, Shanghai, China
| | - Yusu Ni
- Otorhinolaryngology Head and Neck Surgery, Fudan University, Shanghai, China.,Department of Otology Microsurgery and Skull Base Surgery, Institute of Otorhinolaryngology, Eye and ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, China.,NHC Key Laboratory of Hearing Medicine, 159395Fudan University, Shanghai, China
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Update on the management of craniomaxillofacial trauma in low-resource settings. Curr Opin Otolaryngol Head Neck Surg 2019; 27:274-279. [PMID: 31274568 DOI: 10.1097/moo.0000000000000545] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Craniomaxillofacial (CMF) trauma is a common cause of global morbidity and mortality. Although in high resource settings the management of CMF trauma has improved substantially over the past several decades with internal rigid fixation technology; these advancements have remained economically unviable and have not yet reached low and middle-income countries (LMICs) en masse. The purpose of this review is to discuss the current management of CMF injuries in low-resource settings. RECENT FINDINGS Trauma injuries remain a global epidemic with head and neck injuries among the most common. CMF trauma injuries largely occur in LMICs, with motor vehicle trauma being a common cause. Patients present in a delayed fashion which increases complications. Diagnostic methods are often limited to plain radiographs as computed tomography is not always available. In low-resource settings, CMF trauma continues to be treated primarily by closed reduction, maxillomandibular fixation, and transosseous wiring, yielding acceptable results through affordable methods. With the advent of less expensive plating systems, internal fixation with plates and screws are gradually finding their place in the management of facial trauma in low-resource settings. A shortage of CMF surgeons in LMICs is a recognized problem and is being addressed by targeted curricula. SUMMARY CMF trauma is a major cause of morbidity and mortality globally that remains poorly addressed. Currently, conventional methods of treating CMF trauma in low-resource settings have evolved to meet resource constraints. The education of CMF surgeons remains a key leverage point in improving CMF trauma care globally.
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Norozy A, Kalantar Motamedi MH, Ebrahimi A, Khoshmohabat H. Maxillofacial Fracture Patterns in Military Casualties. J Oral Maxillofac Surg 2019; 78:611.e1-611.e6. [PMID: 31445034 DOI: 10.1016/j.joms.2019.06.191] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/21/2019] [Accepted: 06/24/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE Morbidity and death after facial trauma are substantial issues of concern both in civilians and in military personnel. This cross-sectional retrospective study sought to assess the prevalence, pattern, treatment, and complications of soft and hard tissue injuries of the face in military personnel from 2012 to 2018. PATIENTS AND METHODS This cross-sectional, retrospective, chart study analyzed the descriptive statistics of 591 patients by use of Microsoft Excel software (version 2013; Microsoft, Redmond, WA); we assessed military casualties treated at our hospital from 2012 to 2018. All military personnel were documented in our trauma registry. The patient records were studied, and information relating to patients' injuries was documented and assessed after compilation of patient data. This study was approved by our local institutional review board; the causes and complications of maxillofacial (MF) trauma were assessed. Statistical analysis was done. This study used descriptive statistics based on a total of 591 patients and Microsoft Excel software (version 2013). RESULTS Among maxillofacial (MF) fractures, midface fractures (49%) were most prevalent, followed by lower face fractures (43%) and upper face fractures (24%). The most common cause of injury was explosives (58%). The most frequent site of fracture in the mandible was the angle region, followed by the mandibular body and condyle. Nasal fractures were seen in 44% of midface fractures. The most commonly used technique for treatment was open reduction-internal fixation, which was used in 89% of patients. CONCLUSIONS The pattern of MF injuries and the treatment modalities used to treat these patients showed that the most frequent type of injury was midface fracture and most patients were treated by open reduction-internal fixation.
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Affiliation(s)
- Amin Norozy
- Researcher, Trauma Research Center and Department of Surgery, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Hosein Kalantar Motamedi
- Professor, Trauma Research Center, Baqiyatallah University of Medical Sciences, and Oral and Maxillofacial Surgery Department, Craniofacial Trauma Research Center, Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Ali Ebrahimi
- Professor of Plastic Surgery, Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hadi Khoshmohabat
- Assistant Professor, Trauma Research Center, and Department of Surgery, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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Ruslin M, Brucoli M, Boffano P, Forouzanfar T, Benech A. Maxillofacial fractures associated with sport injuries: a review of the current literature. ACTA ACUST UNITED AC 2019. [DOI: 10.23736/s0392-6621.19.02215-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Sharma A, Rastogi S, Shukla M, Choudhury R, Tripathi S, Iqbal J. Use of Transgingival Lag Screw Osteosynthesis in the Management of Alveolar Process Fracture. Craniomaxillofac Trauma Reconstr 2019; 12:27-33. [PMID: 30815212 DOI: 10.1055/s-0038-1629906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Accepted: 09/17/2017] [Indexed: 10/18/2022] Open
Abstract
The purpose of this study is to check the efficacy of transgingival lag screw osteosynthesis in alveolar process fractures of maxilla and mandible. A single-arm nonrandomized observational study was performed for the treatment of alveolar process fractures of maxilla and mandible. In this study, 20 mixed age group patients with alveolar process fracture were included. All the patients were treated by a 2.0-mm transgingival screw fixation under local or general anesthesia. All the patients were evaluated for fracture stability, anatomical reduction, bone loss and bone resorption of alveolar process, tooth loss, and wound infection at 3 months of follow-up. A simple descriptive statistical analysis was done to evaluate the parameters and it was shown that the treatment of alveolar process fracture with two or three lag screws provides adequate fracture stability and anatomical reduction with no signs of bone loss and tooth loss, and wound infections were noted post lag screw fixation. The study concludes that transgingival lag screw fixation is a suitable alternative for alveolar process fractures in all the age groups and two to three lag screws are generally sufficient to fix fractured alveolar process either under local anesthesia or general anesthesia.
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Affiliation(s)
- Ashish Sharma
- Department of Oral and Maxillofacial Surgery, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Sanjay Rastogi
- Department of Oral and Maxillofacial Surgery, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Manish Shukla
- Department of Oral and Maxillofacial Surgery, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Rupshikha Choudhury
- Department of Oral and Maxillofacial Surgery, Regional Dental College, Guwahati, Assam, India
| | - Siddhi Tripathi
- Department of Prosthodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Jawed Iqbal
- Department of Oral and Maxillofacial Surgery, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
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Al-Bokhamseen M, Salma R, Al-Bodbaij M. Patterns of maxillofacial fractures in Hofuf, Saudi Arabia: A 10-year retrospective case series. Saudi Dent J 2018; 31:129-136. [PMID: 30705576 PMCID: PMC6349956 DOI: 10.1016/j.sdentj.2018.10.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 09/30/2018] [Accepted: 10/04/2018] [Indexed: 10/28/2022] Open
Abstract
Objectives This retrospective study was performed to analyze the incidence, etiology, and types of maxillofacial fractures in a major city in Eastern Province, Saudi Arabia. Materials and methods The medical records of all patients treated in the operating rooms for maxillofacial fractures by the Oral and Maxillofacial Surgery Department at King Fahad Hospital, Hofuf, Al-Ahsa, Saudi Arabia, between January 1, 2007, and December 31, 2016, were reviewed. A total of 270 patients with complete records were included. The data extracted included the age, gender, nationality, causes of injury, and patterns of maxillofacial fractures involved. Results Among the 270 patients, 241 (89.3%) were males, and 29 (10.7%) were females. The young adult (19-44 years) age group was the most affected (65.6%). Road traffic accidents (63.3%) were found to be the most frequent causes of maxillofacial fractures; falls were the second most common (15.9%). The rate of mandibular (54.6%) fractures was higher than that of mid-facial (45.4%) fractures. Among the mandibular fractures, the most common type was the parasymphyseal fracture (24.6%). Zygomatic fractures were the most common (48.6%) of midface fractures. Conclusions Similar to reports of other studies in different regions of Saudi Arabia, Al-Ahsa showed that road traffic accidents were the most predominant etiology of maxillofacial fractures affecting most frequently males of young adult age group. These findings emphasize the need for better education of road safety and enforcement of traffic laws, especially for the most affected age group.
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Affiliation(s)
| | - Ra'ed Salma
- Maxillofacial Surgery, Riyadh Elm University, Riyadh, Saudi Arabia
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Esses DFS, Costa FWG, Sá CDL, Silva PGB, Bezerra TMM, Carvalho FSR, de Medeiros JR, Soares ECS. Occupational group, educational level, marital status and deleterious habits among individuals with maxillofacial fractures: retrospective study. Med Oral Patol Oral Cir Bucal 2018; 23:e13-e22. [PMID: 29274150 PMCID: PMC5822534 DOI: 10.4317/medoral.21969] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Accepted: 09/05/2017] [Indexed: 11/24/2022] Open
Abstract
Background To investigate the occupational profile, educational level, marital status and deleterious habits to the health of patients with maxillofacial fractures of a population of northeastern Brazil. Material and Methods A retrospective study of patients records admitted to the Division of Oral and Maxillofacial Surgery at the Walter Cantídio University Hospital (Fortaleza, Brazil) who sustained maxillofacial fractures was conducted in the period between 2006 and 2015. Results A total of 338 patients rendered 355 fractures. Males were the most affected (p<0.001), with prevalence in the third decade of life (p<0.001). There was a predominance of motorcycle accidents (p<0.001), home workers (p<0.001), low educational status (p = 0.032), and no cigarette use (p<0.001) or alcohol (p = 0.023). Fractures of the zygomatic-orbital complex were the most prevalent in the sample (p<0.001). Conclusions The sociodemographic profile exerted a significant influence on the epidemiological profile of maxillofacial fractures in a Brazilian population during the study period. Key words:Epidemiological studies, trauma, facial bones.
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Affiliation(s)
- D-F-S Esses
- Rua Alexandre Barauna 949 - Rodolfo Teofilo, Postal Code: 60430-160 Fortaleza, Ceara, Brazil,
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Chaurasia A, Katheriya G. Prevalence of mandibular fracture in patients visiting a tertiary dental care hospital in North India. Natl J Maxillofac Surg 2018; 9:123-128. [PMID: 30546224 PMCID: PMC6251301 DOI: 10.4103/njms.njms_8_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Injuries of the maxillofacial complex represent one of the most important health problems worldwide. At present, in developing India, due to poor traffic sense, maxillofacial trauma and fractures are most epidemiologic diseases. Mandible is the largest and strongest facial bone and it is the second most commonly fractured bone. Mandibular fractures can involve only one site or can often involve multiple anatomic sites simultaneously. Aims: The present study is aimed to know the age- and sex-related prevalence of parasymphyseal fracture, fracture of angle, condylar fracture, symphyseal fracture, and coronoid fracture of mandible in North Indian population. It also evaluates the correlation of prevalence of parasymphyseal fracture, angle of mandible, condylar fracture of mandible, symphyseal fracture of mandible, and coronoid fracture of mandible. Materials and Methods: All patients fulfilling the selection criteria and having mandible fracture were selected for the study. The data about mandibular fracture was collected by means of a structured questionnaire including age, sex, and anatomic site of fracture. Qualitative variables were compared using Chi-square test/Fisher's exact test as appropriate. Results: The study population consists of 1015 individuals aged between 7 and 68 years with the mean age of 33.49 ± 11.79 years. The most common anatomic site for mandibular fracture was parasymphyseal region (40.3%) followed by angle (28.8%), condyle (27.6%), and symphysis (12.5%) of mandible. The coronoid process of mandible (44, 4.3%) was least involved in mandibular fracture. Males (30.8%) are more predilected for condylar fracture than females (15.7%). The mandibular symphyseal fracture is more common in male (14.9%) than female (3.7%). Conclusion: Mandibular fractures occur in people of all ages and races, in a wide range of social settings. Their causes often reflect shifts in trauma patterns over time. The present assessments of mandibular fracture will be valuable to government agencies and health-care professionals involved in planning future programs of prevention and treatment.
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Affiliation(s)
- Akhilanand Chaurasia
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Gaurav Katheriya
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, King George's Medical University, Lucknow, Uttar Pradesh, India
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Tetteh S, Bibb RJ, Martin SJ. Maxillofacial prostheses challenges in resource constrained regions. Disabil Rehabil 2017; 41:348-356. [PMID: 29065718 DOI: 10.1080/09638288.2017.1390697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND This study reviewed the current state of maxillofacial rehabilitation in resource-limited nations. METHOD A rigorous literature review was undertaken using several technical and clinical databases using a variety of key words pertinent to maxillofacial prosthetic rehabilitation and resource-limited areas. In addition, interviews were conducted with researchers, clinicians and prosthetists that had direct experience of volunteering or working in resource-limited countries. RESULTS Results from the review and interviews suggest rehabilitating patients in resource-limited countries remains challenging and efforts to improve the situation requires a multifactorial approach. CONCLUSIONS In conclusion, public health awareness programmes to reduce the causation of injuries and bespoke maxillofacial prosthetics training programmes to suit these countries, as opposed to attempting to replicate Western training programmes. It is also possible that usage of locally sourced and cheaper materials and the use of low-cost technologies could greatly improve maxillofacial rehabilitation efforts in these localities. Implications for Rehabilitation More information and support needs to be provided to maxillofacial defect/injuries patients and to their families or guardians in a culturally sensitive manner by governments. The health needs, economic and psychological needs of the patients need to be taken into account during the rehabilitation process by clinicians and healthcare organizations. The possibility of developing training programs to suit these resource limited countries and not necessarily follow conventional fabrication methods must be looked into further by educational entities.
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Affiliation(s)
- Sophia Tetteh
- a Loughborough Design School , Loughborough University , Loughborough , UK
| | - Richard J Bibb
- a Loughborough Design School , Loughborough University , Loughborough , UK
| | - Simon J Martin
- b Department of Materials , Loughborough University , Loughborough , UK
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Samieirad S, Aboutorabzade MR, Tohidi E, Shaban B, Khalife H, Hashemipour MA, Salami HR. Maxillofacial fracture epidemiology and treatment plans in the Northeast of Iran: A retrospective study. Med Oral Patol Oral Cir Bucal 2017; 22:e616-e624. [PMID: 28809369 PMCID: PMC5694185 DOI: 10.4317/medoral.21809] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 07/10/2017] [Indexed: 11/30/2022] Open
Abstract
Background The epidemiology of facial injuries varies based on lifestyle, cultural background and socioeconomic status in different countries and geographic zones. This study evaluated the epidemiology of maxillofacial fractures and treatment plans in hospitalized patients in Northeast of Iran (2015-2016). Material and Methods In this retrospective study, the medical records of 502 hospitalized patients were evaluated in the Department of Maxillofacial Surgery in Kamyab Hospital in Mashhad, Iran. The type and cause of fractures and treatment plans were recorded in a checklist. Data were analyzed with Mann–Whitney test, chi-squared test and Fisher’s exact test, using SPSS 21. Results The majority of patients were male (80.3%). Most subjects were in 20-30-year age range (43.2%). The fractures were mostly caused by accidents, particularly motorcycle accidents (MCAs), and the most common site of involvement was the body of the mandible. There was a significant association between the type of treatment and age. In fact, the age range of 16-59 years underwent open reduction internal fixation (ORIF) more than other age ranges (P=0.001). Also, there was a significant association between gender and fractures (P=0.002). Conclusions It was concluded that patient age and gender and trauma significantly affected the prevalence of maxillofacial traumas, fracture types and treatment plans. This information would be useful for making better health policy strategies. Key words:Epidemiology, treatment, facial injuries, maxillofacial fractures, trauma.
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Affiliation(s)
- S Samieirad
- Department of Oral Medicine, School of Dentistry Kerman University of Medical Sciences, Kerman, Iran,
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Teshome A, Andualem G, Tsegie R, Seifu S. Two years retrospective study of maxillofacial trauma at a tertiary center in North West Ethiopia. BMC Res Notes 2017; 10:373. [PMID: 28789668 PMCID: PMC5549360 DOI: 10.1186/s13104-017-2670-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 07/22/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Maxillofacial injury poses a challenge to oral and maxillofacial surgeons working in developing countries with limited resource and human power. The present study aimed to determine the etiology, pattern, and management of maxillofacial trauma in Gondar university of Gondar hospital. METHODS A retrospective descriptive study design was used. Medical registration retrieving of patients with maxillofacial trauma visited dental center of University of Gondar Hospital from September 2013 to August 2015 was done. During data collection, etiology of trauma, pattern of fracture, treatment modality and complications were recorded using predesigned data collection template and analyzed using SPSS computer software version 20. Statistical analysis was done to show the sex distribution of maxillofacial trauma and the effect of alcohol intake on the incidence of trauma. RESULTS During 2-year period, September 2013-August 2015, 326 patients of maxillofacial trauma were treated in the dental center of university of Gondar hospital. The mean age was 29.12 (± 8.62) with age range of 11-75 years. Majority of the study participants (47.2%) were within the age group of 21-30 years. Eighty percent of the participants were male with a male to female ratio of 4.02:1. Interpersonal violence (75.8%) and Road traffic accident (21.5%) were the leading causes. Males are at high risk of maxillofacial trauma relative to females (P < 0.0001). There was high incidence of trauma in the weekend, rural residents, December to February, mandibular fractures and soft tissue injuries were the most common injuries. There was an associated injury in 79 (24.2%) patients in head and neck area, thoracic, abdominal and extremities. Half of the patients were managed conservatively (49.7%) with debridement and suture, while 45.7% of the patients were closed reduction and 4.6% were surgical open reduction. There were 25 post procedure complications especially in mandibular fractures. CONCLUSION Interpersonal violence was the major cause of maxillofacial trauma, while mandible and soft tissue were the most affected maxillofacial areas. The federal ministry of health, Ethiopia should have well-organized maxillofacial center in tertiary hospitals for emergency management to avoid morbidity and mortality.
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Affiliation(s)
- Amare Teshome
- Department of Dentistry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getaneh Andualem
- Department of Dentistry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Rediet Tsegie
- Department of Dentistry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Samuel Seifu
- Department of Stomatology, College of Medicine and Health Sciences, Mekelle University, Mekelle, Ethiopia
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Malik S, Singh G, Kaur G, Yadav S, Mittal HC. Orofacial trauma in rural India: A clinical study. Chin J Traumatol 2017; 20:216-221. [PMID: 28330802 PMCID: PMC5555248 DOI: 10.1016/j.cjtee.2016.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/08/2016] [Accepted: 10/17/2016] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Orofacial trauma is becoming a leading medical problem worldwide. Most of the studies pertaining to orofacial trauma have been done in urban areas but very little scientific literature is available for rural areas. METHODS A prospective medical institute-based study of orofacial injury patients was carried out from May 2013 to April 2016 (36 Months). Data regarding incidence, age and sex distribution, causes, types and site of injury, treatment modalities and trauma associated complications were collected and analysed. RESULTS A total of 784 patients were studied. Males outnumbered females by a ratio of 2.9:1. Age range was 9 months-75 years with the peak incidence in the age-group of 18-34 years. Most injuries were caused by road-side accidents (72.7%), followed by assault and falls in 11.6% and 8% respectively. Soft tissue injuries and mandibular fractures were the most common type of injuries. Head/neck (50.29%) and limb injuries (27.2%) were the most prevalent associated injuries. Surgical debridement and soft tissue suturing was the most common emergency procedure. Closed reduction was performed in 61% of patients and open reduction and internal fixation in 30% of cases and 9% were managed conservatively. Complications occurred in 6.88% of patients, mainly due to infection and malocclusion. The mean duration of hospital stay was (10.12 ± 6.24) days. CONCLUSION This study highlights the importance of department of dental surgery along with other disciplinaries in the management of orofacial injuries. Road-side accident remains the major etiological factor of orofacial injuries in our setting.
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Affiliation(s)
- Sunita Malik
- BPS Government Medical College for Women, Khanpur Kalan, Sonepat, Haryana, India,Corresponding author.
| | - Gurdarshan Singh
- BPS Government Medical College for Women, Khanpur Kalan, Sonepat, Haryana, India
| | - Gagandeep Kaur
- Aadesh Institute of Dental Sciences and Research, Bathinda, Punjab, India
| | - Sunil Yadav
- BPS Government Medical College for Women, Khanpur Kalan, Sonepat, Haryana, India
| | - Hitesh C. Mittal
- BPS Government Medical College for Women, Khanpur Kalan, Sonepat, Haryana, India
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Anslem O, Eyituoyo O, Olabode OV, Ademola OA, Adesina AO. A comparative study of intermaxillary fixation screws and noncompression miniplates in the treatment of mandibular fractures: a prospective clinical study. Oral Maxillofac Surg 2017; 21:233-240. [PMID: 28386782 DOI: 10.1007/s10006-017-0622-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 03/28/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND The main goal of treatment of mandibular fractures is to restore normal dental occlusion and promote appropriate bone healing and a normal mouth opening. Recently, there has been a resurgent interest in the use of screws for intermaxillary fixation of mandibular fractures. This study was therefore designed to determine how the clinical outcomes of the use of screws for intermaxillary fixation compare with the use of miniplates in the treatment of mandibular fractures in Nigeria. OBJECTIVES The objectives of this study are as follows: 1. To compare the clinical outcomes of the use of 2.0 mm × 9.0 mm screws for intermaxillary fixation with 2.0 mm noncompression miniplates in the treatment of simple unilateral mandibular fractures in Lagos, Nigeria 2. To determine the clinical outcomes in the use of 2.0 mm × 9.0 mm screws for intermaxillary fixation (IMF) and 2.0 mm noncompression miniplates in the treatment of simple unilateral mandibular fractures 3. To compare the complications associated with the use of 2.0 mm × 9.0 mm screws for IMF and 2.0 mm noncompression miniplates in the treatment of mandibular fractures METHODOLOGY: This randomized controlled clinical study was carried out at the Department of Oral and Maxillofacial Surgery of the study institution. Subjects with simple unilateral mandibular fractures who met the inclusion criteria were randomly allocated into the study (intermaxillary fixation screw) and control (miniplate) groups through balloting. Factors assessed and compared during and after the procedures included intraoperative pain, postoperative nerve impairment, postoperative occlusion, limitation of mouth opening, incidence of hardware failure, incidence of infection and non-union. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 20. RESULTS A total of 56 subjects participated in the study, with 28 subjects in each group. Majority (91%) of the subjects were male. Road traffic crash was the highest aetiological factor while sport was the least (3.6%). A higher proportion (25.0%) of subjects in the miniplate group had major complications compared with 14.3% in the IMF screw group. There was no statistically significant association between site of mandibular fracture, time elapsed before treatment and complications (p < 0.05). All cases of mandibular fractures healed successfully at 6 weeks. CONCLUSION The use of screws for IMF is as effective as 2.0 mm noncompression miniplates in the treatment of simple unilateral mandibular fractures.
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Affiliation(s)
- Osasuyi Anslem
- Oral and Maxillofacial Surgery, Nigerian Air Force Hospital, Nigerian Air Force Base, Kaduna, Nigeria
| | - Okoturo Eyituoyo
- Head and Neck Surgical Oncology Division, Oral and Maxillofacial Surgery Department, Lagos State University College of Medicine/Teaching Hospital, Lagos, Nigeria.
| | - Ogunbanjo V Olabode
- Oral and Maxillofacial Surgery Department, Lagos State University College of Medicine/Teaching Hospital, Lagos, Nigeria
| | - Olaitan A Ademola
- Oral and Maxillofacial Surgery Department, Lagos State University College of Medicine/Teaching Hospital, Lagos, Nigeria
| | - Ayodele O Adesina
- Oral and Maxillofacial Surgery Department, General Hospital, Lagos, Nigeria
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Obimakinde OS, Ogundipe KO, Rabiu TB, Okoje VN. Maxillofacial fractures in a budding teaching hospital: a study of pattern of presentation and care. Pan Afr Med J 2017; 26:218. [PMID: 28690732 PMCID: PMC5491718 DOI: 10.11604/pamj.2017.26.218.11621] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/26/2017] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Previous reports indicated that there is geographic and sociodemographic variation in the epidemiology of maxillofacial fractures. Audit of maxillofacial injuries managed at any institution is therefore necessary to understand the trends and proffer strategies for prevention. We therefore embarked on this study to determine the pattern of maxillofacial fractures and concomitant injuries in our institution. METHODS We carried out a retrospective review of information on demography, aetiology and type of maxillofacial fracture, patients' status, type of crash, level of consciousness and concomitant injuries. The data collected was analysed with SPSS Version 20. RESULTS A total of 233 patients aged 2 to 66 years were reviewed. A higher male preponderance (M:F 3.4:1) was observed. Road traffic crashes (RTC) accounted for 78.5% of injuries. Motorcycle related crashes were responsible for 69.4% of RTC and 54.5% of all fractures. Fracture of the mandible (63.2% n=172) was the most predominant skeletal injury and the body (25% n=43) was the most common site of fracture while the zygoma (29%) was predominantly affected in the midface. Ninety three patients (40%) suffered loss of consciousness. The relationship between aetiology of injuries and consciousness level of the patients was statistically significant (p=0.001). Of the 43 patients who had concomitant injuries, craniocerebral affectation (60.5%) was the commonest. CONCLUSION RTC remains the major aetiology of maxillofacial fractures. The mandible was mostly affected and nearly half of the patients have associated loss of consciousness. There is need for continual advocacy and enforcement of laws on preventive measures among road users.
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Saperi BS, Ramli R, Ahmed Z, Muhd Nur A, Ibrahim MI, Rashdi MF, Nordin R, Rahman NA, Yusoff A, Nazimi AJ, Abdul Rahman R, Abdul Razak N, Mohamed N. Cost analysis of facial injury treatment in two university hospitals in Malaysia: a prospective study. CLINICOECONOMICS AND OUTCOMES RESEARCH 2017; 9:107-113. [PMID: 28223831 PMCID: PMC5304986 DOI: 10.2147/ceor.s119910] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective Facial injury (FI) may occur in isolation or in association with injuries to other parts of the body (facial and other injury [FOI]). The objective of this study was to determine the direct treatment costs incurred during the management of facial trauma. Materials and methods A prospective cohort study on treatment cost for FIs and FOIs due to road-traffic crashes in two university hospitals in Malaysia was conducted from July 2010 to June 2011. The patients were recruited from emergency departments and reviewed after 6 months from the date of initial treatment. Direct cost analysis, comparison of cost and length of hospital stay, and Injury Severity Score (ISS) were performed. Results A total of 190 patients were enrolled in the study, of whom 83 (43.7%) had FI only, and 107 (56.3%) had FOI. The mean ISS was 5.4. The mean length of stay and costs for patients with FI only were 5.8 days with a total cost of US$1,261.96, whereas patients with FOI were admitted for 7.8 days with a total cost of US$1,716.47. Costs doubled if the treatment was performed under general anesthesia compared to local anesthesia. Conclusion Treatment of FI and FOI imposes a financial burden on the health care system in Malaysia.
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Affiliation(s)
- Bin Sulong Saperi
- International Centre for Casemix and Clinical Coding, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
| | - Roszalina Ramli
- Department of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
| | - Zafar Ahmed
- International Centre for Casemix and Clinical Coding, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
| | - Amrizal Muhd Nur
- International Centre for Casemix and Clinical Coding, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
| | - Mohd Ismail Ibrahim
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian
| | - Muhd Fazlynizam Rashdi
- Department of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
| | - Rifqah Nordin
- Department of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
| | | | - Azizah Yusoff
- School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian
| | - Abd Jabar Nazimi
- Department of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
| | | | | | - Norlen Mohamed
- Malaysian Institute of Road Safety Research, Kuala Lumpur, Malaysia
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Regmi KP, Tu J, Ge S, Hou C, Hu X, Li S, Du J. Retrospective Clinical Study of Maxillary Sagittal Fractures: Predictors of Postoperative Outcome. J Oral Maxillofac Surg 2016; 75:576-583. [PMID: 27986471 DOI: 10.1016/j.joms.2016.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 11/10/2016] [Accepted: 11/10/2016] [Indexed: 01/08/2023]
Abstract
PURPOSE Because of less attention to the sagittal component of maxillary fractures, these fractures are often misdiagnosed or the reduction is missed leading to maxillary transverse discrepancies. Therefore, the purpose of this study was to identify factors associated with good or adverse postoperative outcomes of maxillary sagittal fractures. MATERIALS AND METHODS This study was a single-center retrospective cohort study. The sample was composed of cases of maxillary sagittal fractures treated at the Department of Oral and Maxillofacial Surgery, Craniomaxillofacial Trauma Unit of Xi'an Jiaotong University (Xi'an, China) from January 2008 through December 2013. The predictor variables were age, gender, occupation, cause of injury, injury severity, treatment timing, treatment method, and quality of fracture reduction. The outcome variable was the postoperative treatment effect index. Descriptive, bivariate, and multivariate statistics were computed. The P value was set to .05. RESULTS The sample was composed of 40 cases. The male-to-female ratio was 4:1; the most vulnerable age group was 20 to 30 years (30%); laborers (72.5%) were more prone to injury; and the main cause of injury was motor vehicle accident (62.5%). No cases of isolated sagittal fracture were found and most (35%) occurred with other maxillary fractures, including Le Fort fractures. A statistically significant association between treatment timing and quality of fracture reduction and the postoperative treatment effect index (P < .05) was found. CONCLUSION The results of this study suggest that better results are achieved when fractured bone is treated sooner. Anatomic repositioning of the fractured bone is the important predictor for good postoperative outcomes.
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Affiliation(s)
- Krishna Prasad Regmi
- Resident, Oral and Maxillofacial Surgery, Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research and the Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, and the Research Center of Stomatology, Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - JunBo Tu
- Professor, Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research and the Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, and the Research Center of Stomatology, Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
| | - SuMeng Ge
- Resident, Oral and Maxillofacial Surgery, Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research and the Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, and the Research Center of Stomatology, Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - ChengQun Hou
- Associate Professor, Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research and the Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, and the Research Center of Stomatology, Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - XiaoYi Hu
- Associate Professor, Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research and the Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, and the Research Center of Stomatology, Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - ShiXian Li
- Resident Doctor, Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research and the Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, and the Research Center of Stomatology, Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - JingTing Du
- Resident, Oral and Maxillofacial Surgery, Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research and the Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Disease, College of Stomatology, and the Research Center of Stomatology, Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, China
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Lee CW, Foo QC, Wong LV, Leung YY. An Overview of Maxillofacial Trauma in Oral and Maxillofacial Tertiary Trauma Centre, Queen Elizabeth Hospital, Kota Kinabalu, Sabah. Craniomaxillofac Trauma Reconstr 2016; 10:16-21. [PMID: 28210403 DOI: 10.1055/s-0036-1584893] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 04/30/2016] [Indexed: 10/20/2022] Open
Abstract
The aims of this study were to provide an overview of maxillofacial trauma and its relationship to patient's demographic data and alcohol consumption within the state of Sabah. It was a retrospective study of maxillofacial trauma cases treated by Oral and Maxillofacial Surgery Department, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, from January 1, 2009, until December 31, 2013. A total of 630 maxillofacial trauma cases were included. Details of the trauma were collected from patients' record, including patients' cause of injuries, injuries suffered, treatment indications, and treatment received. Patients' demographic data (age, gender), alcohol consumption in relation to causes, and type of maxillofacial injury were analyzed. There were 538 male (85.4%) and 92 female (14.6%) patients (ratio: 5.8:1), with mean age of 31.0 years. Most common causes of maxillofacial injury were motor vehicle accident (MVA; 66.3%), followed by fall (12.4%) and assault (11.6%). Motorcyclists made up more than half of the total cases (53.1%). Cases referred were primarily due to soft-tissue injury (458 cases). Other cases were dentoalveolar and maxillofacial bone fractures. Treatment provided for the fractures included open reduction and internal fixation (22.9%), closed reduction (28.7%), and conservative management (48.4%). Toilet and suturing were done for all patients with soft-tissue injury. Maxillofacial trauma is a major problem in Sabah. It affects mostly males in the age group of 21 to 30 years. Most of the MVA patients were motorcyclists. Mandibular fracture with parasymphysis involvement recorded the highest number. Most of the patients preferred conservative management, probably due to financial and logistic issue.
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Affiliation(s)
- Chee Wei Lee
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia
| | - Qi Chao Foo
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia
| | - Ling Vuan Wong
- Department of Oral and Maxillofacial Surgery, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, Malaysia
| | - Yiu Yan Leung
- Department of Oral and Maxillofacial Surgery, The University of Hong Kong, Hong Kong, Hong Kong
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Ramisetty S, Gaddipati R, Vura N, Pokala S, Kapse S. Maxillofacial Injuries in Women: A Retrospective Study of 10 Years. J Maxillofac Oral Surg 2016; 16:438-444. [PMID: 29038626 DOI: 10.1007/s12663-016-0954-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 08/24/2016] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Diversities exists in incidence, etiology and epidemiology of facial fractures among male and female individuals due to various reasons. Many of the epidemiological studies published during the millennium have shown male predilection. This study was carried to evaluate the etiology, patterns and distribution of facial fractures among different age groups in women. MATERIALS AND METHODS This Retrospective epidemiological study dealt with a total of 302 women with 422 fractures in maxillofacial region during a period of June 1st 2005 to May 31st 2015 at Mamata Dental College and Hospital, Khammam, Telangana, India. RESULTS Mean age of incidence was 31.58 years, mandibular fractures were highest (44.07 %) followed by zygomaticomaxillary complex injuries (ZMC) (20.37 %). Road traffic accidents (RTA) injuries (53.7 %) were highest, followed by assault (23.9 %) and other causes. Highest number (33.8 %) of fractures were sustained in the 3rd decade and least (0.7 %) in the 8th decade of life. Among soft tissue injuries most commonly seen were lacerations (51 %). CONCLUSION Results of this study suggest that there is an increase in the number of maxillofacial injuries in women, representing changes in the society, exposing women to similar conditions like men and increased number of working women. This study helps to identify trauma burden, assess the awareness of current preventive measures, women protection laws, for instituting new guidelines for prevention and planning health care services for women.
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Affiliation(s)
- Sudhir Ramisetty
- Department of Oral and Maxillofacial Surgery, Mamata Dental College and Hospital, Giriprasad Nagar, Khammam, Telangana 507002 India
| | - Rajasekhar Gaddipati
- Department of Oral and Maxillofacial Surgery, Mamata Dental College and Hospital, Giriprasad Nagar, Khammam, Telangana 507002 India
| | - Nandagopal Vura
- Department of Oral and Maxillofacial Surgery, Mamata Dental College and Hospital, Giriprasad Nagar, Khammam, Telangana 507002 India
| | - Satheesh Pokala
- Department of Oral and Maxillofacial Surgery, Mamata Dental College and Hospital, Giriprasad Nagar, Khammam, Telangana 507002 India
| | - Sheetal Kapse
- Department of Oral and Maxillofacial Surgery, Mamata Dental College and Hospital, Giriprasad Nagar, Khammam, Telangana 507002 India
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Shah A, Nautiyal V, Gupta A, Ramola V. Trends of maxillofacial fractures in the Garhwal Himalayas at Government Medical College, Srinagar, Uttarakhand. Natl J Maxillofac Surg 2016; 7:80-85. [PMID: 28163485 PMCID: PMC5242081 DOI: 10.4103/0975-5950.196139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Evaluation of Maxillofacial fractures in hilly region of Garhwal Himalyas and its relation with age, gender, anatomical location, seasonal variation and treatment provided. AIMS The aim of the present study is to analyze the pattern of maxillofacial fractures in the Garhwal Himalayan region of India and to compare the results with similar studies in India and the rest of the world. SETTINGS AND DESIGN This was a prospective study conducted on 102 patients with 128 facial fractures. MATERIALS AND METHODS This study was conducted on 102 patients who were admitted for the treatment of maxillofacial fractures in the Department of Dentistry at Government Medical College, Srinagar, Uttarakhand, India. STATISTICAL ANALYSIS USED All analyses were performed using Chi-square test and level of significance. RESULTS Peak incidence was noted in the second to fourth decades of life. Male: female ratio was 4:1. Road traffic accident was the main etiology (42.2%), followed by fall (37.2%) and assault (11.8%). Among other etiology of injury, distinguishing feature was bear bite, which was only seen in winters causing 5.9% of total injury. Fall was reported high in females whereas road traffic accident in males. Mandible was fractured in 73.5% of patients while mid-face in 26.5% of patients. Open reduction with internal fixation was the choice of treatment in 60.8% of cases. Nearly 79.4% of patients were treated under local anesthesia. The mean duration of hospitalization was (standard deviation 5.2 days) 5.3 days. CONCLUSIONS Road traffic accidents still remain the main cause of maxillofacial fractures in developing countries such as India. In hilly area, road traffic accident can be minimized by better wide roads with guide walls/parapet, strict law enforcement for overspeed, overload, and to use seat belts while driving, and use of helmet while riding two-wheeler. Open reduction internal fixation remains the first choice of treatment in facial fractures due to early return of function with minimal morbidity and better nutritional status in patients compared to closed reduction.
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Affiliation(s)
- Amit Shah
- Department of Dentistry, Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Srinagar, Pauri, Garhwal, India
| | - Vijay Nautiyal
- Department of Oral and Maxillofacial Surgery, Seema Dental College, Dehradun, Uttarakhand, India
| | - Arti Gupta
- Department of Community Medicine, Veer Chandra Singh Garhwali Government Institute of Medical Science and Research, Srinagar, Pauri, Garhwal, India
| | - Vikas Ramola
- Department of Maxillofacial Surgery, Uttranchal Dental Medical Research Institute, Dehradun, Uttarakhand, India
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Gali R, Devireddy SK, Kishore Kumar RV, Kanubaddy SR, Nemaly C, Akheel M. Faciomaxillary fractures in a Semi-urban South Indian Teaching Hospital: A retrospective analysis of 638 cases. Contemp Clin Dent 2015; 6:539-43. [PMID: 26681862 PMCID: PMC4678555 DOI: 10.4103/0976-237x.169847] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background and Objective: The incidence of maxillofacial trauma is increasing at a very fast pace in developing countries like India and poses a major health burden. Hence, the epidemiological data of maxillofacial trauma during a 6 year period, was analyzed to study the characteristics, factors predisposing, and aid in advocating strict guidelines to prevent the same. Materials and Methods: Data related to 638 cases with maxillofacial trauma, from January 2008 to December 2014 were reviewed retrospectively and the data regarding gender, age, etiology, anatomic location of fracture, alcohol consumption, associated head and other injuries, modality of treatment rendered and associated complications were analyzed with descriptive statistics. Results: A total of 638 patients presenting with 869 maxillofacial fractures were analyzed. Most of them [344 (53.9%)] were young adults aged 18-40, whereas, 123 (19.2%) were 11 to 17 years, and 97(15.2%) adults. Men (79.4%) were more affected than women. Road traffic accidents remain the main etiology causing fractures in 470 (73.6%), whereas 397 (62.2%) had history of consumption of alcohol. Those with alcohol intoxication had multiple injuries. Mandible was more frequently involved with 360 (41.4%) fractures, and condyle being the most common site. A total of 374 (58.6%) underwent open reduction with internal fixation under general anesthesia. Prevalence of other injuries was noted in 207 (32.4%) and complications of fracture treatment in 41(6.4%) cases. Conclusion: Road traffic accidents under alcohol influence were most commonly associated with comminuted facial fractures with head injuries, frequently leading to death. Mandible was the most commonly fractured facial bone followed by zygoma.
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Affiliation(s)
- Rajasekhar Gali
- Department of Oral and Maxillofacial Surgery, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Sathya Kumar Devireddy
- Department of Oral and Maxillofacial Surgery, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - R V Kishore Kumar
- Department of Oral and Maxillofacial Surgery, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Sridhar Reddy Kanubaddy
- Department of Oral and Maxillofacial Surgery, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Chaithanyaa Nemaly
- Department of Oral and Maxillofacial Surgery, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Mohammed Akheel
- Department of Oral and Maxillofacial Surgery, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
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Samieirad S, Tohidi E, Shahidi-Payam A, Hashemipour MA, Abedini A. Retrospective study maxillofacial fractures epidemiology and treatment plans in Southeast of Iran. Med Oral Patol Oral Cir Bucal 2015; 20:e729-36. [PMID: 26116845 PMCID: PMC4670254 DOI: 10.4317/medoral.20652] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 04/01/2015] [Indexed: 11/19/2022] Open
Abstract
Background The epidemiology of facial injuries varies in different countries and geographic zones. Population concentration, lifestyle, cultural background, and socioeconomic status can affect the prevalence of maxillofacial injuries. Therefore, in this study, we evaluated the maxillofacial fractures epidemiology and treatment plans in hospitalized patients (2012-2014) which would be useful for better policy making strategies. Material and Methods In this retrospective study, the medical records of 386 hospitalized patients were evaluated from the department of maxillofacial surgery at Bahonar Hospital of Kerman, Iran. The type and cause of fractures and treatment plans were recorded in a checklist. For data analysis, ANOVA, t-test, Chi-square, and Fisher’s exact test were performed, using SPSS version 21. Results The majority of patients were male (76.5%). Most subjects were within the age range of 20-30 years. Fractures were mostly caused by accidents, particularly motorcycle accidents (MCAs), and the most common site of involvement was the mandible (parasymphysis). There was a significant association between the type of treatment and age. In fact, the age group of 16-59 years under went open reduction internal fixation (ORIF) more than other age groups (P=0.02). Also, a significant association was observed between gender and the occurrence of fractures (P=0.01). Conclusions Considering the geographic and cultural indices of the evaluated population, it can be concluded that patients age and gender and trauma causes significantly affect the prevalence of maxillofacial traumas and fracture kinds and treatment plans. Key words:Epidemiology, treatment, facial injuries, face fractures, maxillofacial trauma, trauma.
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Affiliation(s)
- Sahand Samieirad
- Department of Oral Medicine, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran,
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Zhou HH, Ongodia D, Liu Q, Yang RT, Li ZB. Changing pattern in the characteristics of maxillofacial fractures. J Craniofac Surg 2015; 24:929-33. [PMID: 23714913 DOI: 10.1097/scs.0b013e3182587f86] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study was designed to assess the changes in the etiology, incidence, and pattern of maxillofacial fractures during 2 different study periods in our department. PATIENTS AND METHODS In this retrospective study, patients treated for maxillofacial fractures at our department from January 2000 to December 2009 were included. Data regarding patient's age, sex, etiology of fracture, time of injury, site of fracture, and pattern of fracture were collected and grouped chronologically into two 5-year periods: 2000 to 2004 (period 1) and 2005 to 2009 (period 2); the results of the study during these periods were analyzed and compared. RESULTS A total of 1131 patients sustained maxillofacial fractures: 422 in the first period and 709 in the second period. During the second period, the male-female ratio increased from 3.35:1 to 3.63:1. Road traffic accidents remained the major etiologic factor, which increased remarkably from 49.3% to 54.6% (P = 0.085), whereas assault-related injuries decreased significantly from 16.8% to 12.4% (P = 0.039). The proportion of patients with mandibular fractures decreased from 59.6% to 55.3% (P = 0.037), whereas the proportion of patients with midfacial fractures increased from 40.4% to 44.7% (P = 0.037). CONCLUSIONS The changing pattern of maxillofacial fractures in our center is correlated to the socioeconomic status, population mobility, and etiologic factors. Strict enforcement of traffic laws and regulations is still a focal factor in attaining appreciable reduction in maxillofacial fractures associated with road traffic accidents.
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Affiliation(s)
- Hai-Hua Zhou
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, Hubei, People's Republic of China
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A study on the pattern of maxillofacial injury in patients reporting to a tertiary care hospital in eastern Nepal. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2015. [DOI: 10.1016/j.ajoms.2015.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Zhou HH, Liu Q, Yang RT, Li Z, Li ZB. Maxillofacial Fractures in Women and Men: A 10-Year Retrospective Study. J Oral Maxillofac Surg 2015; 73:2181-8. [PMID: 26296597 DOI: 10.1016/j.joms.2015.07.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 07/28/2015] [Accepted: 07/28/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to evaluate and compare the demographic characteristics of maxillofacial fractures between women and men in China. PATIENTS AND METHODS The sample was composed of all patients who sustained maxillofacial fractures during a 10-year period (2000 through 2009). Incidences, age distributions, etiologies, fracture patterns, associated injuries, and occupation distributions were recorded and analyzed. Data analysis included the χ(2) test, the Fisher exact test, and the t test. A P value less than .05 was considered significant. RESULTS There were 1,131 patients (881 male and 250 female) who sustained maxillofacial fractures, with a male-to-female ratio of 3.5:1. Male patients sustained injuries most frequently during the autumn (P = .048), whereas female patients sustained more maxillofacial injuries during the summer (P = .006). Men sustained motorcycle (P = .023) and assault-related accidents (P = .036) more frequently than women, whereas women were more frequently injured in bicycle-related accidents (P < .001) or falling while at ground level (P = .001) than men. Women presented more frequently with condylar fracture than men (P = .028), whereas men were more prone to symphysis fractures than women (P = .037). For drivers, only men were involved (P = .001). Male workers sustained maxillofacial fractures more frequently than female workers (P < .001). Female children, students, and company staff were more prone to maxillofacial fractures than their male counterparts (P = .010, P = .004, and P = .044 respectively). CONCLUSIONS The demographic characteristics of maxillofacial fractures in female patients considerably differ from those in male patients.
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Affiliation(s)
- Hai-Hua Zhou
- Resident, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology and the Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Qi Liu
- Resident, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology and the Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Rong-Tao Yang
- Resident, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology and the Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Zhi Li
- Associate Professor, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology and the Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Zu-Bing Li
- Professor, State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology and the Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China.
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Lone P, Singh AP, Kour I, Kumar M. A 2-year retrospective analysis of facial injuries in patients treated at department of oral and maxillofacial surgery, IGGDC, Jammu, India. Natl J Maxillofac Surg 2015; 5:149-52. [PMID: 25937724 PMCID: PMC4405955 DOI: 10.4103/0975-5950.154817] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Introduction: The incidence of maxillofacial injuries is on the rise due to motor vehicle accidents and increased incidence of violence in recent times. The aim of this retrospective study was to determine the incidence, etiology, and the pattern of fractures in the maxillofacial region. Materials and Methods: After obtaining permission from the concerned authorities, a predesigned questionnaire was used to collect the necessary data from the department. A retrospective analysis of 787 patients, who suffered trauma and were managed in the Department of Oral and Maxillofacial Surgery, Indira Gandhi Government Dental College (IGGDC), Jammu over a period of 2 years was carried out. Results: Road traffic accident (RTA) was the common cause of maxillofacial injuries. Men sustained more injuries as compared to women. Injuries were most commonly sustained in the age group of 11-40 years, constituting about 76% of all injuries, mandibular fractures were the most common. Conclusion: RTAs were the commonest cause for the maxillofacial injuries.
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Affiliation(s)
- Parveen Lone
- Department of Oral and Maxillofacial Surgery, Indira Gandhi Government Dental College, Jammu, Jammu and Kashmir, India
| | - Amrit Pal Singh
- Department of Oral and Maxillofacial Surgery, Indira Gandhi Government Dental College, Jammu, Jammu and Kashmir, India
| | - Indumeet Kour
- Department of Oral and Maxillofacial Surgery, Indira Gandhi Government Dental College, Jammu, Jammu and Kashmir, India
| | - Misha Kumar
- Department of Oral and Maxillofacial Surgery, Indira Gandhi Government Dental College, Jammu, Jammu and Kashmir, India
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Gonzalez E, Pedemonte C, Vargas I, Lazo D, Pérez H, Canales M, Verdugo-Avello F. Fracturas faciales en un centro de referencia de traumatismos nivel i. Estudio descriptivo. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.maxilo.2013.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gaddipati R, Ramisetti S, Vura N, Reddy KR, Nalamolu B. Analysis of 1,545 Fractures of Facial Region-A Retrospective Study. Craniomaxillofac Trauma Reconstr 2015; 8:307-14. [PMID: 26576235 DOI: 10.1055/s-0035-1549015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 12/27/2014] [Indexed: 10/23/2022] Open
Abstract
Incidence and etiology of facial fractures vary from region to region due to various constituents. This study was carried to evaluate the patterns and distribution of fractures in the facial region among different age groups of patients in both males and females caused due to various etiologies. This is a retrospective epidemiological study, which was performed on patients with fractures in the maxillofacial region during a period of 2005 to 2013 at Mamata Dental College and Hospital, Khammam, India. A total of 1,015 patients with 1,545 fractures were referred for treatment to department of oral and maxillofacial injuries surgery, of Mamata Dental College and Hospital, with a mean age of 31.19. The ratio of males (859):females (156) is 5.5:1. Injuries caused by motorbike injuries (34.9%) are highest. The highest frequency of fractures caused by various reasons is seen more in third decade (39%). Mandible (43.81%) is the most common fracture site in the face. Among soft tissue injuries most commonly seen are lacerations (43%). This study differentiates the etiological factors causing facial trauma in several age groups. Results of this study suggest outcomes indicate that more reliance on individual transport on motor vehicles has increased the frequency of facial bone fractures. Regardless of age, motor vehicle accidents were high in all age groups except the first decade of life and above 60 years of age when traffic accidents dominated. Thus effectiveness of current preventive measures is to be assessed, followed by instituting new guidelines for prevention and inflexible traffic rules shall be levied. More epidemiological surveys can, if encouraged to measure the frequency of fractures, better the world.
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Affiliation(s)
- Rajasekhar Gaddipati
- Department of Oral and Maxillofacial Surgery, Mamata Dental College and Hospital, Khammam, Telangana, India
| | - Sudhir Ramisetti
- Department of Oral and Maxillofacial Surgery, Mamata Dental College and Hospital, Khammam, Telangana, India
| | - Nandagopal Vura
- Department of Oral and Maxillofacial Surgery, Mamata Dental College and Hospital, Khammam, Telangana, India
| | - K Rajiv Reddy
- Department of Oral and Maxillofacial Surgery, Mamata Dental College and Hospital, Khammam, Telangana, India
| | - Bhargav Nalamolu
- Department of Oral and Maxillofacial Surgery, Mamata Dental College and Hospital, Khammam, Telangana, India
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Abstract
BACKGROUND This multicenter study assessed the demographics, prevalence, causes, types, treatment, and complications of maxillofacial (MF) fractures managed by MF surgeons nationwide. METHODS This 5-year retrospective descriptive analytical chart study evaluated 8,818 patients treated for MF fractures from 2007 to 2012 at 11 medical centers. Parameters, including age, sex, cause of injury, site of injury, type of injury, fracture patterns, treatment modalities, and complications, were evaluated from patient charts and radiographs. Collected data were analyzed via t test or χ test using SPSS 20 (Chicago, IL). A p value of less than 0.05 was considered statistically significant. This retrospective chart study was exempt from institutional review board approval. RESULTS There were 7,369 male patients (83.6%), 1,376 female patients (15.7%), and 73 patients (0.8%) of unknown sex (aged 6 months to 112 years); 39.54% (3,457 patients) were in the 21-year to 30-year age group (mean, 28.18 years). We found 5,737 mandibular fractures (65.1%); mandible fracture was the most common (p < 0.05), followed by maxillary (1,641, 18.6%), zygomatic (3,240, 36.0%), orbital floor (743, 8.4%), naso-orbitoethmoidal (472, 5.4%), nasal (848, 9.6%), and frontal (344, 3.9%) fractures. Road traffic accidents were the most common cause. Posttreatment documented complications included remaining neurosensory disturbance of the inferior alveolar nerve (16.01%) and the infraorbital nerve (15.5%), remaining neuromotor disturbance of the facial nerve (2.3%), blurred vision (2.43%), diplopia (3.2%), limitation of eye movement (1.6%), exophthalmoses (1.88%), blindness (0.8%), as well as postoperative infection and chronic osteomyelitis (1.0%). CONCLUSION On the basis of our study, mandibular fractures, in males and resulting from road traffic accidents in the third decade of life, were significant findings. Although the prevalence of MF fractures, demographics, and causes vary from one country to another and awareness of these patterns can provide insight to prevention protocols, this study shows that, despite better law enforcement of traffic regulations, better roads, better automobiles, and the like, the pattern of MF fractures in Iran has not changed significantly during the past 10 years. LEVEL OF EVIDENCE Epidemiologic study, level IV.
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Jeon EG, Jung DY, Lee JS, Seol GJ, Choi SY, Paeng JY, Kim JW. Maxillofacial Trauma Trends at a Tertiary Care Hospital: A Retrospective Study. Maxillofac Plast Reconstr Surg 2014; 36:253-8. [PMID: 27489843 PMCID: PMC4283536 DOI: 10.14402/jkamprs.2014.36.6.253] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 09/07/2014] [Accepted: 10/20/2014] [Indexed: 11/25/2022] Open
Abstract
Purpose: Maxillofacial fractures are rapidly increasing from car accidents, industrial accidents, teenaged criminal activity, and sports injuries. Accurate assessment, appropriate diagnosis, and preparing individual treatment plans are necessary to reduce surgical complications. We investigated recent trends of facial bone fracture by period, cause, and type, with the objective of reducing surgical complications. Methods: To investigate time trends of maxillofacial fractures, we reviewed medical records from 2,196 patients with maxillofacial fractures in 1981∼1987 (Group A), 1995∼1999 (Group B), and 2008∼2012 (Group C). We analyzed each group, comparing the number of patients, sex ratio, age, fracture site, and etiology. Results: The number of patients in each period was 418, 516, and 1,262 in Groups A to C. Of note is the increase in the number of patients from Group A to C. The sex ratios were 5.6:1, 3.5:1, and 3.8:1 in Groups A, B, and C. The most affected age group for fracture is 20∼29 in all three groups. Traffic accidents are the most common cause in Groups A and B, while there were somewhat different causes of fracture in Group C. Sports-induced facial trauma was twice as high in Group C compared with Group A and B. Mandible fracture accounts for a large portion of facial bone fractures overall. Conclusion: We observed an increase in facial bone fracture patients at Kyungpook National University Dental Hospital over the years. Although facial injury caused by traffic accidents was still a major cause of facial bone fracture in all periods, the percentage decreased. In recent years, isolated mandible fracture increased but mandible and mid-facial complex fracture decreased, possibly because of a reduction in traffic accidents.
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Affiliation(s)
- Eun-Gyu Jeon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University
| | - Dong-Young Jung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University
| | - Jong-Sung Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University
| | - Guk-Jin Seol
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University
| | - So-Young Choi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University
| | - Jung-Young Paeng
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University
| | - Jin-Wook Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University
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Aladelusi T, Akinmoladun V, Olusanya A, Akadiri O, Fasola A. Analysis of Road Traffic Crashes-Related Maxillofacial Injuries Severity and Concomitant Injuries in 201 Patients Seen at the UCH, Ibadan. Craniomaxillofac Trauma Reconstr 2014; 7:284-9. [PMID: 25383148 DOI: 10.1055/s-0034-1378183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Accepted: 11/04/2013] [Indexed: 10/25/2022] Open
Abstract
The objective of this study was to determine the prevalence of road traffic crashes (RTC)-related maxillofacial injuries, the concomitant injuries occurring with them, and to assess the relationship between the severity of maxillofacial and concomitant injuries. This was a prospective study involving 201 victims of RTC seen at the Accident and Emergency Department of the University College Hospital, Ibadan with maxillofacial injuries during the study period. Demographic data of the patients, the types of maxillofacial injuries, and concomitant injuries sustained were recorded. Severity of maxillofacial injury was determined using the maxillofacial injury severity scale (MFISS), while the severity of concomitant injuries was based on the ISS. Correlations between types and severity of maxillofacial injury and types and severity of concomitant injury were conducted to determine the predictability of concomitant injuries based on maxillofacial injury severity. Data were processed using SPSS Statistical software (SPSS, version 20.0 for windows, IBM SPSS Inc, Chicago, IL). Maxillofacial injuries constituted 25.4% of RTC-related admission by the Accident and Emergency Department. A total of 151 (75.1%) patients who presented with concomitant injuries participated in the study. Eighty-one (53.6%) sustained injuries to more than one body region. Head injury was the commonest (99, 65.6%) concomitant injury, followed by orthopedic injury (69, 45.7%). Increasing severity of maxillofacial injury showed a positive correlation with increasing ISS. Also, positive correlation was noted with increasing severity of maxillofacial injury and presence of polytrauma (p = 0.01), traumatic brain injury (p = 0.034), and eye injuries (p = 0.034). There was a high prevalence of maxillofacial injuries in victims of RTC. There was a high incidence of concomitant injuries noted with these maxillofacial injuries. Significantly, this study showed a direct relationship between the severity of maxillofacial injury and head, ocular and polytrauma. This study further emphasizes the need for thorough examination of patients presenting with RTC-related maxillofacial injuries.
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Affiliation(s)
- Timothy Aladelusi
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria ; Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan, Oyo, Nigeria
| | - Victor Akinmoladun
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria ; Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan, Oyo, Nigeria
| | - Adeola Olusanya
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria ; Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan, Oyo, Nigeria
| | - Oladimeji Akadiri
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | - Abiodun Fasola
- Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria ; Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan, Oyo, Nigeria
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Boffano P, Kommers SC, Karagozoglu KH, Forouzanfar T. Aetiology of maxillofacial fractures: a review of published studies during the last 30 years. Br J Oral Maxillofac Surg 2014; 52:901-6. [PMID: 25218316 DOI: 10.1016/j.bjoms.2014.08.007] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 08/14/2014] [Indexed: 11/28/2022]
Abstract
The epidemiology of facial trauma may vary widely across countries (and even within the same country), and is dependent on several cultural and socioeconomic factors. We know of few reviews of published reports that have considered the sex distribution and aetiology of maxillofacial trauma throughout the world. The aim of this review was to discuss these aspects as they have been presented in papers published during the last 30 years. We made a systematic review of papers about the epidemiology of maxillofacial trauma that were published between January 1980 and December 2013 and identified 69 studies from Africa (n=9), North America and Brazil (n=6), Asia (n=36), Europe (n=16), and Oceania (n=2). In all the studies men outnumbered women, the ratio usually being more than 2:1. In American, African, and Asian studies road traffic crashes were the predominant cause. In European studies the aetiology varied, with assaults and road traffic crashes being the most important factors. In Oceania assaults were the most important. A comparison of the incidence of maxillofacial trauma of different countries together with a knowledge of different laws (seat belts for drivers, helmets for motocyclists, speed limits, and protection worn during sports and at work) is crucial to allow for improvement in several countries. To our knowledge this paper is the first attempt to study and compare the aetiologies of maxillofacial trauma.
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Affiliation(s)
- Paolo Boffano
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Sofie C Kommers
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - K Hakki Karagozoglu
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Tymour Forouzanfar
- Department of Oral and Maxillofacial Surgery/Pathology, VU University Medical Center and Academic Centre for Dentistry Amsterdam (ACTA), P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
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