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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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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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Brucoli M, Boccafoschi F, Boffano P, Broccardo E, Benech A. The Anatomage Table and the placement of titanium mesh for the management of orbital floor fractures. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:317-321. [DOI: 10.1016/j.oooo.2018.04.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 04/19/2018] [Accepted: 04/29/2018] [Indexed: 10/17/2022]
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Abstract
Mechanisms causing facial fractures have evolved over time and may be predictive of the types of injuries sustained. The objective of this study is to examine the impact of mechanisms of injury on the type and management of facial fractures at our Level 1 Trauma Center. The authors performed an Institutional Review Board-approved review of our network's trauma registry from 2006 to 2010, documenting age, sex, mechanism, Injury Severity Score, Glasgow Coma Scale, facial fracture patterns (nasal, maxillary/malar, orbital, mandible), and reconstructions. Mechanism rates were compared using a Pearson χ2 test. The database identified 23,318 patients, including 1686 patients with facial fractures and a subset of 1505 patients sustaining 2094 fractures by motor vehicle collision (MVC), fall, or assault. Nasal fractures were the most common injuries sustained by all mechanisms. MVCs were most likely to cause nasal and malar/maxillary fractures (P < 0.01). Falls were the least likely and assaults the most likely to cause mandible fractures (P < 0.001), the most common injury leading to surgical intervention (P < 0.001). Although not statistically significant, fractures sustained in MVCs were the most likely overall to undergo surgical intervention. Age, number of fractures, and alcohol level were statistically significant variables associated with operative management. Age and number of fractures sustained were associated with operative intervention. Although there is a statistically significant correlation between mechanism of injury and type of facial fracture sustained, none of the mechanisms evaluated herein are statistically associated with surgical intervention. Clinical Question/Level of Evidence: Therapeutic, III.
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Cillo JE, Holmes TM. Interpersonal Violence Is Associated With Increased Severity of Geriatric Facial Trauma. J Oral Maxillofac Surg 2016; 74:1023.e1-7. [PMID: 26850874 DOI: 10.1016/j.joms.2016.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 01/04/2016] [Accepted: 01/04/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE The geriatric population is rapidly increasing in number with increased demand on health care resources including those spent on the treatment of maxillofacial trauma. The purpose of this analysis was to investigate the independent and cumulative associations between potential risk factors (age, gender, mechanism of injury, drug use, and alcohol use) for and the severity of geriatric facial trauma. METHODS This was a cross-sectional analysis of secondary data of geriatric (individuals aged ≥65 years) facial trauma using the Allegheny General Hospital Trauma Registry database. Data were collected for diagnosis codes that reflected facial trauma (International Classification of Diseases, Ninth Revision codes 802.0 to 802.9, 800.1 to 801.9, and 803.0 to 804.9) and specific mechanisms of injury (E810 to E819, motor vehicle traffic accidents; E880 to E888, accidental falls; and E960 to E969, injury purposely inflicted by other persons). The Facial Injury Severity Scale (FISS) is a validated measurement that was used to determine the severity of the facial trauma and calculated through analysis of the abstracted data obtained from the trauma registry and patient records. Pearson correlations, 2-way independent t test, 1-way analysis of variance, and multiple linear regression were used to test hypotheses for independent and cumulative associations between the risk factors for and the severity of geriatric facial trauma. Statistical significance was set at the P < .05 level. RESULTS The sample was composed of 229 patients with a mean age of 72.3 ± 4.5 years. A statistically significant association between mechanism of injury and the severity of geriatric facial trauma (P = .019) was found. Specifically, interpersonal violence (assault) was associated with the greatest facial trauma severity (FISS score, 4.2) when compared with motor vehicle collisions (FISS score, 2.2; P = .011) and falls (FISS score, 2.4; P = .016). CONCLUSIONS Interpersonal violence (assault) is associated with increased severity of geriatric facial trauma compared with other risk factors.
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Affiliation(s)
- Joseph E Cillo
- Assistant Professor and Program Director, Division of Oral and Maxillofacial Surgery, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA.
| | - Talmage M Holmes
- Faculty, College of Health Sciences, Walden University, Minneapolis, MN
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Roccia F, Boffano P, Bianchi FA, Zavattero E. Maxillofacial Fractures due to Falls: does Fall Modality Determine the Pattern of Injury? EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2014; 5:e5. [PMID: 25635212 PMCID: PMC4306323 DOI: 10.5037/jomr.2014.5405] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 06/17/2014] [Indexed: 11/16/2022]
Abstract
Objectives In several epidemiological studies of maxillofacial trauma, falls were one of the most frequent causes of facial injury. The aim of this study is to analyse the patterns of fall-related maxillofacial injuries based on the height of the fall. Material and Methods Using a systematic computer-assisted database of patients hospitalised with maxillofacial fractures, only those with fall-related injuries were considered. The falls were divided into four groups: falls from slipping, tripping or stumbling (STSF), loss of consciousness (LOCF), stairs (SAF), and height (HF). Data on the age, gender, fracture site, Facial Injury Severity Scale (FISS), facial lacerations, associated lesions, type of treatment, and length of hospital stay were also analysed. Results This study included 557 patients (338 males, 219 females; average age 51.5 years [range 4 - 99 years]). In the over 60 age group, females were more prevalent in STSF than males. According to aetiology, STSF was the most frequent cause of maxillofacial fractures (315 patients; 56.5%) followed by LOCF (157; 28.2%), HF (55; 9.9%), and SAF (30; 5.4%). The middle third of the face was affected most frequently. After LOCF, however, the inferior third was prevalently involved. The majority of associated fractures, as well as the most severe injuries and greatest rate of facial lacerations, occurred secondary to HF. Conclusions This study showed that fracture severity and site are influenced not only by patient age, but also by the nature of the fall.
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Affiliation(s)
- Fabio Roccia
- Surgical Science Department, San Giovanni Battista Hospital, University of Turin, Turin Italy
| | - Paolo Boffano
- Surgical Science Department, San Giovanni Battista Hospital, University of Turin, Turin Italy
| | - Francesca A Bianchi
- Surgical Science Department, San Giovanni Battista Hospital, University of Turin, Turin Italy
| | - Emanuele Zavattero
- Surgical Science Department, San Giovanni Battista Hospital, University of Turin, Turin Italy
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Roccia F, Boffano P, Bianchi FA, Ramieri G. An 11-year review of dental injuries associated with maxillofacial fractures in Turin, Italy. Oral Maxillofac Surg 2013; 17:269-274. [PMID: 23138750 DOI: 10.1007/s10006-012-0371-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 10/22/2012] [Indexed: 06/01/2023]
Abstract
INTRODUCTION The aim of the study was to analyze the incidence, characteristics, and correlations between maxillofacial fractures and dental injuries in patients who were treated at a first-level trauma center in a metropolitan center in northwest Italy in the last 11 years. MATERIAL AND METHODS Between January 1, 2001 and December 31, 2011, 2,110 patients with maxillofacial fractures were admitted. Only dentulous patients with complete clinical records who presented with associated dental injuries were included in this study. Data on the age, gender, mechanism of injury, damaged tooth, type of dental injury, site of facial fractures, and concomitant injuries were recorded. RESULTS On the whole, 267 patients (13.1%), mainly males aged 20-29 years, presented with 759 dental injuries associated with maxillofacial fractures, especially following motor vehicle accidents. The maxillary teeth, most often the anterior elements with decreasing involvement from the incisors to the molars, were the teeth most frequently damaged overall. The main types of dental trauma in patients with maxillofacial fractures were luxations and dental fractures. DISCUSSION Our findings show that patients with mandibular fractures were statistically and significantly associated with dental injury, and the teeth in the upper jaw were the most frequently injured teeth, exhibiting mainly luxations and crown fractures. Confirmation of the predominant impact site in patients with dental injuries associated with maxillofacial fractures comes from the 177 lacerations noted in the chin and lip regions in 267 patients.
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Affiliation(s)
- Fabio Roccia
- Division of Maxillofacial Surgery, Head and Neck Department, San Giovanni Battista Hospital, University of Turin, Corso A.M. Dogliotti 14, 10126, Torino, Italy,
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Roccia F, Boffano P, Bianchi FA, Gerbino G. Maxillofacial injuries due to work-related accidents in the North West of Italy. Oral Maxillofac Surg 2013; 17:181-186. [PMID: 22868983 DOI: 10.1007/s10006-012-0336-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 07/16/2012] [Indexed: 06/01/2023]
Abstract
INTRODUCTION The aim of this study was to assess the incidence and patterns of work-related maxillofacial injuries, identifying worker categories with a high risk of injury. MATERIAL AND METHODS From a systematic computer-assisted database that has continuously recorded patients hospitalized with maxillofacial fractures, only patients with work-related injuries were considered. Occupation, mechanism of injury, and demographic and clinical data were analyzed. RESULTS Work-related facial injuries represented the fifth most common cause of injury, with a percentage of 6.3 %. Maxillofacial fractures were most often seen in construction workers (37.9 %). The middle third was involved in 67 % of the cases; the mandible was the most frequently injured site. CONCLUSIONS Work-related maxillofacial trauma is rare, but it is often complex and challenging as Facial Injury Severity Scale values show. In agreement with the few published reports, construction workers, together with farm and forestry workers, are at the highest risk of injuries, mainly because of struck by a thrown, projected, or falling object.
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Affiliation(s)
- Fabio Roccia
- Division of Maxillofacial Surgery, Head & Neck Department, San Giovanni Battista Hospital, University of Turin, Corso A.M. Dogliotti 14, 10126, Torino, Italy.
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