Pattern of Maxillofacial Injuries and Determinants of Outcome in a Large Series of Patients admitted to a Level-I Trauma Center

Prevalence and pattern of maxillofacial injuries associated with domestic violence: A retrospective study at a major trauma center

BACKGROUND/AIM

This study aimed to analyze the frequency and pattern of maxillofacial injuries associated with domestic violence.

MATERIALS AND METHODS

Medical records of victims of domestic violence between May 2016 and May 2023 were scrutinized retrospectively. The following data were analyzed: gender and age, history of previous abuse, hospital admission, pregnancy, type of facial injuries, anatomical location of injuries, side of injuries, concomitant injuries, mechanism of impact, treatment modality, and history of drug and alcohol abuse.

RESULTS

Seventy-eight patients were included, comprising of 75 (96.2%) women and 3 (3.8%) men. Domestic violence was an etiology of 2.7% of all maxillofacial injuries. The mean age was 27.06 ± 5.5 years. 33.3% of cases had a history of previous domestic violence. The assailant was drug addicted in 47.4% of cases. The attacker was the current partner of the victim in 79.5% of the victims. Soft tissue injuries were found in 96.1% of cases. Maxillofacial fracture was observed in 52.6% of victims among which zygoma was the most common (16.7%) followed by the nose and mandible (15.4%). Isolated fracture was observed in 85.3% of patients and 71.8% of the injuries were observed on the left. Concomitant injuries were present in 51.3% of patients with arms/hands being the most frequent (48.7%). Punch (67.9%) constituted the majority of the mechanism of impact. Based on the statistical analysis, punches resulted in significantly higher soft tissue contusion (p = .046), and injuries that required no intervention were significantly higher in punched victims (p = .002).

CONCLUSION

Maxillofacial soft tissue injuries with or without isolated fracture on the left side of the zygoma, mandibular angle, or nose in association with arms/hands injuries in young adult women could be clues of domestic violence. Appropriate care such as preventive programs for drug or alcohol abuse should be implemented to reduce domestic violence, thereby reducing these injuries.

A RETROSPECTIVE STUDY OF THE MAXILLOFACIAL INJURIES IN TWO EMERGENCY DEPARTMENTS IN TBILISI, GEORGIA

Maxillofacial injuries are a global problem in our modern society. It can be a major cause of increased morbidity and mortality. Maxillofacial trauma can lead to scar distortion accompanied by emotional and psychological problems. The epidemiology of facial fractures varies in terms of trauma type, the extent of injury, and severity. The main aim of this research is to explore the scope, the burden, and the etiology of maxillofacial injuries in Tbilisi, Georgia. Data was retrospectively collected from two large emergency departments in Tbilisi, Georgia using a cross-sectional design. Inclusion criteria was patients admitted in hospitals during one year with diagnosis maxillofacial injury. SPSS 21 software was used for statistical analysis. Differences in categorical variables were assessed with Chi-square tests of independence. This research shows that men are still the most frequent victims of maxillofacial injuries. Out of 598 patients, whose age ranged from 1month to 87 years - 67% were males, and 33% patients were females, including both, maxillofacial trauma alone and also combined injuries. With only maxillofacial injuries, the male patients were still leading, with 51% (307) and female patients were 28% (167), these results gave us a statistically significant difference (p=0.026). The main causes of maxillofacial injuries were falls, which equaled to 63% (378 patients) from total recorded data, as in many other countries. The results of this research provide really important information about future preventive interventions in the country. It also shows us that educating the public with prevention strategies is substantial.

Metabolic response to maxillofacial trauma revisited: A retrospective study

Purpose:

Management of a trauma patient aims at stabilization or resuscitation and revival from critical condition resulting from various sequences of systemic pathophysiological responses in the body. Hematological changes are the first signs reflecting the homeostasis mechanisms starting in the body after injury. The aim of the current study is to evaluate the physiological changes following maxillofacial trauma and extrapolate the findings to understand the posttrauma responses.

Patients and Method:

This is a retrospective study involving 192 subjects divided into two groups, trauma group and control group. In both the groups, baseline vitals and complete blood picture were recorded for comparison. In trauma group, the recordings were made within 24 h after maxillofacial injury.

Results:

All the parameters were analyzed using SPSS version 18. Independent sample t-test was used to assess the nature of data distribution and statistical significance was considered only at P value < 0.05. On comparison of complete blood picture mean values of hemoglobin (13.63 vs 12.18), RBC count (4.51 vs 4.10), WBC count (8835.48 vs 8336.56) were seen to be higher in trauma patients compared to control subjects. The mean bleeding times are almost equal (2.35 vs 2.47) but the clotting times (5.42 vs 5.26), random blood glucose (94.78 vs 90.13), and blood urea (27.14 vs 26.30) were marginally higher in trauma group but were statistically insignificant. The mean value of serum creatinine (0.84 vs 0.80) was comparatively higher in trauma patients and was statistically significant. Study of vitals revealed that mean systolic blood pressures were almost equal (120.65 vs 121.08) in both the groups. The mean diastolic blood pressures (79.46 vs 88.49) and oxygen saturation (93.73 vs 98.86) in trauma patients are comparatively reduced. The mean values of temperature (99.30 vs 98.50) and pulse rate (102.38 vs 97.14) were on relatively higher side in trauma group compared with control group.

Summary and Conclusion:

Using basic blood parameters and vitals in the present study, the compensatory mechanisms happening in the body after maxillofacial trauma can be seen. These changes although significant on side by side comparison can still fall within the normal physiological range provided by various diagnostic setups. Hence, the need for maxillofacial surgeon to be sensitive to minor variations in these aspects to ensure safety of the patient cannot be overemphasized.