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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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Bicsák Á, Abel D, Tack L, Smponias V, Hassfeld S, Bonitz L. Complications after osteosynthesis of craniofacial fractures-an analysis from the years 2015-2017. Oral Maxillofac Surg 2020; 25:199-206. [PMID: 32885304 DOI: 10.1007/s10006-020-00903-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/31/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Complications mean a recurring problem in everyday clinical practice. Complication rates between 6 and 13% are described for the treatment of bony injuries to the head and neck area. This paper aims to provide a detailed analysis of the complications after osteosynthesis in facial skull fractures. MATERIAL AND METHOD In this retrospective study, we reviewed all patient records of injured treated in the Department of Cranial and Maxillofacial Surgery at the Dortmund General Hospital between 2015 and 2017. RESULTS Of the 22,031 head and neck injuries, 685 were treated with osteosynthesis. A clinically significant complication was reported in 32 patients (4.76%). The number of total complications was 63. In total, 66.7% of all complications have been identified in the paramedian mandible (44%), median mandible, mandibular angle, and in the collar area (each 12.7%). Eleven implants (in 5 patients) showed a cancellous bone impaction. Broken implants have been recognized in two cases. In 8 cases, there was a pseudarthrosis in the fracture area; in one case, there was a broken implant and pseudarthrosis in combination. CONCLUSION Osteosynthesis is a safe method of treating facial skull fractures, which is why we consider it the gold standard of therapy. The complication rate is well below 5%. The 3-dimensional adaptation (bending) and shortening of the osteosynthesis implants do not lead to an increase in complications.
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Affiliation(s)
- Ákos Bicsák
- Department of Cranio-, Maxillofacial Surgery, Regional Plastic Surgery, Dortmund General Hospital, Muensterstrasse 240, D-44145, Dortmund, Germany.
| | - Dietmar Abel
- Department of Cranio-, Maxillofacial Surgery, Regional Plastic Surgery, Dortmund General Hospital, Muensterstrasse 240, D-44145, Dortmund, Germany
| | - Laurence Tack
- Department of Cranio-, Maxillofacial Surgery, Regional Plastic Surgery, Dortmund General Hospital, Muensterstrasse 240, D-44145, Dortmund, Germany
| | - Velissarios Smponias
- Department of Cranio-, Maxillofacial Surgery, Regional Plastic Surgery, Dortmund General Hospital, Muensterstrasse 240, D-44145, Dortmund, Germany
| | - Stefan Hassfeld
- Department of Cranio-, Maxillofacial Surgery, Regional Plastic Surgery, Dortmund General Hospital, Muensterstrasse 240, D-44145, Dortmund, Germany
| | - Lars Bonitz
- Department of Cranio-, Maxillofacial Surgery, Regional Plastic Surgery, Dortmund General Hospital, Muensterstrasse 240, D-44145, Dortmund, Germany
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Cohn JE, Licata JJ, Othman S, Shokri T, Zwillenberg S. Comparison of Maxillofacial Trauma Patterns in the Urban Versus Suburban Environment: A Pilot Study. Craniomaxillofac Trauma Reconstr 2020; 13:115-121. [PMID: 32642042 DOI: 10.1177/1943387520910338] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Introduction Assault appears to be the most frequent cause of facial fractures in certain urban trauma centers, possibly due to the ease of acquiring weapons and increasingly aggressive behavior. The objectives of this study were to identify specific demographic, socioeconomic, maxillofacial fracture, and assault patterns in urban versus suburban communities. Methods A retrospective chart review of patients who sustained maxillofacial fractures from August 2014 through August 2016 at one urban campus, Einstein Medical Center, Philadelphia, and two suburban campuses, Einstein Medical Center Montgomery and Elkins Park. The χ2 testing was used to compare the categorical variables between the 2 groups. Results A total of 259 maxillofacial trauma patients were identified, with 204 (79%) in the urban and 55 (21%) in the suburban environment. Patients in the urban population were more likely to be African American (70% vs 33%) and Hispanic (15% vs 6%) but less likely to be Caucasian (12% vs 55%, P < .0001). Urban patients were more likely to be single (70% vs 47%, P < .01), unemployed (64% vs 44%, P < .001), and receive Medicaid coverage (58% vs 26%, P < .001). Urban patients were more likely to be victims of assault (63% vs 44%), whereas suburban patients were more likely to sustain accidental injuries (16% vs 2%, P < .0001). Urban victims were more likely to be assaulted with an object (30% vs 12%) or gun (7% vs 0%, P = .05). Conclusion Maxillofacial trauma patterns were shown to be significantly different in the urban versus suburban environment.
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Affiliation(s)
- Jason E Cohn
- Department of Otolaryngology-Head and Neck Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Jordan J Licata
- Department of Otolaryngology-Head and Neck Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Sammy Othman
- Drexel University College of Medicine, Philadelphia, PA, USA
| | - Tom Shokri
- Department of Otolaryngology-Head and Neck Surgery, Penn State Hershey Medical Center, Hershey, PA, USA
| | - Seth Zwillenberg
- Department of Otolaryngology-Head and Neck Surgery, Einstein Medical Center, Philadelphia, PA, USA
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Olojede A, Gbotolorun OM, Ogundana OM, Emeka IC, Emmanuel MM, Oluseye S, Runsewe O. PATTERN OF ASSAULT-RELATED MAXILLOFACIAL INJURIES TREATED AT THE GENERAL HOSPITAL, LAGOS, NIGERIA. JOURNAL OF THE WEST AFRICAN COLLEGE OF SURGEONS 2016; 6:68-82. [PMID: 28856125 PMCID: PMC5555727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND The human face often constitutes the first point of contact in various human interactions and it is frequently the preferred target for blows in assault cases. AIM To analyze the pattern of assault-related maxillofacial injuries treated at the General Hospital, Lagos over a period of one year. METHODOLOGY This is one year prospective study of assault-related maxillofacial injuries treated at the Department of Oral-Maxillofacial Surgery, Dental Centre, General Hospital, Lagos, Nigeria. A face-to-face interviewer-administered structured proforma was used to obtain information from study subjects. RESULTS Thirty-three patients with maxillofacial injuries met the inclusion criteria for this study. Their age ranged between 16 and 48 years with a mean age of 28.2 ± 7.4 years. There were 25(75.8%) males and 8(24.2%) females with a male/female ratio of 3:1. Majority of the patients, 24(72.7%) did not have any skilled employment while the remaining 9(27.3%) were road transport workers, specifically commercial bus drivers and motorcycle riders. The most frequently seen soft tissue injury was contusion which accounted for 17(51.5%) cases while 13 (39%) of the patients sustained mandibular fracture which was the most common hard tissue injury. CONCLUSION Assault-related maxillofacial injuries are most common amongst young adult males who are not skillfully employed; this can be attributed to the increased disposition to violence in males in our environment.
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Affiliation(s)
| | | | - O M Ogundana
- Department of Oral and Maxillofacial Pathology/Biology, College of Medicine, University of Lagos, Nigeria
| | - I C Emeka
- Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital Lagos, Nigeria
| | - M M Emmanuel
- Department of Oral Pathology, College of Medicine, Lagos State University, Ikeja, Lagos, Nigeria
| | - Sab Oluseye
- Oral and Maxillofacial Surgery Unit, General Hospital, Lagos Island, Lagos, Nigeria
| | - O Runsewe
- Oral and Maxillofacial Surgery Unit, General Hospital, Lagos Island, Lagos, Nigeria
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Head and maxillofacial injuries in child and adolescent victims of automotive accidents. ScientificWorldJournal 2014; 2014:632720. [PMID: 25574492 PMCID: PMC4276672 DOI: 10.1155/2014/632720] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 11/11/2014] [Accepted: 11/16/2014] [Indexed: 11/22/2022] Open
Abstract
Background. Victims of motor vehicle accidents may suffer multiple lesions, including maxillofacial injuries. The aim of this study was to evaluate the prevalence and factors associated with head, facial, and maxillofacial injuries in child and adolescent victims of automobile accidents. A cross-sectional study was carried out with analysis of forensic medical reports from the Legal Medical Institute of Campina Grande, Brazil, between January 2008 and December 2011. Descriptive and inferential statistical analysis was conducted using the chi-square test (α = 0.05). From 1613 medical reports analyzed, the sample is composed 232 (14.4%) reports referring to child and adolescent victims of automobile accidents aged 0–19 years of both sexes. Victims were mostly adolescents aged from 15 to 19 years (64.2%), males (73.7%), and motorcyclists (51.3%). More than half of the victims had single lesions (54.3%) located in the head (20.7%) and face (21.6%). Head injuries occurred more frequently in children aged 0–4 years (53.8%, PR = 5.065, 95% CI = 1.617–5.870) and pedestrians (30.4%, PR = 2.039, 95% CI = 1.024–4.061), while facial and maxillofacial injuries occurred in higher proportion among females (31.1%, PR = 0.489, 95% CI = 0.251–0.954). Our findings suggest that accidents involving motorcyclists are the most prevalent, affecting male adolescents aged from 15 to 19 years, resulting in a high frequency of injuries in the head and face regions.
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