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Bataineh AB. The incidence and patterns of maxillofacial fractures and associated head and neck injuries. J Craniomaxillofac Surg 2024; 52:543-547. [PMID: 38582675 DOI: 10.1016/j.jcms.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 03/12/2024] [Indexed: 04/08/2024] Open
Abstract
The aim of this study was to evaluate the incidence and patterns of maxillofacial fractures and the demographic characteristics of associated head and neck injuries. This single-center retrospective cohort study was conducted at the Department of Oral and Maxillofacial Surgery of King Abdullah University Hospital (KAUH) in Irbid, northern Jordan. The data was obtained from the electronic clinical records of all patients in whom maxillofacial fractures and associated head and neck injuries were confirmed. During the five-year period captured by this retrospective study, 481 patients with 1026 maxillofacial fractures (equivalent to 2.13 fractures per patient) were treated. The sample comprised of 369 (76.7%) males and 112 (23.3%) females, resulting in a male/female ratio of 3.3:1. Majority of the patients were in the 21-30 age group and RTA was the most common cause of maxillofacial fractures, accounting for 299 (62.1%) of the analyzed cases. In 316 cases, maxillary fractures were accompanied by associated injuries, 132 (41.77%) of which were intracranial lesions, 80 (25.32%) were skull fractures, and 59 (18.67%) were cervical spine injuries. Based on the obtained data, it can be concluded that the high occurrence of RTA emphasizes the significance of adhering to traffic laws and regulations, as individuals who have suffered serious head and neck injuries as a result of maxillofacial trauma may experience potentially fatal consequences. Thus, management for patients with maxillofacial fractures and concomitant traumas should be multidisciplinary and coordinated.
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Affiliation(s)
- Anwar B Bataineh
- Oral & Maxillofacial Surgery, Faculty of Dentistry, Jordan University of Science & Technology, Jordan.
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Chandra L, Deepa D, Atri M, Pandey SM, Passi D, Goyal J, Sharma A, Gupta U. A retrospective cross-sectional study of maxillofacial trauma in Delhi-NCR Region. J Family Med Prim Care 2019; 8:1453-1459. [PMID: 31143738 PMCID: PMC6510095 DOI: 10.4103/jfmpc.jfmpc_89_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aim and Objectives To evaluate the pattern, prevalence, etiology, site of fractures, and their management in patients with maxillofacial injury in Delhi-NCR region. Materials and Methods A total of 1278 maxillofacial trauma patients visiting different registered hospitals from Delhi-NCR region from January 2012 to December 2017, treated by open reduction and internal fixation under general anesthesia (GA)/local anesthesia (LA) or closed reduction/conservatively, were taken into the study. The parameters considered in the study were age and sex distribution, etiological factors and incidence of maxillofacial trauma, pattern and site distribution of maxillofacial fractures, and management. Results From a total of 2250 trauma patients, 1278 patients (1053 males and 225 females) had maxillofacial injury. The average prevalence rate was 56.8%. Yearly incidence rate was 20.4%. Road traffic accident (RTA) was the most common cause of trauma in 1029 (80.5%) patients, followed by physical assault [158 (12.3%)] with significant male predominance in different age groups. Isolated mandibular fractures were the most common [48.6% (parasymphysis 31.6%, condyle 28.2%)], followed by midface with maxilla fracture [27.6% (zygomatic bone and arch 50.2% and Lefort II fractures 18%)]. Treatment modalities were conservative management, closed reduction, and open reduction with internal fixation under GA/LA. Conclusion RTA followed by physical assault is still the leading cause of maxillofacial trauma in young males in Delhi-NCR region. Mini plate osteosynthesis is the main treatment procedure for maxillofacial trauma. We need to enforce strict traffic rules, road safety law, and preventive measures along with improvement in education and socioeconomic status in the population to avoid maxillofacial injuries.
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Affiliation(s)
- Lokesh Chandra
- Department of Oral and Maxillofacial Surgery, ESIC Dental College and Hospital, Rohini, Delhi, India
| | - D Deepa
- Department of Oral and Maxillofacial Surgery, NSVK Sri Venkateshwara Dental College and Hospital, Bengaluru, Karnataka, India
| | - Mansi Atri
- Department of Public Health Dentistry, ESIC Dental College and Hospital, Rohini, Delhi, India
| | - Souvir Mohan Pandey
- Department of Prosthodontics, Teerthankar Mahaveer Dental College and Hospital, Moradabad, Uttar Pradesh, India
| | - Deepak Passi
- Department of Dentistry, Subdivisional Hospital, Bundu, Ranchi, Jharkhand, India
| | - Jyoti Goyal
- Department of Public Health Dentistry, ITSCDSR, Ghaziabad, Uttar Pradesh, India
| | - Abhimanyu Sharma
- Department of Oral and Maxillofacial Surgery, ESIC Dental College and Hospital, Rohini, Delhi, India
| | - Utkarsh Gupta
- Department of Public Health Dentistry, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
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Patil SG, Munnangi A, Joshi U, Thakur N, Allurkar S, Patil BS. Associated Injuries in Maxillofacial Trauma: A Study in a Tertiary Hospital in South India. J Maxillofac Oral Surg 2018; 17:410-416. [PMID: 30344378 DOI: 10.1007/s12663-017-0998-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 01/23/2017] [Indexed: 11/26/2022] Open
Abstract
Aim Maxillofacial trauma when associated with concomitant injuries has a significant potential for increased morbidity. This study aims to identify the causes of trauma, evaluate the types of associated injuries and to highlight the significance of multi professional collaboration in sequencing of treatment. Patients and Methods A total of 300 patients who reported to the casualty of a tertiary Hospital in Karnataka with facial fractures were enrolled. Results Associated injuries were sustained by 162 patients. The predominant aetiology was the Road Traffic Accident with maximum number of patients in the age group of 20-29 and a male to female ratio of 10.1:1. The mandible was the most frequently fractured bone. Head injury was the most common associated injury. The mortality rate was 0.66%. The mean ISS and GCS values among the patients who sustained associated injuries along with maxillofacial trauma were higher and lower respectively, as compared to those without associated injuries with a statistically significant difference (p < 0.001). Conclusion Implementation of strict road safety measures in the rural and interior regions of South India, to prevent morbidity and mortality due to road traffic accidents is essential. Injuries to the facial skeleton must be approached with the knowledge of probable associated injuries that could have been incurred.
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Affiliation(s)
- Satishkumar G Patil
- Department of Oral and Maxillofacial Surgery, Room no:2, H.K.E's S. Nijalingappa Institute of Dental Sciences and Research, Sedam Road, Kalaburagi, 585105 Karnataka India
| | - Ashwini Munnangi
- Department of Oral and Maxillofacial Surgery, Room no:2, H.K.E's S. Nijalingappa Institute of Dental Sciences and Research, Sedam Road, Kalaburagi, 585105 Karnataka India
| | - UdupiKrishna Joshi
- Department of Oral and Maxillofacial Surgery, Room no:2, H.K.E's S. Nijalingappa Institute of Dental Sciences and Research, Sedam Road, Kalaburagi, 585105 Karnataka India
| | - Nitin Thakur
- Department of Oral and Maxillofacial Surgery, Room no:2, H.K.E's S. Nijalingappa Institute of Dental Sciences and Research, Sedam Road, Kalaburagi, 585105 Karnataka India
| | - Soumya Allurkar
- Department of Oral and Maxillofacial Surgery, Room no:2, H.K.E's S. Nijalingappa Institute of Dental Sciences and Research, Sedam Road, Kalaburagi, 585105 Karnataka India
| | - Bindu S Patil
- Dept of Periodontics, H.K.E's S. Nijalingappa Institute of Dental Sciences and Research, Sedam Road, Kalaburagi, 585105 Karnataka India
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Halsey JN, Hoppe IC, Granick MS, Lee ES. A Single-Center Review of Radiologically Diagnosed Maxillofacial Fractures: Etiology and Distribution. Craniomaxillofac Trauma Reconstr 2017; 10:44-47. [PMID: 28210407 PMCID: PMC5305313 DOI: 10.1055/s-0036-1597582] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 09/17/2016] [Indexed: 10/20/2022] Open
Abstract
The etiology of fractures of the maxillofacial skeleton varies among studies, with motor vehicle accidents and assaults oftentimes the most common. The number of males outnumbers females throughout most studies. Fractures of the zygoma, orbit, and mandible are usually cited as most common fracture types. This study examines a single center's experience with regards to etiology and distribution of fractures. A retrospective review of all radiologically confirmed facial fractures in a level 1 trauma center in an urban environment was performed for the years 2000 to 2012. Patient demographics, etiology of injury, and location of fractures were collected. During this time period, 2,998 patients were identified as having sustained a fracture of the facial skeleton. The average age was 36.9 years, with a strong male predominance (81.5%). The most common etiologies of injury were assault (44.9%) and motor vehicle accidents (14.9%). Throughout the study period, the number of fractures as a result of assault remained relatively constant, whereas the number as a result of motor vehicle accidents decreased slightly. The most common fracture observed was of the orbit, followed by mandible, nasal bones, zygoma, and frontal sinus. Patients sustaining a fracture as a result of assault were more likely to have a mandible fracture. Patients in motor vehicle accidents were more likely to suffer fractures of the maxilla, orbit, and frontal sinus. Mandible fractures are more common in cases of assault. Motor vehicle accidents convey a large force, which, when directed at the craniofacial skeleton, can cause a variety of fracture patterns. The decreasing number of fractures as a result of motor vehicle accidents may represent improved safety devices such as airbags.
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Affiliation(s)
- Jordan N. Halsey
- Division of Plastic Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Ian C. Hoppe
- Division of Plastic Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Mark S. Granick
- Division of Plastic Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Edward S. Lee
- Division of Plastic Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
- Department of Plastic Surgery, VA New Jersey Health Care System, East Orange, New Jersey
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Patil SG, Patil BS, Joshi U, Allurkar S, Japatti S, Munnangi A. The facial skeleton: Armor to the brain? Indian J Dent 2016; 7:116-120. [PMID: 27795644 PMCID: PMC5015560 DOI: 10.4103/0975-962x.180318] [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: 11/04/2022] Open
Abstract
BACKGROUND With the development of urban setting worldwide, the major issue of concern is the increase in the mortality rate in the population due to road traffic accidents. The face, being the most exposed region is susceptible to injuries and maybe associated with injuries to the adjacent neuro-cranium. The literature has conflicting views on the relationship between facial fractures and head injuries with some authors opining that the facial skeleton cushions the brain while some other authors claim that the facial fractures act as indicators for head injuries. OBJECTIVES To analyze the correlation between the facial fractures and head injuries and to assess if the facial skeleton acts to protect the brain from injury. PATIENTS AND METHODS A prospective study that included patients who reported to the emergency department of Basaveswar Teaching and General Hospital, Gulbarga, during 2 years, between August 2013 and July 2015 was conducted. A total of 100 patients with facial fractures were enrolled in the study. RESULTS Head injuries were sustained by 51 patients in the study. Maximum number of patients was in the age group of 20-29 with a male to female ratio of 10.1:1. The mandible was the most frequently fractured bone in the facial skeleton followed by the zygomatico-maxillary complex. A majority (96%) of patients with head injuries had fractures of either the upper third or the middle third of the face. Contusions and pneumocephalus were the most common head injury encountered. The Glasgow Coma Scale score was significantly lower in patients with associated head injuries as compared to those patients with facial trauma alone. The mortality rate in the study was 2% with both the victims having sustained middle third and upper third fractures respectively with associated head injuries. CONCLUSION The facial skeleton does not act to cushion the brain from injury but, in fact, the facial trauma victims should be considered potential head injury patients.
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Affiliation(s)
- Satishkumar G Patil
- Department of Oral and Maxillofacial Surgery, H.K.E's S. Nijalingappa Institute of Dental Sciences and Research, Gulbarga, Karnataka, India
| | - Bindu S Patil
- Department of Periodontics, H.K.E's S. Nijalingappa Institute of Dental Sciences and Research, Gulbarga, Karnataka, India
| | - Udupikrishna Joshi
- Department of Oral and Maxillofacial Surgery, H.K.E's S. Nijalingappa Institute of Dental Sciences and Research, Gulbarga, Karnataka, India
| | - Soumya Allurkar
- Department of Oral and Maxillofacial Surgery, H.K.E's S. Nijalingappa Institute of Dental Sciences and Research, Gulbarga, Karnataka, India
| | - Sharanabasappa Japatti
- Department of Oral and Maxillofacial Surgery, ACPM Dental College, Dhule, Maharashtra, India
| | - Ashwini Munnangi
- Department of Oral and Maxillofacial Surgery, H.K.E's S. Nijalingappa Institute of Dental Sciences and Research, Gulbarga, Karnataka, India
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Akhiwu BI, Suleiman HH, Muktar M, Amole IO. Cost of illness in patients with mandibular fracture following road traffic crash and its socioeconomic implications in KANO STATE, NIGERIA. JOURNAL OF THE WEST AFRICAN COLLEGE OF SURGEONS 2015; 5:1-16. [PMID: 27738617 PMCID: PMC5020889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND The Upward trend in facial injuries following road traffic crashes has been attributed to increasing urbanization and industrialization. AIM This study was conducted to determine the cost of illness for mandibular fractures and its socioeconomic implications. METHODOLOGY All the consecutive patients with mandibular fractures following road traffic crashes that presented to the Aminu Kano Teaching hospital in Kano State were recruited over one year. RESULTS A total of 50 patients were managed during the study period with 58% in the age range 21-30 years with mean of 27.9 ± 8.1 years, motorcycle-related road traffic crashes constituted the commonest aetiology. The cost of illness for mandibular fractures was N89, 312.20 ($488) per person. Cost of managing mandibular fractures was equivalent to 8.4% of the health care budget of the state and also equivalent to 15.2 % of the GDP per capita of the year of study surpassing the cost of illness for hypertension and diabetes. CONCLUSION These findings highlight the need for policies that would ensure safe driving, enforce the use of safety gadgets, protocols for efficient fracture management and reduced hospital stay.
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Affiliation(s)
- B I Akhiwu
- Dental and Maxillofacial Surgery Department , Jos University Teaching Hospital, Jos, Nigeria
| | - H H Suleiman
- Department of Economics. Bayero University, Kano, Nigeria
| | - M Muktar
- Department of Economics. Bayero University, Kano, Nigeria
| | - I O Amole
- Dental and Maxillofacial Surgery Department , Aminu Kano Teaching Hospital, Kano, Nigeria
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