Aetiology, prevalence, fracture site and management of maxillofacial trauma

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.

The epidemiology of facial trauma in a city in Northern Brazil

“…Men are significantly more affected than women (Leporace and Paulesini Júnior 2009;Rashid et al 2013;Siwani et al 2014;Flandes et al 2019;Kanala et al 2021), which was confirmed by the present study, but in a lower ratio (3.5:1) than all other regions examined, including Brazil itself. There have been reports that the more severe the facial fracture the more likely it is that a man is involved (Horibe et al 2004).…”

“…The most affected anatomical region (about half) in facial fractures is the mandible (Falcão and Leite Segundo 2005;Rashid et al 2013;Motamedi et al 2014;Liu et al 2020;Kanala et al 2021) followed by fractures of the middle third of the face, although in some studies this relationship is reversed but very close (Cabalag et al 2014;Abosadegh et al 2019), as in the present study (figure 4). The proportion of lower and upper jaw fractures was significantly lower compared to other studies, while the incidence of zygomatic and nasal fractures was significantly higher.…”

“…Patients of all ages are affected by facial fractures, but the 21-30 age group is the largest sample ( falls that are also etiological factors for the elderly (Silva et al 2009). However, in developed countries, the frequency of fractures in children and adolescentes has an important relationship with comorbidities (asthma and migraines), a history of mental illness (depression, anxiety and hyperactivity) and/or alcohol, tobacco and marijuana abuse (Siwani et al 2014;Brucoli et al 2019;Kanala et al 2021). The incidence curve of facial fractures in elderly patients is increasing, due to the increased life expectancy, especially in industrialized countries (Tatsumi et al 2015).…”

“…There are epidemiological surveys that contradict this information thaand state that traffic accidents are the main cause of facial fractures in industrialized countries (Siwani et al 2014;Chen et al 2020). The main reasons are deficiencies in legislation and traffic, vehicle maintenance, bad roads and recklessness (Elgehani and Orafi 2009;Silva et al 2009;Eskitaşcioǧlu et al 2013;Agudelo-Suárez et al 2015;Bede 2015;Kanala et al 2021). Illiteracy and difficulty reading road signs also influence the number of accidents in some countries (Elarabi and Bataineh 2018).…”

Prevalência do trauma maxilofacial em um hospital de referência da República Dominicana

“…A compreensão da frequência e distribuição de casos de fraturas faciais em uma população pode auxiliar no estabelecimento de prioridades de pesquisa para o tratamento e prevenção eficazes dessas lesões (KANALA et al, 2021) As fraturas faciais exigem especial atenção durante o diagnóstico por causa da proximidade anatômica do cérebro e da associação frequente com lesões concomitantes graves, como lesão cerebral traumática. As estruturas vitais na região da cabeça e pescoço devem, portanto, ser avaliadas sempre que houver suspeita de lesão na região maxilofacial (ABOSADEGH, RAHMAN & SADDKI, 2017).…”