Assessment of maxillofacial trauma in emergency department

Abstract

IntroductionThe incidence and epidemiological causes of maxillofacial (MF) trauma varies widely. The objective of this study is to point out maxillofacial trauma patients’ epidemiological properties and trauma patterns with simultaneous injuries in different areas of the body that may help emergency physicians to deliver more accurate diagnosis and decisions.MethodsIn this study we analyze etiology and pattern of MF trauma and coexisting injuries if any, in patients whose maxillofacial CT scans was obtained in a three year period, retrospectively.Results754 patients included in the study consisting of 73.7% male and 26.3% female, and the male-to-female ratio was 2.8:1. Mean age was 40.3 ± 17.2 years with a range of 18 to 97. 57.4% of the patients were between the ages of 18–39 years and predominantly male. Above 60 years of age, referrals were mostly woman. The most common cause of injuries were violence, accounting for 39.7% of the sample, followed by falls 27.9% and road traffic accidents 27.2%. The primary cause of injuries were violence between ages 20 and 49 and falls after 50. Bone fractures found in 56,0% of individuals. Of the total of 701 fractured bones in 422 patients the most frequent was maxillary bone 28,0% followed by nasal bone 25,3%, zygoma 20,2%, mandible 8,4%, frontal bone 8,1% and nasoethmoidoorbital bone 3,1%. Fractures to maxillary bone were uppermost in each age group.8, 9% of the patients had brain injury and only frontal fractures is significantly associated to TBI (p < 0.05) if coexisting facial bone fracture occurred. Male gender has statistically stronger association for suffering TBI than female (p < 0, 05). Most common cause of TBI in MF trauma patients was violence (47, 8%).158 of the 754 patients had consumed alcohol before trauma. No statistically significant data were revealed between alcohol consumption gender and presence of fracture. Violence is statistically significant (p < 0.05) in these patients.ConclusionStudies subjected maxillofacial traumas yield various etiologic factors, demographic properties and fracture patterns probably due to social, cultural and governmental differences. Young males subjected to maxillofacial trauma more commonly as a result of interpersonal violence.

Frequency of infra-orbital nerve injury after a Zygomaticomaxillary complex fracture and its functional recovery after open reduction and internal fixation

“…The age group affected was 18-39 years which was also concordant with our study (18-30 years had 20% cases and 31-40 years had 34.67% cases totalling 54.67% of the reported cases) but the main cause in their study for ZMC fractures was interpersonal assault as opposed to our results which was RTA. 18 Balakrishnan from India also reported age group 20 to 40 being more prone to RTAs which was also concordant with our results. 19 Nerve injury following fracture may present with various pathophysiology involving traction, pressure, ischemia, inflammation and physical damage of the infra-orbital nerve resulting in sensory neuropathy and motor functions in the area of innervation of infra-orbital nerve both as presenting symptom and as a postoperative complication.…”

“…17 Arslan et al from Turkey reported 2.8:1 male to female ratio. 18 However our result showed a male: female ratio of 5:3, the difference in the ratios can be due to high RTAs in females as they commonly accompany males especially on the motorbike which is itself a major cause of RTA. The age group affected was 18-39 years which was also concordant with our study (18-30 years had 20% cases and 31-40 years had 34.67% cases totalling 54.67% of the reported cases) but the main cause in their study for ZMC fractures was interpersonal assault as opposed to our results which was RTA.…”

Maxillofacial Fractures: Etiology, Pattern of Presentation, and Treatment in University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

“…These fractures occur commonest in young adults especially males in third and fourth decades of life because they are majorly involved in many outdoor activities and reckless driving [5,9,10,12]. This assertion is supported by our study in which more than 75% of the study populations were males and 68.6% were between the ages of 20 to 40 years.…”

“…This is as a result of the centrality of the facial region as a key factor in human identity, esthetics, and general well-being [1,2]. These injuries can affect both skeletal and soft tissue structures of the facial region [3,4] and often times, based on the etiology and mechanism of injury, occur in association with other systemic injuries thereby requiring multidisciplinary approach for their management [4][5][6][7].…”

Assessment of Maxillofacial Trauma in Emergency Department

“…They found that etiologic factors, demographic properties, and fracture patterns yielded various results due to social, cultural, and governmental differences, and MF trauma was more prevalent in young males as a result of interpersonal violence (15).…”