Cervical Spine Injury in Association with Craniomaxillofacial Fractures

Elahi, Mohammed M.; Brar, Mantaj S.; Ahmed, Najma; Howley, D B; Nishtar, Saadia; Mahoney, James

doi:10.1097/01.prs.0000293763.82790.aa

Cited by 57 publications

(10 citation statements)

References 31 publications

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“…Midface fractures propose an independent risk factor for cervical spine injuries [20]. In our cohort the incidence of cervical spine fractures in patients with midface fractures was 7.8% (16/204) which indicates similar relevant levels as previously reported by other teams (2.6% by Ardekian et al-9.7% by Mithani et al) [20][21][22][23][24][25]. Therefore, diagnostics and treatment of CMF and OT patients in trauma centers with a department for spinal surgery is strongly advised.…”

Section: Cervical Spine Injuries In Patients With Midface Fracturessupporting

confidence: 90%

Combined trauma in craniomaxillofacial and orthopedic-traumatological patients: the need for proper interdisciplinary care in trauma units

Mühlenfeld

Thoenissen

Verboket

et al. 2020

Eur J Trauma Emerg Surg

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Aim The primary aim of this study was to analyze frequency and characteristics of combined facial and peripheral trauma with consecutive hospitalization and treatment. Materials and methods The study included all patients with concomitant orthopedic-traumatolgical (OT) and craniomaxillofacial (CMF) injuries admitted to our level I trauma center in 2018. The data were collected by analysis of the institution's database and radiological reviews and included age, sex, injury type, weekday and time of presentation. All patients were examined and treated by a team of surgeons specialized in OT and CMF directly after presentation. Results A total number of 1040 combined OT and CMF patients were identified. Mean age was 33.0 ± 26.2 years. 67.3% (n = 700) were male patients. Primary presentation happened most frequently on Sundays (n = 199) and between 7 and 8 pm (n = 74). 193 OT fractures were documented, where cervical spine injuries were most frequent (n = 30). 365 facial and skull fractures were recorded. 10.8% of the 204 patients with fractures of the viscerocranium presented with at least one fracture of the extremity, 7.8% (16/204) with cervical spine fractures, 33.3% (68/204) with signs of closed brain trauma and 9.8% (20/204) with intracranial hemorrhage. Discussion The study shows a high frequency of combined facial with OT-injuries and brain damage in a predominantly young and male cohort. Attendance by interdisciplinary teams of both CMF and OT surgeons specialized in cervical spine trauma surgery is highly advisable for adequate treatment. Conclusion Diagnostics and treatment should be performed by a highly specialized OT and CMF team, with a consulting neurosurgeon in a level-1 trauma center to avoid missed diagnoses and keep mortality low.

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Section: Cervical Spine Injuries In Patients With Midface Fracturessupporting

confidence: 90%

Combined trauma in craniomaxillofacial and orthopedic-traumatological patients: the need for proper interdisciplinary care in trauma units

Mühlenfeld

Thoenissen

Verboket

et al. 2020

Eur J Trauma Emerg Surg

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“…Previous studies have estimated the complication rate of trauma patients admitted to the ICU to be 17.0- 31.2%, 16 , 17 whereas, others have found complication rates of 12.0-50.3% for traumatic facial fractures. 9 , 19 , 20 Studies have shown age, gender, traumatic CNS injury, chronic alcohol use, the type of intensive care unit, and number of operations to influence complication rates. 16 , 17 , 21 , 30 , 31…”

Section: Discussionmentioning

confidence: 99%

Age and Number of Surgeries Increase Risk for Complications in Polytrauma Patients with Operative Maxillofacial Fractures

Lalezari

Lee²,

Paydar³

et al. 2018

wjps

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BACKGROUNDPoly-trauma patients often sustain complex head/neck injuries requiring prolonged hospitalizations and multiple operations. Few studies have evaluated the associated injury patterns and risk factors for poor clinical outcomes.METHODSConsecutive poly-trauma patients with operative maxillofacial fractures treated at a level 1 trauma medical center between 1995 and 2013 were evaluated. Concomitant head/neck injuries to identify potential injury patterns were numerated. Lastly, a multivariate analysis was performed to determine independent risk factors for complications during the acute hospitalization period.RESULTSTotally, 232 poly-trauma patients presented with operative maxillofacial fractures, while 38.8% of patients had a secondary maxillofacial fracture, 16.4% had intracranial hemorrhage, 23.7% had skull fractures, and 12.1% had spinal fractures. The rate of complication during admission was 28.3%. Multivariate analysis revealed advanced patient age and increased number of operations to predict the rate of complication. Patients requiring more than one operation had a 1.8-fold increase in complication rate (p<0.01) and older patients had a 4.5% increase in complication rate (p<0.05) for every year of increased age. CONCLUSIONPoly-trauma patients have a high incidence of secondary maxillofacial fractures, concomitant head/neck injury, and inpatient complication rate. Knowledge of associated injury patterns can help increased awareness and can guide physician decision-making to avoid missed/delayed injuries.

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“…Although many studies have investigated the epidemiology of maxillofacial injures, most of them focus on a single type of concomitant injury like brain or cervical spine [9–11], have emphasized on concomitant injuries with a particular type of facial fracture [12, 13], or have investigated facial injuries in response to trauma mechanism. Although only few examinations exist, that pertain to the incidence of maxillofacial injuries in a general population of severely injured patients [1, 3], the data of most of the underlying investigations was collected twenty years ago and safety precautions have since significantly improved.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of the existing studies on facial injuries focused on a single type of concomitant injury like brain or cervical spine [9–11]. Others broach the issue of concomitant injuries with a particular type of facial fracture [12, 13].…”

Section: Introductionmentioning

confidence: 99%

Maxillofacial injuries in severely injured patients

Scheyerer

Döring

Fuchs

et al. 2015

J Trauma Manage Outcomes

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BackgroundA significant proportion of patients admitted to hospital with multiple traumas exhibit facial injuries. The aim of this study is to evaluate the incidence and cause of facial injuries in severely injured patients and to examine the role of plastic and maxillofacial surgeons in treatment of this patient collective.MethodsA total of 67 patients, who were assigned to our trauma room with maxillofacial injuries between January 2009 and December 2010, were enrolled in the present study and evaluated.ResultsThe majority of the patients were male (82 %) with a mean age of 44 years. The predominant mechanism of injury was fall from lower levels (<5 m) and occurred in 25 (37 %) cases. The median ISS was 25, with intracranial bleeding found as the most common concomitant injury in 48 cases (72 %). Thirty-one patients (46 %) required interdisciplinary management in the trauma room; maxillofacial surgeons were involved in 27 cases. A total of 35 (52 %) patients were treated surgically, 7 in emergency surgery, thereof.ConclusionMaxillofacial injuries are often associated with a risk of other serious concomitant injuries, in particular traumatic brain injuries. Even though emergency operations are only necessary in rare cases, diagnosis and treatment of such concomitant injuries have the potential to be overlooked or delayed in severely injured patients.

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Cervical Spine Injury in Association with Craniomaxillofacial Fractures

Abstract: The relationship between cervical spinal injuries and craniomaxillofacial trauma has been better defined as it relates to a regional trauma registry. The implications as related to the trauma assessment, diagnosis, and treatment of these injuries are reviewed.

Cited by 57 publications

References 31 publications

Combined trauma in craniomaxillofacial and orthopedic-traumatological patients: the need for proper interdisciplinary care in trauma units

Combined trauma in craniomaxillofacial and orthopedic-traumatological patients: the need for proper interdisciplinary care in trauma units

Age and Number of Surgeries Increase Risk for Complications in Polytrauma Patients with Operative Maxillofacial Fractures

Maxillofacial injuries in severely injured patients

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