Classifying and Standardizing Panfacial Trauma With a New Bony Facial Trauma Score

Casale, Garrett G.; Fishero, Brian A.; Park, Stephen S.; Sochor, Mark; Heltzel, Sara; Christophel, J. Jared

doi:10.1001/jamafacial.2016.1105

Cited by 8 publications

(9 citation statements)

References 9 publications

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“…It is possible that information about concomitant soft tissue injury was not accurate in the medical record or that the severity could be high even if there was no soft tissue injury due to blunt trauma. FISS, which is an index that assesses the severity of craniofacial trauma, is a clinically simple but useful indicator that can predict the patients' severity of the injury, economic burden, and hospital length of stay [5]. In line with recent studies, this study found that higher FISS was associated with higher trauma severity and that the predictions could be made with the most optimal sensitivity and specificity when the cutoff is 4 points.…”

Section: Discussionsupporting

confidence: 80%

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Trauma severity and mandibular fracture patterns in a regional trauma center

Lee

Kim

Choi

et al. 2020

Arch Craniofac Surg

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Background: Mandibular fractures are one of the most common types of facial fractures, the treatment of which can be delayed due to the severity of the trauma resulting in an increase of complications; thus, early evaluation of trauma severity at the time of visit is important. In South Korea, trauma patients are triaged and intensively treated in designated regional trauma centers. This study aimed to analyze the relationship between trauma severity and mandibular fracture patterns. Methods: A medical records review was performed on patients who visited the regional trauma center at our hospital for mandibular fracture between 2009 and 2018. Epidemiologic data and mandibular fracture patterns were analyzed and compared with the conventional facial injury severity scale (FISS). Results: Among 73 patients, 51 were classified as non-severe trauma patients and 22 as severe trauma patients. A higher trauma severity was associated with older age (odds ratio [OR], 1.164; 95% confidence interval [CI], 1.057-1.404) and lower risk was associated with fractures located in the angle (OR, 0.001; 95% CI, 0-0.022), condylar process (OR, 0.001; 95% CI, 0-0.28), and coronoid process (OR, 0.004; 95% CI, 0-0.985). The risk was lower when the injury mechanism was a pedestrian traffic accident (OR, 0.004; 95% CI, 0-0.417) or fall (OR, 0.004; 95% CI, 0-0.663) compared with an in-car traffic accident. Higher FISS (OR, 1.503; 95% CI, 1.155-2.049) was associated with a higher trauma severity. The proposed model was found to predict the trauma severity better than the model using FISS (p < 0.001). Conclusion: Age, location of mandibular fractures, and injury mechanism showed significant relationships with the trauma severity. Epidemiologic data and patterns of mandibular fractures could predict the trauma severity better than FISS.

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Section: Discussionsupporting

confidence: 80%

“…Another method to assess the severity of facial trauma is facial injury severity scale (FISS) ( Table 1). FISS is a clinically useful index because it can predict the severity of facial injuries and is an indicator of the hospital length of stay [5].…”

Section: Archives Of Craniofacial Surgerymentioning

confidence: 99%

Trauma severity and mandibular fracture patterns in a regional trauma center

Lee

Kim

Choi

et al. 2020

Arch Craniofac Surg

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“…To simulate blunt force trauma to the face, an impactor that applied a measurable amount of force was used to create facial fractures. At the University of Virginia, a drop tower was used to drop a 34-kg sled onto the head from heights ranging from 113 cm to 258 cm, generating varying amounts of force delivered to the face ranging from 1340 to 7160 N. 3 Plain radiographic films were used to confirm the presence of fractures, and each head then underwent scanning with high-resolution computed tomography (CT) ( Figure 1A and B). A similar protocol was used at The Ohio State University Wexner Medical Center; however, the impactor was hydraulically powered to deliver a similar range of force.…”

Section: Methodsmentioning

confidence: 99%

A Facial Trauma Simulation Course for Evaluation and Treatment of Facial Fractures

Christophel

Park

Nogan

et al. 2017

JAMA Facial Plast Surg

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Traditional facial trauma laboratories are used for teaching basic concepts of fracture reduction and hardware manipulation. Facial trauma simulation laboratories allow training physicians the opportunity to develop unique treatment plans as they would in real patient encounters. OBJECTIVE To assess the value of a novel facial trauma simulation course requiring residents to practice advanced decision making. DESIGN, SETTING, AND PARTICIPANTS Data were prospectively collected July 23 and August 23 and 24, 2016, in a survey study during a resident physician trauma simulation course.Fresh frozen cadaver heads were fractured using an impactor that applied a measurable amount of force. Each head was scanned with high-resolution computed tomography. Residents were paired and tasked with evaluating their specimen's imaging findings and developing a treatment plan. MAIN OUTCOMES AND MEASURESBefore the course, residents were asked their postgraduate year level, number of facial fractures treated as a resident surgeon, and their comfort level based on the Otolaryngology Milestone for Facial Trauma (OMFT; ratings range from 0-5, with 5 indicating equivalent to fellow-level experience). After the course, residents were asked to assess the course's value relative to a theoretical number of actual operative cases, and a posttraining OMFT assessment was obtained.RESULTS Thirty resident physicians completed the course at 2 institutions. Residents represented an equivalent distribution of postgraduate year levels. The residents stated that the course was worth a mean (SD) of 6.4 (2.8) operative cases of facial trauma in terms of surgical learning. The mean change in self-reported OMFT rating after the course was 0.87 (95% CI, 0.67-1.07; P < .001, paired t test). On the basis of this change in self-perceived OMFT rating, the course was deemed to be worth 1.5 years of residency training in the management of facial fractures.CONCLUSION AND RELEVANCE Conducting a facial trauma simulation course increases resident experience with advanced surgical decision making.LEVEL OF EVIDENCE NA.

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“…[ 2 4 5 ] According to the literature, men are more often affected, and the male-to-female ratio is about 2:1–8.9:1. [ 3 6 7 8 9 ] Young men are most often affected. In the age group between 15 and 29 years, jaw injuries are most frequently detected.…”

Section: Introductionmentioning

confidence: 99%

“…[ 15 16 17 18 19 ] Neither the AO papers nor other authors use the nomenclature for “panfacial fractures” or “complex fractures” consistently. [ 4 7 19 20 21 ] According to the definition applied in our study, a panfacial fracture includes several fractures from different facial regions. [ 4 ]…”

Section: Introductionmentioning

confidence: 99%

Evaluation of panfacial fractures in a german supraregional trauma center between 2015 and 2017 – A retrospective study

Bicsák¹,

Abel²,

Wruck³

et al. 2021

Ann Maxillofac Surg

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Introduction: Panfacial fractures represent the most severe injuries to the face. The combination of these fractures determines the treatment strategy. This study aims to retrospectively review the data of adult patients treated for complex facial skull fractures in a hospital in Dortmund, Germany from 2015-2017. Materials and Methods: We extracted related patient data from the hospital electronic repository and reviewed the patient files and radiological images. The fractures were classified based on the AO-Classification. The statistical analysis was performed by descriptive statistical methods. The main goal was to determine the most common fracture combinations. Results: A total of 188 patients with panfacial fractures were identified (181 adults, 7 children and adolescents). The gender and age distribution corresponded to the international literature (male-to-female ratio: 3.1:1, most common injuries among young men). 2–9 fracture sites were identified per patient, resulting in a fracture frequency of 3.13 per patient. 69 different fracture combinations have been identified. The most common ones were combinations of lateral and central mid-face fractures, and combinations of nasal bone fractures with lateral midface fractures or nasal bone fractures combined with mandibular fractures. Between 1 and 13 osteosynthesis implants per patient were used for osteosynthesis; the most commonly used plates were 2.0 mm and 1.5 mm straight plates. The average inpatient stay was 3 days (standard deviation [SD] = 3.0 days), and the average operation time (incision to suture) was 39.5 min (SD = 53.5 min). Discussion: Panfacial fractures are the most complex maxillofacial injuries. The complication rate in this study (4.5%) is below the international data. The treatment of panfacial fractures requires designated centers with experienced teams and good interdisciplinary cooperation.

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Classifying and Standardizing Panfacial Trauma With a New Bony Facial Trauma Score

Cited by 8 publications

References 9 publications

Trauma severity and mandibular fracture patterns in a regional trauma center

Trauma severity and mandibular fracture patterns in a regional trauma center

A Facial Trauma Simulation Course for Evaluation and Treatment of Facial Fractures

Evaluation of panfacial fractures in a german supraregional trauma center between 2015 and 2017 – A retrospective study

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