Facial Fracture in the Setting of Whole-Body CT for Trauma: Incidence and Clinical Predictors

Whitesell, Ryan T.; Steenburg, Scott D.; Shen, Changyu; Lin, Hongbo

doi:10.2214/ajr.14.13589

Cited by 23 publications

(16 citation statements)

References 37 publications

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“…10 However, MVAs can provide enough force to disrupt this rigid protective framework of the orbital contents, intracranial space, and midfacial structures. 10,25…”

Section: Discussionmentioning

confidence: 99%

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A Single-Center Review of Radiologically Diagnosed Maxillofacial Fractures: Etiology and Distribution

Halsey

Hoppe

Granick

et al. 2017

Craniomaxillofacial Trauma & Reconstruction

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Maxillofacial injury represents a significant number of emergency room visits worldwide.1-4 Several studies have examined the trends and demographics associated with patients sustaining facial fractures. 2,3,5,6 The mechanism of injury, age, and sex distribution, and the types of bones cited as most commonly fractured have been shown to vary by region. 4,6-8Etiologies typically reported as most common are often motor vehicle accidents (MVA) or interpersonal violence. 3,9Males have been observed to sustain facial fractures more often than women, and the mechanism of injury often varies between the sexes. 5,6 In most studies, the nasal bones, mandible, orbit, and zygoma are cited as the most commonly fractured bones of the facial skeleton. The purpose of this paper is to examine the demographic characteristics, Keywords► facial fractures ► facial trauma ► urban trauma center ► assault cases ► motor vehicle accidents AbstractThe 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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“…10 However, MVAs can provide enough force to disrupt this rigid protective framework of the orbital contents, intracranial space, and midfacial structures. 10,25…”

Section: Discussionmentioning

confidence: 99%

“…The greater thickness of bone in these facial buttresses prevents their injury in most cases of lower velocity trauma 10. However, MVAs can provide enough force to disrupt this rigid protective framework of the orbital contents, intracranial space, and midfacial structures 1025…”

Section: Discussionmentioning

confidence: 99%

A Single-Center Review of Radiologically Diagnosed Maxillofacial Fractures: Etiology and Distribution

Halsey

Hoppe

Granick

et al. 2017

Craniomaxillofacial Trauma & Reconstruction

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“…Fractures affecting the maxillofacial region are classified as very serious and are often associated with disfigurement, functional impairment, severe morbidity and high costs for health services and may require complex therapeutic modalities for treatment [29][30][31][32] . In this study, they were more associated with men exposed to community violence, suggesting greater severity of injuries occurred to this group.…”

Section: Dimension 1 Dimensionmentioning

confidence: 99%

Violência interpessoal, circunstâncias das agressões e padrões dos traumas maxilofaciais na região metropolitana de Campina Grande, Paraíba, Brasil (2008-2011)

Bernardino

Barbosa

Nóbrega

et al. 2017

Ciênc. saúde coletiva

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“…Although some authors affirm that appropriate physical examination of the face reliably rules out fractures in some patients (as low impact trauma ones) and some clinical variables are associated with facial fractures [16], physical examination alone cannot classify facial injuries. In other patients like such with polytrauma is widely known that even that physical exam does not rule out fractures because of distracting injuries, obtundation, or facial swelling [17].…”

Section: Introductionmentioning

confidence: 99%

Facial fractures: classification and highlights for a useful report

et al. 2020

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In patients with facial trauma, multidetector computed tomography is the first-choice imaging test because it can detect and characterize even small fractures and their associated complications quickly and accurately. It has helped clinical management and surgical planning, so radiologists must communicate their findings to surgeons effectively. In Le Fort fractures, there is a breach between the pterygoid plates and the posterior maxilla. These fractures are classified in three basic patterns that can be combined and associated with various complications. Conceptualized when low-speed trauma was predominant, the Le Fort classification system has become less relevant giving more importance on maxillary occlusion-bearing segments. The classification of naso-orbito-ethmoid depends on the extent of injury to the attachment of the medial canthal tendon, with possible complications like nasofrontal duct disruption. Displaced fractures of the zygomaticomaxillary complex often widen the angle of the lateral orbital wall, resulting in increased orbital volume and sometimes in enophthalmos. Severe comminution or angulation can lead to wide surgical exposure. In orbital fractures, entrapment of the inferior rectus muscles can lead to diplopia, so it is important to assess its positioning and morphology. Orbital fractures can also result in injuries to the globe or infraorbital nerve. Frontal sinus fractures that extend through the posterior sinus wall can create a communication with the anterior cranial fossa resulting in leakage of cerebrospinal fluid, intracranial bleeding. It is essential to categorize fracture patterns and highlight features that may affect fracture management in radiology reports of facial trauma.

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Facial Fracture in the Setting of Whole-Body CT for Trauma: Incidence and Clinical Predictors

Cited by 23 publications

References 37 publications

A Single-Center Review of Radiologically Diagnosed Maxillofacial Fractures: Etiology and Distribution

A Single-Center Review of Radiologically Diagnosed Maxillofacial Fractures: Etiology and Distribution

Violência interpessoal, circunstâncias das agressões e padrões dos traumas maxilofaciais na região metropolitana de Campina Grande, Paraíba, Brasil (2008-2011)

Facial fractures: classification and highlights for a useful report

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