Medico-legal evaluation and trend of the different patterns of maxillofacial fractures concomitant with closed head injury in Upper Egypt: retrospective study

Abstract

Background: Maxillofacial fractures are of great medico-legal implications because they are of common occurrence with other injuries, predominantly head injuries that might involve serious esthetic and functional problems, and so clinically described as consequential injuries. The aims were to assess the medico-legal aspects of maxillofacial fractured cases concomitant with closed head injury over a 6-year period (2011-2016) in the Trauma Unit of Assiut University Hospitals, Egypt, and to evaluate the demographic feature and the trend of different patterns of such fractures. Patient and methods: A descriptive hospital-based study included all cases of maxillofacial fractures combined with closed head injury attending the Trauma Unit of Assiut University Hospitals in the period of January 2011 to December 2016. Results: The study included 1221 cases, the percent of maxillofacial fractures with a closed head injury was 4%, the age group 18-40 years was having the highest incidence, and mean age was 25.9 ± 15.3 years with male to female ratio of 7:1. Road traffic accidents were the main etiology of injury (69.7%), followed by falls (15.1%) and violent assaults (10.2%) while firearm injuries were the last (5%). Unintentional injuries were the commonest in 83.1% followed by homicidal (16.3%); only 7 cases were due to suicidal attacks. The mandibular fracture was the commonest (49.7%) followed by fracture maxilla (19.2%), fracture zygoma (16.8%), and lastly frontal bone and nasal fracture. The trend of maxillofacial fractures over the 6-year period tended to be increased with the highest number in 2011 (21.5%) and the lowest in 2014 (13.3%). Conclusion: Maxillofacial fracture with a closed head injury in Upper Egypt is common in the middle age with male predominance. Road traffic accident is the main etiologic factor, and accidental trauma is the commonest manner. Mandibular fractures are the commonest pattern followed by fracture maxilla. Traumatic head injuries in cases of maxillofacial fractures were mild in about half of the cases. The trend of maxillofacial fractures over the 6year period of the study (2011-2016) tended to be increased with the highest number in 2011 and the lowest in 2014.

Value of Platelet Rich Fibrin as Surgical Adjuvant in Management of Mandibular Fracture.

“…reported that males represent 88% of cases (12). Road traffic accidents were found to be the most frequent cause of fractures accounting for 62.5% of the cases, followed by falls 20.0% then violent assaults 17.5%, which was in agreement with El Shehaby et al, and Chen et al, (12) (13). This may be attributed to the fact that the females drive vehicles less frequently and more carefully than males.…”

An Injury Profile of Maxillofacial Trauma in Yaoundé: An Observational Study in Cameroon

“…However, this result is higher than the one found by Lebeau, et al, in France in 2006 who reported a gender ratio of 2. This difference can be explained by the fact that in the West, women are much more active and involved in economic, cultural and social activities; thus, they are equally exposed to RTAs, sports accidents and assaults [13].…”