Equine-associated maxillofacial injuries: retrospective 5-year analysis

We explored the relation between the causes of facial injuries in equestrians and the presence or absence of associated injuries. Over a 5-year period we retrospectively reviewed all patients who presented to the John Hunter Hospital, New South Wales, with facial injuries that had resulted from activity with horses. We analysed the rates of hard and soft tissue injuries, and of associated injuries by sex and mechanism. A total of 85 patients were included (50 female and 35 male) with an age range of 2–88 years. There was a significant difference in the rate of maxillofacial and associated injuries when groups were analysed for sex and mechanism of injury. Facial injuries caused by falling from a horse were more often associated with other injuries in men than in women (p < 0.05), and men were 4 times more likely to present with associated injuries than women (OR 3.9; 95% CI 1.1 to 14) We also found significant differences in the rates of facial fracture. Women who had been kicked by a horse were more likely to sustain bony injuries than men (p < 0.05). Our data confirm the association between kicks and facial fracture, and this may provide an impetus for the development of appropriate protective equipment. Patients who sustain facial injuries when falling from a horse often present with associated injuries and this has practical implications for clinicians involved in their management.     

Pattern of associated brain injury in maxillofacial trauma: a retrospective study from a high-volume centre

The incidence of head injury in maxillofacial trauma patients varies widely in the literature. A good understanding of the patterns of association between these injuries would aid in efficient multidisciplinary treatment. The aim of this study therefore was to understand the associations between head injury and facial trauma by retrospectively analysing the records of patients seen at a tertiary care trauma centre. Demographic data were also described. Records of 4350 facial trauma patients over a five-year period were reviewed. A total of 3564 (81.9%) patients were victims of motor vehicle accidents (MVA). Male patients predominated, comprising 3711 (85.3%), and 36.6% were in the third decade of life. Facial fractures were seen in 2120 (48.7%), the most common being zygomatic fractures (60%). At the time of trauma, 2383 (57.3%) patients were under the influence of alcohol, and 2821 (87.8%) victims of two-wheeler MVAs were not using their helmet. Of all patients, 29.75% sustained a traumatic brain injury (TBI). Midface fractures were strongly associated with TBI. Maxillofacial injury may be considered a risk factor for TBI, and as such should immediately be suspected and investigated in all patients. Prompt recognition and management can improve outcomes in these patients.     

Causes and incidence of maxillofacial injuries in India: 12-year retrospective study of 4437 patients in a tertiary hospital in Gujarat

Maxillofacial injuries are unique because of the anatomical complexity of the area and their associated psychological effects. An understanding of the epidemiology of these injuries is important if we are to develop preventive measures, increase the efficiency and delivery of health services, improve the skills of healthcare providers, and better distribute resources. We retrospectively evaluated data on 4455 patients (aged between 3 and 84 years) who presented with maxillofacial injuries to a tertiary referral hospital in Ahmedabad, India, between 1 January 1999 and 31 January 2010. Of these, 18 needed only rest and medication so 4437 were included. Data included patients’characteristics and the cause of injury. Details on the presentation and severity of injury, associated injuries including head injuries, the influence of alcohol and other drugs, treatment, and outcome, were also included. Around one-third were aged between 21and 30 years, and the male to female ratio was 5:1. The main causes of injury were road traffic accidents (n = 2347, 53%) and interpersonal violence (n = 1041, 23%). Most road traffic accidents involved two-wheeled vehicles. Alcohol was associated with 11% of injuries. A total of 2546 patients (57%) had mandibular fractures. To reduce the number of injuries we need better road safety laws with stringent enforcement, and the public, particularly those between 15 and 45 years of age, must be educated about road safety.     

Epidemiological analysis of maxillofacial fractures treated at a university hospital,Xinjiang, China: A 5-year retrospective study

PurposeTo investigate the epidemiological characteristics of maxillofacial fractures treated at a university hospital, Xinjiang, China over a 5-year period.Patients and methodsBetween 2006 and 2010, a total of 1350 patients with maxillofacial fractures were reviewed retrospectively. The data collected included demographics, aetiology, site of fracture, time regarding injuries, presence of associated injuries, treatment modalities, and complications.ResultsA total of 1860 maxillofacial fractures were seen in 1350 patients with a male to female ratio of 4.9:1. The most common aetiology of the fractures was motor vehicle accident, followed by interpersonal violence. The age group 21–30 years accounted for the largest subgroup in both sexes. The mandible was the most common site of fracture followed by the zygoma. Associated injuries were found in 48.3% of patients, with a prevalence of intracranial injuries (37.0%). Majority of fractures were treated with open reduction (62.4%), and 7.2% of patients presented post-operative complications.ConclusionRoad traffic accident is the most common cause of maxillofacial fractures in China, which is characterized by an increasing prevalence and resulting in more associated injuries. Thus, more attention should be paid on the prevention and treatment of these injuries caused by road traffic accidents in our country.     

Review of maxillofacial injuries in Chennai, India: a study of 2748 cases

We reviewed the medical records of 2748 patients treated for maxillofacial injuries at Sri Ramachandra Medical and Dental College and Hospital between January 1999 and December 2005. 1332 (42%) had soft tissue injuries, 1176 (37%) had mid face fractures, and 512 (16%) had mandibular fractures. Most patients with midface fractures had fractures of the zygomaticomaxillary region 422 (36%), while fractures of the parasymphyseal region were more common in the mandible 156 (31%). Most patients were in the 21-30 year-old age group, and the male:female ratio was 3.7:1. Road crashes, particularly involving motorcycles, accounted for 1710 (62%), with a high prevalence during the month of September and on Saturdays.     

885例颌面部损伤回顾分析

目的:回顾分析深圳特区885例颌面部损伤的临床流行病学特点。方法:对深圳市龙岗中心医院口腔科1998年1月-2002年6月间收治的885名颌面部损伤患者的病历资料进行临床流行病学回顾性研究。结果:颌面损伤患者人数占本科住院总人数的76.6％,男女比例为3.5:1,21-30岁为发病高峰年龄段,机动车事故在致伤原因中居首位,占52.09％。颌面部损伤以单纯软组织损伤最为多见,占68.93％;颌面部骨折以下颌骨骨折最多见,占面部骨折总数的17.85％,其次是颧骨和上颌骨骨折。颅脑损伤和四肢损伤是颌面损伤的常见合并伤。结论:男性青年为颌面损伤高发人群,机动车是主要致伤原因,软组织伤最多见,下颌骨为骨折多发部位,颅脑伤为常见合并伤。     

Injury patterns and outcomes in bicycle-related maxillofacial traumata: A retrospective analysis of 162 cases

The objective of the current study is to retrospectively evaluate cycling related dental and maxillofacial injuries and to gain insight into the epidemiology and results of these accidents. Data of patients who were admitted due to the maxillofacial injuries between April 2018 and September 2020 were retrospectively evaluated regarding the patients’ characteristics, helmet wearing, type of radiological assessment required for diagnosis and therapy, injury patterns, duration of hospitalization and concomitant injuries. Data of 162 patients were included. 86 (53.08%) patients presented with at least one maxillofacial fracture. A total of 186 maxillofacial bones were fractured. Zygomatico-maxillary complex was the most commonly affected region (n:103, 55,36%). Analysis of the dental traumata revealed that crown fracture without pulp exposure was the most commonly observed entity (n:37, 32.46%) and upper central incisors (n:61, 53.50%) were the most commonly affected teeth. The overall ratio of the number of the fracture line/fracture case was 2.80. However, this ratio was statistically higher in e-bike cases (4.25) compared to non-e-bike riders (2.34) (p:0.014). Bicycle related maxillofacial injuries could correlate with specific morbidity rates and result in severe injuries of the maxillofacial region.     

2461例颌面部骨折患者临床分析

目的 对2461例颌面部骨折病例进行临床回顾研究.方法 对广州中医药大学附属佛山中医院2003至2009年间因颌面部创伤住院的2461例骨折患者进行回顾分析,明确患者性别、年龄、损伤原因、职业、地域分布、血型、骨折部位、多处合并伤、损伤程度、首诊收入科室、治疗效果.结果 2461例颌面部骨折病例中,男女比例为4.28∶1;20～40岁为发病的高峰年龄(1424/2461,57.86%);道路交通伤938例(40.98%),在致伤原因中居首位;第三产业900例(78.53%),尤其从事交通运输业人员是最易骨折群体;颧骨复合体、鼻骨、下颌骨骨折分别占22.08%(955处/4325处)、20.67%(894处/4325处)和16.35%(707处/4325处),以上是颌面部骨折最好发部位;常合并颅骨、颅脑损伤及软组织挫裂伤,分别为21.74%、38.36%和48.84%.简明损伤评分法(abbrebiated injury scale,AIS)评分85.98%(2116例/2461例)患者小于2分;38.16%(939例/2461例)的患者首诊收入骨科.结论 颌面部骨折发病率逐年上升,交通事故为主要致伤原因,损伤程度较轻,常合并骨科损伤,男性较女性多见,发病人群以青壮年为主.

Abstract：

Objective To review the 2461 cases of maxillofacial fractures. Methods From 2003 to 2009, 2461 maxillofacial fracture cases were treated in Foshan Hospital of Traditional Chinese Medicine,Guangzhou University of Traditional Chinese Medicine. Data regarding sex, age, cause of injury,occupation,geographic distribution, blood type, fracture site, multiple associated injuries, injury severity, the patient's first admitted department, treatment results were reviewed. Results The male and female ratio was was road traffic accident(938 cases,40.98% ). People in tertiary industry(900 cases,78.53% ) were most vulnerable to injuries. The zygomatic complex (22.08% ), nasal bone (20.67% ) and mandible ( 16.35% )were the most frequent fracture sites, which were often associated with skull ( 21.74% ), brain ( 38.36% )and soft tissue contusion injury (48.84% ). 85.98% (2116/2461 cases), of patients' AIS score was less than 2. Orthopaedics (939/2461 cases, 38.16% ) was the first admitted department. Conclusions The traffic accidents are the main cause of the maxillofacial fractures. Most injuries are found in the young and middle-aged people.     

Trends of maxillofacial and mandibular fractures in level I and II trauma patients in a tertiary hospital in Saudi Arabia

BackgroundMaxillofacial injury is a major health concern worldwide. Incidence of maxillofacial fractures is influenced by socio-demographic, economic, and cultural factor of the population investigated. Identifying the patterns of these fractures is crucial to establish effective treatments and prevention measures. The aim of the study was to to analyze the incidence, etiology, and types of maxillofacial fractures in a tertiary trauma center.MethodsA retrospective analysis was conducted for all patients who were admitted with maxillofacial fractures at King Abdulaziz Medical City, Riyadh, Saudi Arabia. A total of of 422 patients with 978 maxillofacial fractures were enrolled over a 4-year period.ResultsAmong the 422 patients, 387 (91.8%) were males, and 35 (8.2%) were females. The mean age of our population was 31.1 years old. Our study has shown that motor vehicle accidents are the leading cause of maxillofacial fractures, followed by pedestrian trauma. The most common maxillofacial fractures were orbital fractures, followed by maxillary fractures. The mandibular body was most fractured among mandibular fractures. Our data has shown that males have higher incidence of maxillofacial fractures than females.ConclusionOur study further validated that road traffic accidents are the most common cause of maxillofacial fractures in our region. These findings emphasized the importance of improving road safety protocols and enforcing traffic laws.     

Patterns of maxillofacial fractures in Hofuf,Saudi Arabia: A 10-year retrospective case series

Objectives

This retrospective study was performed to analyze the incidence, etiology, and types of maxillofacial fractures in a major city in Eastern Province, Saudi Arabia.

伴全身多系统创伤颌面伤患者的综合救治

目的:研究伴发身体其他部位创伤的颌面伤患者综合救治中专科确定性手术时机和适应证。方法:回顾性统计4所大型综合医院口腔科病房近20年收治的4 869例口腔颌面部创伤患者的临床资料,分析伴发身体其他部位创伤状况和专科手术时机。结果:4 869例患者中,面骨骨折3 364例,软组织伤1 505例。伴发其他部位创伤1 524例(占31.3%),其中颅脑伤570例(37.4%),肢体伤545例(35.8%),胸部伤170例(11.2%),眼创伤151例(9.9%),脊柱伤54例(3.3%),腹部伤34例(2.2%)。74%的颅脑伴发伤患者伤后4周内、76.2%的眼伴发伤患者伤后7d内进行了面骨骨折手术治疗。而肢体、脊柱、胸腹部伴发伤患者,面骨骨折手术均有不同程度延误。结论:伴发多系统创伤的颌面伤患者的救治需要多学科间的合作,在患者呼吸系统、循环系统等全身状况稳定的情况下,大部分颌面多发伤患者可以同期或早期进行专科处理。     

3050例颌面部损伤临床分析

目的：分析3050例颌面部损伤的临床表现及治疗效果,为颌面部损伤综合治疗方案的确定提供数据资料。方法选择因颌面部损伤住院的3050例患者的临床资料进行回顾,分析患者的性别、年龄、损伤原因、职业、地域分布、血型、骨折部位、合并伤、首诊收入科室及治疗效果等因素。结果3050例颌面部损伤患者中,男女比例为3.9∶1;20～40岁（1711例,56.1%）为发病的高峰年龄;交通事故伤（1055例,34.6%）在致伤原因中居首位;颧骨复合体（707例,23.2%）、鼻眶筛骨（650例,21.3%）、下颌骨（540例,17.7%）在颌面部骨折中居前三位。颌面部损伤常合并颅脑损伤（1321例,43.3%）及面部软组织挫裂伤（1275例,41.8%）。2632例骨折患者中,首诊收入科室包括口腔科（67.3%）、骨科（11.6%）及脑外科（8.4%）。所有患者的简明损伤评分（abbrebiated injury scale,AIS）平均得分为2.3分,介于中度与较重度之间。手术治疗1694例（55.5%）,保守治疗1356例（44.5%）。结论颌面部损伤患者中以男性为主,以青壮年比例最高;交通事故伤为主要致伤原因;颧骨复合体、鼻眶筛骨及下颌骨最容易发生骨折;颌面部损伤常合并颅脑、胸腹腔、四肢等其他重要部位损伤;颌面部损伤的治疗效果总体满意。     

Elderly patients with maxillofacial trauma: the effect of an ageing population on a maxillofacial unit's workload

The purpose of this study was to identify the aetiology and management of facial fractures in patients over 60 years old and to identify potential trends in caseload to assist with planning of resources for maxillofacial services in the coming decades. We made a prospective study over 2 years (2009–2010), during which all injured patients referred to the oral and maxillofacial surgery unit at The Canberra Hospital, Australia were recruited. The patients were classified into two groups: less than 60 years old (younger group); or 60 years old or more (older group). Factors studied included sex, age, aetiology, site of fractures, severity scored using the Maxillofacial Injury Severity Score (MFISS), and management. Based on current trends, the expected workload was extrapolated. A total of 470 patients were recruited (younger: n = 430 and older: n = 40). Falls were the most common cause of fracture in the older group (85%) and the zygoma (40%) was the bone most commonly fractured. The mean (SD) MFISS for the older group was 3.8 (2.2) (17% of these maxillofacial injuries were operated on) and 6.0 (5.0) for the younger group (72% of these were operated on). In Australia, population trends suggest that older people as a proportion of the total population will rise from about 20% of 22 million to 26% of 30 million by 2034. As the older group increases there will be a corresponding increase in the number of older people who present with trauma to maxillofacial units. The overall maxillofacial surgical workload will probably not increase much because the injuries tend to be less severe and are less likely to require operation.     

1001例口腔颌面部创伤患者临床分析

目的:通过对1001例口腔颌面创伤患者回顾分析,了解口腔颌面部创伤患者的流行病学特点。方法:对第四军医大学口腔医院口腔颌面外科2008年8月—2011年3月期间收治的1001例口腔颌面创伤患者的病历资料进行统计分析。结果:1001例口腔颌面创伤患者男女比为2.80∶1;20～29岁(30.07%)为发病的高峰年龄段;交通事故(48.45%)在致伤原因中居首位。在口腔颌面创伤中,下颌骨骨折573例,发生率最高。合并伤以眼部最多见(171例),其次为颅脑伤和四肢创伤。结论:口腔颌面创伤患者以骨折多见。骨折发生的数量、部位等与致伤原因、受力性质及相应部位的解剖结构有关。眼部创伤、颅脑创伤及四肢创伤为最常见的并发症,应予以充分重视,治疗时不可忽视全身状况。     

Pediatric maxillofacial and dental trauma: A retrospective review of pediatric emergency management in Riyadh,Kingdom of Saudi Arabia

BackgroundDue to the high prevalence of oral and maxillofacial (OMF) trauma in city of Riyadh, a special focus on pediatric trauma is needed. The purpose of this audit was to assess the protocol followed by the OMF unit at King Khalid University Hospital (KKUH) on pediatric trauma patients. The trauma incidence, mechanism of injury, volume, the type of pediatric trauma operated and dental management were analyzed.Materials and MethodsA quantitative retrospective review of 223 patients, at pediatric emergency unit of KKUH, Riyadh, KSA from January 2017 to July 2018, was done. The data retrieved included variables such as, age, gender, and cause of injury, site of injury, type of injury, and assessment of jaws, and teeth. Data regarding the type of investigations, treatment protocol, follow up visit, and dental management, were extracted from the medical records.ResultsOf the 223 pediatric patients presenting to the emergency unit, 116 (52%) were under the age of 5 years. A total of 64.4% of patients reported “self-fall” as the cause of injury. Soft-tissue injuries were common in 63 (56.8%) of patients in the form of lacerations 87 (41.2%). Involvement of the teeth in the injury was observed in 57 patients, in which 33 (57.9%) patients were reported to have tooth/teeth avulsions, 15 (26.3%) patients had luxation and 9 (15.8%) patients had crown fractures. 27 (47%) patients were referred to the pedodontist for a follow-up visit.ConclusionsIt can concluded that clinicians facing maxillofacial trauma in an emergency department need to have access to useful and practice guidelines. The study also showed the need for more manpower-oriented training such as a pedodontist and a general dentist to join the OMFS team to manage pediatric patients. The regional referral hospitals should be equipped to decentralize the management of these patients to the Dental University Hospital.     

Traumatology of the facial skeleton in octogenarian patients: A retrospective analysis of 96 cases

AimThe aim of this retrospective study was to evaluate the frequency and distribution of maxillofacial trauma patients over 80 years, with regard to type and environment of accidents as well as treatment and complications.Patients and methodsData for 94 patients (96 cases; aged 80–94 years) with maxillofacial fractures were retrospectively analysed.ResultsData of 30 male and 64 female patients with an average age of 85 years were analysed. In 90% of the study population, the cause of fractures was a fall, followed by traffic accidents (9%) and assault (1%). Seventy-two patients had fractures of the midface, 10 had factures of the mandible, 9 had fractures of both the midface and mandible and 5 had fractures of the neurocranium and midface. Surgical intervention was required in 57% of the patients. Post-operative complications were: four cases of diplopia, two cases of infected plates, four cases of lower eyelid ectropion and in one case a retrobulbar haematoma.ConclusionFacial trauma in the elderly can often be treated conservatively unless the patient complains of functional problems. Due to co-morbidities, special attention should be paid to hypertension, anticoagulant agents and the surgical approach.     

Pattern of maxillofacial fractures at a tertiary hospital in northern India: a 4‐year retrospective study of 718 patients

Abstract – Purpose: Pattern and aetiology of maxillofacial injuries varies from one country to another and even within the same country depending on prevailing socio‐economic, cultural and environmental factors. Various studies have been carried out in various countries to study the epidemiology and demographics of the maxillofacial injuries but the studies from India are few. Material and methods: Retrospective study was undertaken at Christian Medical College Ludhiana (India) from January 2006 to December 2009. Treatment records of the patients was checked and age, gender, aetiology of injury, associated injuries, maxillofacial fractures and treatment offered were recorded. Results: A total of 1075 fractures were recorded in 718 patients, ranging from 11 months to 85 years of age. Male:female ratio was 6.6:1. Maxillofacial injuries were most common in third decade of life. A total of 517 patients suffered injuries because of road traffic accident, 115 because of accidental fall and 67 because of interpersonal violence. A total of 184 patients had 221 associated injuries of which 56.1% head injuries, 29.0% orthopaedic injuries and 14.9% other injuries were present. Of 596 middle third fractures, 29.8% were managed conservatively; for 21.7% and 48.7% of fractures, closed reduction and open reduction were performed respectively. Of 479 mandibular fractures, 1.8% was managed conservatively; for 16.7% and 81.5% fractures, closed reduction and open reduction were performed respectively. Conclusion: Better socio‐economic status of people, increased vehicular movements and non‐implementation of road safety norms have increased road traffic accidents. Proper education of the people who are most commonly involved in the RTA can be one of the possible ways to reduce the maxillofacial injuries.