Patterns and etiology of maxillofacial fractures in Riyadh City,Saudi Arabia

ObjectiveThe aim of the present study was to study the etiologies and patterns of maxillofacial fractures in patients treated in Riyadh City, Saudi Arabia, between 2007 and 2011.Patients and methodsData were obtained through a retrospective review of 237 patients admitted to the King Saud Medical City Dental Department with a diagnosis of maxillofacial trauma. After excluding patient files with incomplete or unclear records, and cases in which computed tomography showed no evidence of fracture, the files of 200 patients with a diagnosis of maxillofacial fracture were included in the study. For each case, patient’s sex and age, pattern of facial fractures, and cause of injury were recorded on a data sheet. The data were transferred to an SPSS (ver. 16.0; SPSS Inc., Chicago, IL, USA) spreadsheet for statistical analysis. The chi-square test was used to test the association between two categorical variables or factors (age group, cause) with p value set at p<0.05, and t-test value at <0.05 and independent.ResultsMotor vehicle accidents were the most common cause of maxillofacial fractures in most age groups, especially in males. Within the study sample, mandibular fractures were significantly more common than middle-third facial fractures (56.4% vs. 43.6%; p=0.006). Among mandibular fractures, parasymphyseal fractures were most common (47%), followed by condylar fractures (35.3%). Most (77.2%) middle-third facial fractures involved the zygomatic complex, and the incidence of such fractures differed significantly between male and female patients. p=0.72, not significant.ConclusionMales were more prone to maxillofacial fractures, perhaps as a result of the conservative nature of Saudi society, as the rules of Saudi Arabia do not allow the females to drive. Motor vehicle accidents were the most common cause of maxillofacial fractures in patients aged 10–29 years, indicating the high demand for the application of stricter traffic rules to reduce the rate of such accidents.     

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.     

Incidence and pattern of maxillofacial fractures in the elderly

The results of an audit analysing patients above 60 years and above treated for maxillofacial fractures over a 15-year period at the University College Hospital, lbadan are presented. Of the total number of 1689 patients of all ages treated for facial fractures, 53 (3.1%) were within the age range of the study.The male to female ratio was 1.1:1 and 41 (77.4%) patients were younger than 70 years. Road traffic accidents were the most common cause of facial fractures (58.5%) and the mandible was involved in 91% of cases. Complications were noted in 2 (3.8%) patients.Attention should be paid to update driving courses and home safety instructions in order to reduce the incidence of maxillofacial fractures in the elderly.     

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.     

Mountainbiking--a dangerous sport: comparison with bicycling on oral and maxillofacial trauma.

The popularity of bicycling is reflected in the number of cycling-related oral and maxillofacial injuries. Five hundred and sixty-two injured bicyclists (10.3% of all trauma patients) were registered at the Department of Oral and Maxillofacial Surgery, University of Innsbruck, Austria, between 1991 and 1996, accounting for 31% of all sports-related accidents and 48.4% of all traffic accidents. A review of the patient records revealed more severe injury profiles in sixty mountainbikers, with 55% facial bone fractures, 22% dentoalveolar trauma and 23% soft tissue injuries, compared to 502 street cyclists showing 50.8% dentoalveolar trauma, 34.5% facial bone fractures and 14% soft tissue lesions. The dominant fracture site in bicyclists was the zygoma (30.8%), whereas mountainbikers sustained an impressive 15.2% LeFort I, II and III fractures. Condyle fractures were more common in bicyclists, with 18.8% compared to 10.8% in mountainbikers. Reduction of facial injuries due to cycling-related accidents needs appropriate design of helmets with faceguards and compulsory helmet use for all cyclists, and particularly mountainbikers.     

548例颌面创伤患者的回顾性分析

目的：通过回顾分析本院颌面创伤住院患者的临床资料，了解西安地区颌面创伤病例的构成、发病特点和临床流行病学现状。方法：对第四军医大学口腔医学院口腔颌面外科2003年7月～2006年6月3年间548例口腔颌面创伤患者的年龄、性别、时间、致伤原因、骨折特点、好发部位、神经损伤以及合并损伤等方面进行流行病学调查分析，采用SPSS10．12软件录入、分析所有数据。结果：颌面创伤患者占本院同期住院患者的22％，男女比例为3．9：1，21～40岁为发病高峰年龄。颌面创伤患者以7月份最多，2月份最少。交通事故在致伤原因中占50．91％，居于首位。颌面损伤以多发性骨折为主，人均骨折部位数为2．3处。在颌面骨骼中，下颌骨骨折最常见，其次是上颌骨和颧弓。在颌面部神经中，眶下神经和面神经损伤最常见。颅脑伤、四肢伤和眼损伤是颌面骨折最常见的合并伤。结论：近年来颌面创伤发病率逐年上升，且伤度加重、伤情复杂，交通事故伤呈上升趋势，创伤患者有年轻化趋势，男女比率有一定下降。     

A comparative study on maxillofacial fractures in central and eastern Anatolia. A retrospective study

The present report is an analysis of 190 patients with maxillofacial fractures from East Anatolia, and 212 patients with maxillofacial fractures from Central Anatolia. The aetiology, types, sites, sex, age, treatment and the results are discussed. These showed a high male:female ratio. The highest incidence was seen in the second and third decades and the lowest incidence in the seventh decade. The predominant causative factor in this study was traffic accidents, followed by fights and falls. Fractures of the body of the mandible, and LeFort I fractures in the midface, were the most common fractures in this study.     

The pattern of the maxillofacial fractures – A multicentre retrospective study

Aim of the present study was to report on the survey of fractures, frequency of presentation, sex and age distributions, aetiology, site distributions, associated injuries & modalities of treatment rendered at muticentres treated by the division of oral and maxillofacial surgery between 2000 and 2005 in Karnataka state of India. Study revealed that the common cause for the facial fractures was found to be traffic accidents (72.7%) with a male preponderance and peak incidence during 20–30 years of age. Isolated mandibular fractures were most frequent [1035 patients (41.7%)] followed by isolated mid face fractures [526 patients (21.2%)]. Among mid face fractures, zygomatic bone and arch were most frequently involved. Open reduction and internal fixation and closed method were used in almost the same frequency. Traffic accidents are the leading cause of the maxillofacial fractures from the observation made from the study. Legislations preventive measures to be enforced and abided by every citizen.     

Etiology and patterns of facial fractures in the United Arab Emirates

A retrospective study on facial fractures was carried out in the Department of Oral and Maxillofacial Surgery at Tawam Hospital (Al Ain, United Arab Emirates) between January 1, 1998 and December 31, 2001. The study included 144 patients with a mean age of 26.5 years; the most frequently injured patients belonged to the 16- to 20-year-old age group. The male predilection was 83%. Road traffic accident was the most common causative factor (59%), followed by falls (21.5%), accidents where camels were involved (5.5%), work- and sport-related accidents (4.8% and 4.8%, respectively), and assault (4.1%). A total of 53.4% of the patients suffered isolated mandibular fractures, 32.6% had isolated midface fractures, and 13.8% had combined midface and mandibular fractures. Associated injuries were noted in 22.2% of the patients. The number of patients treated increased from 28.3 (1990-1995) to 36 (1998-2001) on an annual average; a reduction in isolated nasal fractures and associated injuries, including facial lacerations, was noted with no change in age or etiology predilection. Sufficient data could not be obtained to determine if the favorable results with the associated injuries were a result of the effect of a compulsory seat belt law introduced on June 1, 1998, but the increasing number of maxillofacial injuries suggests that the seat belt law is ignored in this country.     

Pattern of paediatric maxillofacial fractures in Lagos, Nigeria

BACKGROUND: Maxillofacial fractures in children are rare when compared to those occurring in adults. To establish the incidence, pattern, and aetiology of maxillofacial fractures in children aged 15 years and below in Lagos, Nigeria. DESIGN: A review of patients with maxillofacial fractures aged 15 years and below seen and treated at the Lagos University Teaching Hospital, Lagos, Nigeria between January 1997 and December 2004 was conducted. RESULTS: Of the 225 patients with maxillofacial fractures seen within the study period, 37 (16.4%) were children aged 15 years and below, with a male-to-female ratio of 1.5 : 1. The highest incidence recorded was found within the age group 12-15 years (41%), with the lowest incidence occurring in the age group 0-5 years (27%). Multiple fractures were commoner in older patients (P > 0.05), and in boys (P > 0.05). There were no statistically significant relationships between the age of the patients, gender distribution, and mechanisms of injury. Road traffic crashes were the most common aetiological factor (64.9%), with the mandible being the most involved facial bone (63.8%). Majority of the mandibular fractures (33.3%) were located in parasymphyseal region. Zygomatic complex fractures were the most common in the mid-facial region. Most of the fractures (81.1%) were immobilized by simple methods (arch bars, eyelet wires, acrylic splint with circum-mandibular wiring) with or without intermaxillary fixation. Of the cases, 18.9% were managed conservatively. CONCLUSION: The incidence of facial fractures in this study was found to be higher than previously reported in Nigeria and worldwide, with almost two-thirds of cases a result of road traffic crashes. There is a need to enforce legislation aimed at preventing road traffic crashes to reduce maxillofacial injuries in children.     

Maxillofacial injuries in western Iran: a prospective study

Introduction

Although the epidemiology of facial injuries has been studied in many populations, there is a paucity of information in the literature in this relation in the Middle East including Iran. The aim of this study was to assess the epidemiology and mode of treatment of facial injuries in western Iran.

Material and methods

We examined all patients with a maxillofacial injury who presented to the outpatient department or who were hospitalized in the Besat Hospital of Hamedan City, Iran, between 20 December 2007 and 20 December 2009.

Results

Of 2,450 patients (77% male, 23% female) with a facial injury, 90% sustained soft tissue injuries and 37% had bone fractures. Motor vehicle accidents (MVAs) were the most common cause of injuries (35%). The most frequent bone fracture occurred in the nasal bone (63.4%). The incidence of associated injuries was 8.3% (mostly orthopedic). Rigid internal fixation was the main treatment of facial fractures. Malpositioned zygomas and functional and aesthetic problems after reconstruction of nasal-orbital-ethmoid injuries were the most common postoperative complications.

Discussion

Although in many countries the rate of facial injuries due to traffic accidents is decreasing, MVA is still the major cause of facial trauma in Iran. This may be due to the lack of enforcement of traffic laws by police and insufficient compliance of the population in obeying traffic rules. Rigid internal fixation was the most common mode of treatment of facial fractures, and in spite of the severity of facial injuries, the rate of postoperative complications was relatively low.     

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.

Have the causes of maxillofacial fractures changed over the last 16 years in Finland? An epidemiological study of 725 fractures

Abstract –  A retrospective study was undertaken to assess causes of maxillofacial fractures in Helsinki in 1981 and 1997. Hospital records of 725 patients were analyzed according to several factors including age, sex, cause of fracture and time of the injury. The time intervals between the accident and hospital examination were also evaluated. Number of maxillofacial fractures was 318 in 1981 and 407 in 1997 (27.9% increase) and most patients were men. The male to female ratio was 2.8:1 in 1981, 3:1 in 1997. In 1981, most affected patients were in the age group of 31–40 years (33.2% of men, 28.9% of women). Sixteen years later the most affected age group was 41–50 years (23.3% of men, 30.4% of women). Assault was the cause of the injury in 42% of patients followed by traffic accidents (26%) and fall (17%). During the study period violence had become more severe in nature. Kicking as the cause of maxillofacial fracture increased by 7.3% and use of a weapon by 5.7% between the years studied. Bicycle accidents increased by 19.3% but motor vehicle accidents decreased by 31.6% between the years. Falls, and bicycle and pedestrian accidents were the causes that accounted for most of the increase in maxillofacial fracture. In 1997, maxillofacial fractures were slightly more common from June to August and from Friday to Sunday than at other times (45.2 and 50%, respectively).     

Pediatric injuries in maxillofacial trauma: a 5 year study

Fractures of the facial skeleton in children are less frequent. This clinical retrospective study of 5 year was conducted on 95 patients aged less than 16 years who sustained maxillofacial injuries during the period 2003 to 2008. Age, sex, etiology incidence and type of fracture were studied. The ratio of boys to girls was 1.9:1. The 7–12 year age group was commonly involved and the highest incidence was at age of ten years. Falls were the most common cause of injury accounting for 41%, followed by road traffic accidents (30%). Sports related injuries, assault and child abuse were also the causes of injury in children. Dentoalveolar injuries were found to be highest incidence with 42.1% followed by mandibular fractures. The soft tissue injuries were associated the pediatric maxillofacial trauma were found to be 34.7% of all cases.     

Retrospective analysis of 471 surgically treated zygomaticomaxillary complex fractures

Purpose

Zygomaticomaxillary complex (ZMC) fractures are frequent in facial trauma; only fractures of the mandible are more common. Although the frequency of these fractures is geographically consistent, the aetiology differs widely among countries and even regions. Differences in socio-economic status and the ageing population seem to be two causes.This retrospective epidemiological study evaluates patients who were surgically treated for ZMC fractures at a Swiss university clinic.

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.     

颌面部多发性骨折特征的回顾性研究

目的 :探讨面部多发性骨折的特征。方法 :对武汉大学口腔医学院颌面外科近 10年收治的 2 0 4例面部多发性骨折病例进行分析。结果 :面部多发性骨折 3 2 .3 6%发生于 2 0 -2 9岁年龄段 ,男∶女 =3 .86:1,交通事故伤占 61.76%。 63 .45 %的患者有下颌骨骨折。面部多发性骨折的发病率有增加的趋势。结论 :面部多发性骨折有明显的年龄、性别、部位特征 ,交通事故是造成面部多发性骨折的重要因素     

Patterns of Maxillofacial Fractures in Goa

Background

The maxillofacial skeleton is commonly fractured due to its prominent position. The pattern of maxillofacial fractures varies from one country to another. The aim of this retrospective study was to analyze the patterns of maxillofacial injuries in the state of Goa and compare the results with similar studies in India and rest of the world.

Patients and Methods

The data were collected from the records of the patients who reported to the Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital between 2005 and 2010. The site of fracture, age of patient, etiology of trauma, daily and monthly variation of the fractures was analysed.

Results

Records of 2,731 patients sustaining maxillofacial injury were examined. The most commonly fractured facial bone was the mandible followed by zygomaticomaxillary complex. Most fractures occurred in the third and fourth decade of life with male and female ratio of 6:1. Main etiology was road traffic accidents.

Conclusion

Despite strict traffic legislation, road traffic accidents are the main cause of maxillofacial injuries.     

Epidemiologie und Behandlungsmanagement bei Schockraumpatienten mit Gesichtsschädelverletzungen

Objective

To minimize overall mortality and optimise reconstructive and cosmetic outcome in severely injured patients with maxillofacial injuries the interdisciplinary coordination of several surgical disciplines is required. It is still discussed controversy whether patients with maxillofacial fractures benefit from early fracture repair or if delayed operative management also yields in good results.

Methods

Herein we analysed the data of 1252 severely injured patients between May 1998 through June 2002 in our trauma department regarding fractures of the maxillofacial region, injury severity, length of ICU stay and postoperative complications in patients with either early (within 72?hours) or delayed (>?3?days) facial fracture repair.

Results

147 patients had severe facial fractures. Average age was 39.8 years (3–87 years), mean ICU was 25 (+/– 16) and the overall mortality 12% (n?=?18). The most common cause for the injuries were traffic accidents in 45%. 78 patients (53%) underwent surgical repair of the maxillofacial fractures; 18 patients had early fracture repair and 60 patients had delayed operative repair. We found 4 complications (22%) in the early repair group and 13 local complications (21%) in the group with delayed surgical repair.

Conclusion

Delayed repair of maxillofacial injuries in severely injured patients is feasible and yields in good results compared to early fracture repair.