Motorcycle related cranio-maxillofacial injuries at a tertiary hospital in the Philippines

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To describe the type and determine the number of motorcycle related cranio-maxillofacial injuries that were seen by the ORL service in the emergency room of a tertiary hospital from January 2013 to December 2013.<br /><strong>METHODS: </strong> <br /><strong>Design:</strong> Cross sectional retrospective chart review<br /><strong>Setting:</strong> Tertiary National University Hospital<br /><strong>Participants:</strong> One hundred nine (109) charts of patients seen atr the emergency room from Jnuary 2013 to December 2013 were reviewed<br /><strong>RESULTS:</strong> Of the 109 charts of patients involved in vehicular accidents, there were 76 documented cases of motorcycle related accidents. Of these, 91% involved males and 9% involved females. Seventy one percent (71%) did not wear helmets of whom 36% were young adult males between the ages of 18-30 years. Those that wore helmets had a total of 27 different facial fracture sites: 19% zygomatic tripod fractures, 15% temporal bone fractures and 11% with no fractures noted. Among those who did not wear helmets 75 fractures were noted. Twenty four percent (24%) were tripod fractures, 15% temporal bone fractures and 12% maxillary fractures. only one did not incur any fractures.<br /><strong>CONCLUSION:</strong> Most cranio-maxillofacial fractures seen at the emergency room were from motorcycle related injuries (70%). Despite implementation of Republic Act 10054 (The Motorcycle Helmet Act of 2009) majority of motorcycle-related accidents are still incurred by riders without helmets.</p>

Operative Results in Orbital Floor Fracture Associated with Malar Tripod Fracture

17 patients underwent operations in malar tripod fracture combined with orbital floor fracture from January 1995 to June 1998. Age distribution was from 16 to 62. Sexual distribution was 15 males and 2 females. 11 cases were due to slip or all down. All orbital floors were reconstructed with silastic sheet through subciliary incision. In case of type I and type II, one-point fixation was performed with miniplate and screws on zygomaticomaxillary suture, In type III and IV, two-point fixation was done with miniplate and screws on zygomaticomaxillary and zygomaticofroptal suture by Gillies' approach and lateral eyebrow incision. Among 9 patients with preoperative diplopia, 5 patients improved within 1 week, 2 patients within 1 month. Among 3 patients with severe preoperative diplopia, 2 patients remained with mild diplopia, but no interference with daily work was encountered. In postoperative apperance and X-ray findings, excellent results were noted in 4 cases(24%), good cases in 10 cases (59%), fair cases in 3 cases (18%), but no poor case was found. 5 cases with Preoperative mouth opening limitation improved during postoperative period. In patients with malar tripod fracture with orbital floor fracture, it can serve as a good surgical method that bony fragment reduction by Gillies' approach and fixation with miniplate and screws.