Functional recovery time after facial fractures: characteristics and associated factors in a sample of patients from southern Brazil / Tempo de recuperação funcional após fraturas faciais: perfil e fatores associados em amostra de pacientes do sul do Brasil

ABSTRACT Understanding the cause, severity, and elapsed time for the restoration of the functions of maxillofacial injuries can contribute to the establishment of clinical priorities aiming at effective treatment and further prevention of facial trauma. The objective of this study was to understand the factors associated with the restoration of mastication, ocular, and nasal functions in the face of trauma victims, estimating their recovery time after surgical treatment. We analyzed 114 medical records of patients treated at the Hospital Montenegro, who attended follow-up consultations for up to 180 days. For analysis of the recovery time, we performed survival analysis, followed by COX analysis. We observed that half of the patients recovered their functions within 20 days. The average time for recovery from trauma in the zygomatic-orbital-malar-nasal complex was 11 days, and in the maxillary-mandibular complex, 21 days (HR: 1.5 [0.99 2.3], p = 0.055). Although functional reestablishment has reached high rates after the surgical approach, it is necessary to analyze the failing cases, as well as the economic impacts and the prevention strategies associated with facial trauma, to improve the service to the population.

RESUMO O entendimento da causa, da gravidade e do tempo decorrido para o restabelecimento das funções de lesões maxilofaciais pode contribuir para o estabelecimento de prioridades clínicas objetivando o efetivo tratamento e prevenção dos traumatismos de face. Assim, o objetivo deste estudo foi compreender quais os fatores associados ao restabelecimento das funções mastigatórias, oculares e nasais em vítimas de trauma de face, estimando o tempo para recuperação das funções, após o tratamento cirúrgico. Foram analisados 114 prontuários de pacientes atendidos no Hospital de Montenegro que compareceram às consultas de acompanhamento por até 180 dias. Para a análise do tempo para a recuperação, foi realizada a análise de sobrevida, seguida da análise de COX. Observou-se que metade dos pacientes recuperaram as funções em até 20 dias, sendo que o tempo médio para recuperação dos traumas no complexo zigomático-orbitário-malar-nasal foi de 11 dias e do complexo maxilo - mandibular de 21 dias (HR: 1,5 (0,99 - 2,3) p=0,055). Embora o restabelecimento das funções tenha atingido taxas elevadas após abordagem cirúrgicas, faz-se necessária a análise dos casos de insucessos bem como os impactos econômicos e as estratégias de prevenção associados aos traumas de face a fim de qualificar o serviço prestado à população.

Fractura mandibular / Mandibular fracture

Introducción: las fracturas mandibulares son frecuentemente atendidas en cirugía bucal y maxilofacial. Objetivo: realizar una revisión bibliográfica sobre consideraciones anatómicas, diagnóstico, clasificación, tratamiento y complicaciones de las fracturas mandibulares. Métodos: se realizó una revisión bibliográfica de julio a agosto de 2016. Se evaluaron revistas de impacto de Web of Sciencies (35 revistas) y 3 libros. Se consultaron las bases de datos de MEDLINE, PubMed y ScieELO con los descriptores: mandibular fracture, treatment, epidemiology. Se incluyeron artículos en idioma inglés, preferentemente de los últimos 5 años. Se obtuvieron 120 artículos. El estudio se circunscribió a 51. Análisis e integración de la información: las consideraciones anatómicas de la región mandibular son un punto de partida en este tema. El diagnóstico se basa en el interrogatorio, examen físico y medios auxiliares de diagnóstico. La clasificación precisa permite escoger la modalidad terapéutica a emplear y evitar complicaciones. Conclusiones: la revisión de la bibliografía permite precisar que hay razones anatómicas para la alta incidencia de las fracturas de ángulo mandibular. El primer objetivo del interrogatorio es obtener una historia exacta del paciente. El examen físico regional debe realizarse de forma ordenada y precisa. La radiografía panorámica es una buena opción en el diagnóstico. El primer paso en el desarrollo de un plan de tratamiento es establecer qué tipo de lesión se ha sufrido para proporcionar una solución adecuada usando técnicas abiertas y cerradas, y evitar complicaciones posteriores(AU)

Introduction: mandibular fractures are often treated by oral and maxillofacial surgery. Objective: conduct a bibliographic review about the anatomical considerations, diagnosis, classification, treatment and complications of mandibular fractures. Methods: a bibliographic review was conducted from July to August 2016. The evaluation included high impact journals from the Web of Sciences (35 journals) and 3 books. The databases MEDLINE, PubMed and SciELO were consulted, using the descriptors mandibular fracture, treatment, epidemiology. Papers written in English were included, preferably if published in the last five years. Of the 120 papers obtained, the study considered 51. Data analysis and integration: anatomical considerations about the mandibular region are a starting point in this topic. Diagnosis is based on interrogation, physical examination and auxiliary diagnostic means. An accurate classification makes it possible to choose the therapy to be used and prevent complications. Conclusions: the bibliographic review permitted to confirm that there exist anatomical reasons for the high incidence of mandibular angle fractures. The first goal of interrogation is to obtain an exact patient history. The regional physical examination should be performed in an orderly, accurate manner. Panoramic radiography is a good choice of diagnostic technique. The first step in developing a treatment plan is to determine the type of lesion so as to provide an appropriate solution based on open and closed techniques, thus avoiding later complications(AU)

Revisão de 150 casos de fratura de mandíbula entre os anos de 2010 e 2013 no Hospital Universitário Cajuru - Curitiba, PR / Review of 150 cases of mandible fracture between 2010 and 2013 at the Cajuru University Hospital, Curitiba, PR

Introdução: As fraturas mandibulares correspondem ao segundo tipo de lesões faciais mais frequentes na maioria dos estudos. Contudo, os dados epidemiológicos desta fratura podem variar conforme o país, o mecanismo de trauma e a época em que foram avaliadas, uma vez que são influenciadas por fatores culturais, tecnológicos, ambientais e socioeconômicos. Consistem em importante fator de custo e morbidade. Delinear o perfil epidemiológico dos casos de fratura de mandíbula tratados no Hospital Universitário Cajuru no período entre 2010 e 2013. Método: Foi realizado um estudo retrospectivo, observacional e descritivo de 236 pacientes internados no Hospital Universitário Cajuru, no período de janeiro de 2010 a julho de 2013, diagnosticados com fratura de mandíbula. Foram incluídos no trabalho apenas os pacientes que apresentavam os prontuários contendo informações completas, totalizando 150 pacientes. Resultados: Dos 150 prontuários analisados, encontrou-se prevalência das fraturas de mandíbula no sexo masculino, média de idade de 29,9 anos. Em relação ao mecanismo de trauma, as mais comuns foram a agressão interpessoal (36,7%), acidentes automobilísticos (36,7%), ferida por arma de fogo (16%). Com relação ao tratamento, o uso de placa e parafuso foi a forma mais realizada (111 pacientes). Conclusões: As fraturas de mandíbula são causadas principalmente por agressão interpessoal, são mais incidentes em homens e jovens. As fraturas múltiplas estão presentes em quase metade dos pacientes. Nas fraturas únicas, a região do côndilo e parassínfise foram, ambas, as mais acometidas. O tratamento cruento foi o mais empregado, sendo a reconstrução com placa de titânio a forma mais comum.

Introduction: Mandible fractures are the second most frequent type of facial injury according to most studies. However, the epidemiological data on mandible fractures may vary between countries, or according to the trauma mechanism and the period of injury evaluation, owing to the influence of cultural, technological, environmental, and socioeconomic factors. This type of trauma comprises an important cost and morbidity factor. The aim of this study was to outline the epidemiological profile of mandible fractures treated at the Cajuru University Hospital from 2010 to 2013. Methods: A retrospective, descriptive, observational study was performed with 236 patients hospitalized in the Cajuru University Hospital, from January 2010 to July 2013, in whom mandible fracture was diagnosed. Only patients with complete records were included in the study, resulting in a total of 150 patients. Results: From the 150 records analyzed, it was found that mandible fractures were more prevalent in males, and the average age of patients was 29.9 years. Concerning the trauma-causing mechanisms, the most common were interpersonal violence (36.7%), traffic accidents (36.7%), and wounds caused by firearms (16%). Plate and screw fixation was the most frequently used treatment (111 patients). Conclusions: Mandible fractures were mainly caused by interpersonal violence, and were more frequent in young males. Multiple fractures were present in almost half of the patients. In single fractures, the condyle and parasymphysis regions were the most affected. Open treatment was most commonly performed, with reconstruction with a titanium plate being the most common approach.

Análisis de las fracturas mandibulares causadas por accidentes laborales: estudio descriptivo retrospectivo / Analysis of mandibular fractures caused by work related accidents: retrospective descriptive study

El objetivo de este estudio fue evaluar la tendencia de los pacientes con fracturas mandibulares asociados a accidentes laborales. Se realizó un estudio descriptivo retrospectivo en todos los casos de fracturas mandibulares que asistieron al servicio de cirugía maxilofacial del Hospital Clínico Mutual de Seguridad C.Ch.C., Santiago de Chile en un periodo de 4 años (enero 2009 - diciembre 2012). Todas las fracturas mandibulares fueron consignadas. La información fue recopilada a través de revisión de fichas clínicas electrónicas. Entre los años 2009 al 2012 se presentaron un total de 74 pacientes incluidos en el estudio con 102 rasgos de fracturas mandibulares. La fractura más común fue la de cóndilo mandibular (35 pacientes). Se observó una tasa de complicaciones del 8%. Los resultados mostrados en este estudio están en línea con la literatura y el análisis de este reporte provee información para el diseño de planes de prevención de riesgos, especialmente para desarrollar medidas de protección facial. Nivel de Evidencia: Tipo II. Estudio descriptivo.

The objective of this study was to evaluate the tendency of patients with mandibular fractures associated with working accidents. A retrospective descriptive study was performed in all cases of mandibular fractures who attended the maxillofacial surgery service at the Clinical Hospital Mutual Seguridad C.CH.C. Santiago de Chile, in a 4-year period (January 2009 - December 2012). All mandibular fractures were recorded. The information was collected through review of electronic medical records. Between 2009 and 2012, 74 patients were included in the study with 102 lines of mandibular fractures. The most common fracture was the mandibular condyle (35 patients). The complication rate was 8%. The results shown in this study are in line with the literature and the analysis of this report provides information for the design of risk prevention plans, especially in developing measures of facial protection.

Analysis of maxillofacial injuries spread over one year period in Karachi sample

This descriptive case series study assessed the spectrum of maxillofacial injuries seen at the Emergency Department of Abbasi Shaheed Hospital, Karachi, Pakistan from March 2009 to February 2010. A total of 1295 patients with maxillofacial injuries were included in the study, of whom 875 [67.6%] were male and 420 [32.4%] female. Injuries were most common 340 [26.25%] in first decade. The most common cause was road traffic collision [611] patients and fall was second most common cause [415] patients. The mandible was the most common bone fractured [309] patients, followed by dentoalveolar [142] patients. There were 73 patients with fractured maxilla. Isolated soft tissue injuries occurred in 578 patients most commonly occurring in the lower third of the face. Most of the maxillofacial injuries were received between 1500 and 2100 hrs, [665] and Saturdays were the busiest days with [242] patients. The collection of data over the one from emergency department regarding the maxillofacial fractures including soft tissues injuries helps us how to manage on early basis and also may guide us regarding the time and day of the week which is busiest time of the emergency department

Maxillofacial fractures in Hyderabad city: a 1-year study of 448 patients

This descriptive study assesses the cause, type, incidence and treatment modalities of maxillofacial fractures managed at our center during the 1-year of time period. Descriptive Study. This study was carried out at Department of Oral and Maxillofacial surgery Institute of Dentistry LUMHS, Jamshoro. A total 384 cases were studied. A detailed history, clinical examination was performed and finally diagnosis confirmed with the help of radiograph, at least two radiographs were taken. Records of patients enrolled who were either treated in the Emergency Room, Out-Patients Department or in the Ward. A numbers of parameters, including Age, gender, cause, type of injury and treatment provided were assessed. Out of 448 patients, 318 were male and 130 were female. Majority of patients belong to 3[rd] decade [21-30 years] of life. Road traffic accidents 56.91% accounted for the majority of cases of maxillofacial fractures followed by assault 10.49%, fall 19.86%, sports 4.68% Mandible was seen as the most commonly fractured bone 44% [287] followed by maxillary bone 23.92% [156], Zygomatic bone complex 18.40% [120] and majority of the bony maxillofacial injuries were treated by open reduction and internal fixation [ORIF]. Males of age group 21-30 years were more frequently involved in maxillofacial fractures. Road traffic accident was the most common cause of trauma in this part of the country, which requires proper implementation of traffic legislation use of helmet while riding the cycle or motor bike. Mandible was fractured in majority of cases; common treatment modality of maxillofacial fractures at our center was Maxillo-mandibular fixation with miniplates

Comportamiento de las fracturas maxilofaciales atendidas en el Hospital Universitario de Maabar, República de Yemen / Behavior of the maxillofacial fractures in the Maabar's University Hospital, Yemen Republic

Introducción: las fracturas maxilofaciales constituyen más del 50 porciento del total de fracturas, y en muchas ocasiones están asociadas a otras fracturas del cuerpo humano. Objetivos: estudiar el comportamiento de estas lesiones en el Hospital Universitario de Maabar, de la Universidad de Thamar (Yemen), determinar su relación con la edad, sexo, etiología y localización, y compararlo con los resultados de otros estudios realizados en Cuba y en otros países. Métodos: se realizó un estudio estadístico descriptivo retrospectivo de las fracturas maxilofaciales atendidas por la brigada de profesores cubanos en este hospital entre los años 2006 y 2009. Las variables estudiadas fueron: sexo, edad, causa de la fractura y región afectada, así como el tipo de fractura y los traumatismos asociados. Resultados: el sexo masculino fue mucho más afectado que el femenino. Los accidentes del tránsito fueron la causa más común (más del 50 por ciento de los casos). La fractura nasal fue la más frecuente, y en más de 150 casos se detectaron traumatismos asociados, muchos muy graves, como fracturas de cráneo, de miembros y heridas de partes blandas. Conclusiones: se confirman los resultados que el sexo masculino es el más afectado, y que los accidentes del tránsito son la principal causa de fracturas en la cara. La fractura nasal es la más frecuente de todas las de los huesos faciales (más del 50 por ciento de los casos), pero otros registran la mandíbula o la región zigomática como la zona más frecuente. Impresionaron las fracturas mandibulares en niños, lo cual no es frecuente en Cuba(AU)

Introduction: the maxillofacial fractures account for more than the 50 percent of the total of fractures and often are associated with other fractures of the human body. Objectives: to study the behavior of these lesions in patients from the Maabar's University Hospital of the Thamar's University (Yemen), to determine its relation to age, sex, etiology and location and to compare it with the results of other studies conducted in Cuba and other countries. Methods: a retrospective, descriptive and statistic study was conducted on the maxillofacial fractures seen by the Cuban professor brigade in this hospital between 2006 and 2009. The study variables were: sex, age, cause of the fracture and involved region, as well as the type of fracture and associated traumata. Results: the male sex was more involved that the female one. The road accidents were the commonest cause (more than the 50 percent of cases). The nose fracture was the more frequent and in more than of 150 cases there were associated traumata much of them very severe including skull fracture, of extremities and soft tissue wounds. Conclusions: the results confirm that the male sex is the more involved one and that the road accidents are the leading cause of face fractures. The nose fracture is the more frequent of all that of facial bones (more than 50 percent of cases), but others register the mandible or the zygomatic region as the more frequent involved zone. The mandibular fractures were impressive in children, something not frequent in Cuba(AU)

Retrospective study of prevalence of face fractures in southern Brazil.

Context: Trauma has been an important public health problem worldwide. Facial injuries are among the most common types of trauma treated at emergency departments, associated or not with injuries in other anatomic sites. The patterns of facial fractures are usually affected by geography and socioeconomic conditions. Aim: To investigate the prevalence of facial fractures in Lages, state of Santa Catarina, southern Brazil, from September 2003 to August 2008. Settings and Design: Cross-sectional, retrospective, epidemiological study. Materials and Methods: Data on patients' gender, age, etiological agent, and facial region affected by fracture were collected from the charts of patients treated with facial fractures. Statistical Analysis Used: Qualitative variables were expressed as absolute and relative frequencies, and quantitative variables as means and standard deviation. The Chi-square test was used to evaluate the association between gender, traffic accidents and facial region affected. The association between etiological agents and facial region affected was assessed using the chi-square test and the adjusted residuals analysis. Results: 492 patients presented with oral and maxillofacial trauma, with 988 facial fractures; 80.9% of the patients were men, and the most frequent age group was 21-30 years (29.5%). The most frequent causes of fractures were: Traffic accidents in 27.9%, physical assault in 14.9%, and bicycle falls in 10.5%; several other causes scored below 10%. Conclusion: Regular publication of epidemiological data is extremely important for the implementation of prevention campaigns and for an increased awareness of the etiology of fractures affecting the face and other anatomic sites.

Fractura de cóndilo mandibular: alternativas de tratamiento / Mandibular condyle fractures: treatment alternatives

Las fracturas mandibulares se presentan de manera frecuente en pacientes con trauma facial. Pueden ser la única manifestación traumática de o bien combinarse con otros trazos fracturarios del macizo facial. Las fracturas de cóndilo mandibular constituyen entre el 25 y el 35 por ciento de las lesiones del maxilar inferior y son provocadas en la gran mayoría de los casos por un mecanismos traumático indirecto. Los abordajes terapéuticos pordrían resumirse en dos grupos, los denominados tratamientos conservadores cerrados y los tratamientos abiertos, quirúrgicos, con fijación interna estable en alguna de sus formas. El objetivo de este trabajo es exponer las distintas alternativas de tratamiento y evaluar la eficacia de los mismos a corto y mediano plazo. Se realiza, además, una extensa revisión bibliográfica, comparando la evidencia encontrada con la experiencia acumulada en nuestro servicio.

Mandibular fractures: a comparative analysis between young and adult patients in the southeast region of Turkey

OBJECTIVE: The purpose of this study was to review and compare the differences between mandibular fractures in young and adult patients. MATERIAL AND METHODS: Patients treated at the Oral and Maxillofacial Department of Dicle University during a five-year period between 2000 and 2005 were retrospectively evaluated with respect to age groups, gender, etiology, localization and type of fractures, treatment methods and complications. RESULTS: 532 patients were included in the study, 370 (70 percent) males and 162 (30 percent) females, with a total of 744 mandibular fractures. The mean age of young patients was 10, with a male-female ratio of 2:1. The mean age of adult patients was 28, with a male-female ratio of 3:1. The most common causes of injury were falls (65 percent) in young patients and traffic accidents (38 percent) in adults. The most common fracture sites were the symphysis (35 percent) and condyle (36 percent) in young patients, and the symphysis in adults (36 percent). Mandibular fractures were generally treated by arch bar and maxillomandibular fixation in both young (67 percent) and adult (39 percent) patients, and 43 percent of the adult patients were treated by open reduction and internal fixation. CONCLUSION: There was a similar gender, monthly and type of treatment distribution in both young and adult patients in the southeast region of Turkey. However, there were differences regarding age, etiology and fracture site. These findings between young and adult patients are broadly similar to those from other studies. Analysis of small differences may be an important factor in assessing educational and socioeconomic environments.

Estudo epidemiológico das fraturas mandibulares em hospital público da cidade de São Paulo / Epidemiologic study of mandible fractures in a public hospital of São Paulo

OBJETIVO: Analisar a frequência epidemiológica de fraturas mandibulares correlacionando gênero, faixa etária, fatores etiológicos, localização anatômica, e tipos de traços de fratura. MÉTODOS: Estudo retrospectivo nos prontuários de 883 pacientes portadores de fraturas faciais, atendidos no Pronto Socorro do Hospital Geral de Vila Penteado, pelo Serviço de Cirurgia e Traumatologia Buco Maxilo Facial (São Paulo - Brasil), num período de três anos (janeiro de 2004 a dezembro de 2006). RESULTADOS: Dos 883 pacientes avaliados, 270 apresentaram fraturas mandibulares (30,5 por cento). O gênero masculino foi o mais acometido (76,7 por cento) na faixa etária de 20 a 29 anos (33,0 por cento), o fator etiológico de maior freqüência foi acidente com veículos automotores (35,2 por cento), o corpo da mandíbula foi a localização anatômica mais atingida (47,4 por cento) e os traços únicos prevaleceram (76,7 por cento). CONCLUSÃO: As fraturas, em sua maioria, foram simples (traço único), localizadas em corpo mandibular, e destacadas no sexo masculino, na faixa etária de 20 a 29 anos, além do que o fator etiológico mais comum foi acidente com veículos automotores.

OBJECTIVE: To analyze the frequency epidemiological description of mandibular fractures correlating gender, age, etiological factors, anatomic location, and types of fracture's traces. METHODS: A retrospective survey of the medical history of 883 patients with facial fractures, attended at the Buco-Maxilo-Facial Surgery and Traumatology Service of the Hospital Geral de Vila Penteado in São Paulo (São Paulo - Brazil), in a period of 3 years (from January 2004 to December 2006). RESULTS: From 883 patients evaluated, 270 presented mandibular fracture (30,5 percent). The male gender was the most affected (76,7 percent) in the age of 20 to 29 years (33,0 percent), the most frequent etiological factor was the car accident (35,2 percent), the body of the mandible was the most affected anatomic location (47,4 percent) and the single traces prevailed (76,7 percent). CONCLUSION: The majority of the fractures were simple, located in the body of the mandible, and higligted in males, aged from 20 t0 29 years, and caused by car accident.

Analysis of 185 maxillofacial fractures in the state of Santa Catarina, Brazil

A retrospective study was performed to assess maxillofacial fractures in patients treated at a public hospital from 2002 to 2006. The data collected included age, gender, etiology, type of injury, treatment modalities and period of treatment. Causes were grouped into seven categories: road traffic collisions, sports accidents, occupational accidents, gunshot fractures, falls, violence and other causes. The analyses involved descriptive statistics, the Chi-squared Test and the Fisher Exact Test. Records from 132 patients sustaining 185 maxillofacial fractures were evaluated. The mandible (54.6 percent) was the most commonly fractured bone in the facial skeleton, followed by the zygoma (27.6 percent). The mean age of the patients was 37.7 years, and the male:female ratio was 4.3:1. Most fractures occurred in adults with ages ranging from 18 to 39 years. A significant statistical relation was found between the age and the etiology of the trauma (p < 0.05), and between the number of fractured sites and the age of the patient (p < 0.05). Considering the age groups, accidents were the most frequent cause of maxillofacial fractures in the age group between 18 to 39 years, and interpersonal violence was the most frequent cause of maxillofacial fractures in the age group between 40 to 59 years. Treatment was performed on the same day as the diagnosis in 44.7 percent of the patients. Open surgery with internal stable fixation was indicated for most of the patients. Facial fractures occurred primarily among men under 30 years of age, and the most common sites of fractures in the face were the mandible and the zygomatic complex. Traffic road collisions were the main etiologic factor associated with maxillofacial trauma.

A five-year retrospective statistical analysis of maxillofacial injuries in patients admitted and treated at two hospitals of Mysore city.

OBJECTIVES: This study aims to provide a five-year retrospective statistical analysis of maxillofacial injuries in patients admitted and treated during 1 st January 1998 and 31 st December 2002 in two hospitals of Mysore city; to determine the age and sex distribution, etiology, type of injury, day and time of accident, and the influence of alcohol and other drugs; and to suggest measures to prevent such injuries. MATERIALS AND METHODS: After obtaining permission from the concerned authorities, a pre-designed questionnaire was used to collect the necessary data from the two hospitals. The data was then computerized and statistical analysis was done using statistical package for the social sciences (SPSS) windows version 10. RESULTS: Road traffic accident (RTA) was the common cause for maxillofacial injuries. Men sustained more injuries compared to women. The injuries were mostly sustained in the age group of 11-40 years, constituting about 78% of all the injuries. Two wheelers were the most commonly involved compared to other vehicle types. Influence of alcohol at the time of injury was found in about 58% of the patients with maxillofacial injuries. The most number of accidents occurred in the weekends. Mandibular fractures were the most common. CONCLUSION: RTAs are the most common cause for maxillofacial injuries. If RTAs are considered an epidemic of modern times, then prevention is its vaccine.

Fraturas de mandíbula: análise retrospectiva de 27 casos / Mandible Fractures: Retrospective analysis of 27 cases

As fraturas mandibulares compreendem a maior parte das injúrias tratadas pelos serviços de cirurgia bucomaxilofacial. O objetivo da presente pesquisa foi o relatar o perfil epidemiológico de pacientes portadores de fratura de mandíbula, diagnosticados e tratados no Serviço de Cirurgia e Traumatologia Buco-Maxilo-Facial do Hospital Universitário Oswaldo Cruz - HUOC/UPE, através de um estudo descritivo retrospectivo. De um total de 27 pacientes, no período de janeiro de 2004 a dezembro de 2006 (03 anos) foram analisadas as variáveis sexo, faixa etária, ocupação dos pacientes, etiologia do trauma, distribuição topográfica das fraturas, dia do trauma/dia da cirurgia e método de fixação de fraturas. Constatou-se que 22 casos (81.5%) eram do sexo masculino, as ocupações mais freqüentes foram: estudante, agricultor e vigilante (16 casos - 59.2%). Foram mais observados acidente automobilístico e agressão física (08 casos - 29.6% cada), de ocorrência maior na 2ª e 3ª décadas de vida. Corpo e ângulo (12 casos - 44.4%) foram as localizações de maior ocorrência. As fraturas mandibulares ainda são mais freqüentes nos indivíduos adultos jovens do sexo masculino, e geralmente ocorrem mais nas regiões de corpo e ângulo mandibular. Os perfis epidemiológicos são de fundamental importância para profundo conhecimento do problema, otimizando, assim, seu tratamento

Características e distribuição das fraturas mandibulares por causas externas: estudo retrospectivo / Characteristics and distribution of mandibular fractures due to external causes: a retrospective study

Objetivo: Analisar as características e a distribuição das fraturasmandibulares por causas externas no Hospital Regional de CampinaGrande/PB, no período de Janeiro de 2002 a Dezembro de 2006.Método: Por meio da observação indireta foram examinados 691prontuários médico-hospitalares do Serviço de CirurgiaBucomaxilofacial, dos quais 59 (8,5 por cento) referiam-se a vítimas defraturas mandibulares. Foram analisadas as variáveis: gênero, faixaetária, período da ocorrência (dia e horário), etiologia, presença defraturas associadas, tipo de tratamento e o tempo de internação.Resultados: Os resultados mostraram o gênero masculino o maisacometido (83,1 por cento), sendo a faixa etária de 21-30 anos a maisafetada (40,7 por cento). Os atendimentos ocorreram com maior freqüênciaaos sábados e domingos (40,6 por cento) e à noite (30,5 por cento). A queda(28,8 por cento), violência interpessoal (23,7 por cento) e o acidente de motocicleta(23,7 por cento) foram as principais etiologias. Cinco pacientes (8,5 por cento)apresentaram fraturas em outros ossos da face, com o uso de fiode aço com bloqueio intermaxilar se constituindo no tratamentomais freqüente (50,8 por cento). O tempo médio de internação foi de 5,28dias.Conclusão: A prevalência de fraturas mandibulares é maior nogênero masculino, durante a terceira década de vida; sendo aqueda o principal fator etiológico, com a maioria dos casosocorrendo no fim de semana.

Evaluación de las fracturas mandibulares: estudio de 8 años en el Servicio de Cirugía Buco Maxilofacial del Hospital Maciel / An assessment of mandibular fractures: an 8 year study at the Oral and Maxilofacial Surgery Department of Maciel Hospital

El objetivo de este trabajo fue describir retrospectivamente a los pacientes con fracturas mandibulares, atendidos por el Servicio de Cirugía Buco Maxilofacial del Hospital Maciel durante un período de 8 años.La fractura mandíbular se diagnóstico en 22.7 % de los pacientes con traumatismo maxilofacial. Se estudiaron las causas, la incidencia, la distribución demográfica y por región anatómica de 309 fracturas mandibulares de 184 pacientes. Las causas principales, accidentes de transporte (43.5 %) y agresiones (36.9 %) son prevenibles. Los hombres fueron más afectados que las mujeres y la región condilar fue el área más fracturada.

[Prevalence of condylar fractures in patients referred to oral and maxillofacial department at Dr. Shariati hospital, Tehran 1994-2004]

This is an epidemiological study of patterns of condylar fractures. The aim of this study was to assess the incidence and etiology of condylar fractures. In this retrospective study, data were obtained by means of special questionnaire regarding age, gender, anatomic site, pattern, causes of injury, treatment modalities and complications. During an 11 years period [1994-2004] 475 patients represented 134 condylar fractures [28.2%] admitted to Dr. Shariati Hospital of Tehran-Iran. Of the 134 patients, 105 [78%] were men and 29 [22%] were women [ratio 3.6:1]. Patients' age at the time of injury ranged from 2 to 75 years, with a mean age 24.7 years. The highest incidence was seen in the third decade of life [27.6%]. The predominant causative factors in this study was motor vehicle accident [42%] followed by falls and assaults. Most patients [88.8%] were treated by close reduction surgery. The seasonal distribution showed that summer accounted a highest percentage [31%] of all fractures. The condylar fractures included 28.2 percentages of all mandibular fractures in this study. The most common part of condylar fractures was subcondylar site [76.1%]. The most common causes were traffic accidents [42.2%]. The most common treatment method was close reduction [88.2%]. The most common fixation method was maxillomandibular fixation [MMF]. Fracture rate in men was more than women [78.4% Vs. 21.6%]. The most important associated complications with condylar fractures was ankylosis [2.98%]

Epidemiologie des fractures de la mandibule traitees au Centre Hospitalier Universitaire d'Antananarivo - Madagascar

Justification: Les fractures de la mandibule font partie des lesions traumatiques de la face. Les causes sont constituees par les violences interpersonnelles; les accidents de la route et les chutes. A Madagascar; nous ne disposons pas encore de donnees concernant les fractures de la mandibule. Alors; nous avons voulu mener a terme cette etude. Objectif: L'objectif de cette etude est de determiner l'epidemiologie des fractures de la mandibule a Antananarivo - Madagascar.Patients et methodes: Nous avons realise une etude retrospective des dossiers medicaux et des cliches radiographiques des malades porteurs de fractures de la mandibule traites au service de Chirurgie maxillo-faciale du Centre Hospitalier Universitaire (CHU) d'Antananarivo - Madagascar - durant 3 ans et demi. Resultats: Parmi 2363 consultants; 170 ont presente au moins une fracture de la mandibule (77;27) sur 220 cas de traumatisme maxillo-facial. Cent trente sept (80;58) cas sont de sexe masculin. Ces fractures surviennent a tout age avec une nette predominance des jeunes de 21 a 34 ans (59;41). Les causes des fractures et les circonstances de survenue sont dominees par les violences interpersonnelles avec 55;88(traumatisme direct par coup de poing ou par objet contondant); puis les accidents de la voie publique (victimes a l'interieur des vehicules ou sur les 2 roues). Le trait de fracture est unique dans 130 cas (76;47); double dans 37 cas (21;76) et le foyer et triple dans 3 cas. Les fractures de l'angle sont les plus rencontrees dont plus de 70sont a gauche. Conclusion : Cette etude montre la frequence elevee des fractures mandibulaires engendrees par les agressions et aussi leur survenue chez les hommes jeunes

Epidemiology of mandibular fractures treated in a Brazilian level I Trauma Public Hospital in the city of São Paulo, Brazil

This article reviews cases of mandibular fractures treated at the Service of Oral and Maxillofacial Surgery of the Hospital Complex of Mandaqui (SUS/SP), which is a reference hospital complex for trauma in the northern area of the city of São Paulo, Brazil. Ninety-eight patients with mandibular fractures were seen at the hospital between January and December, 2001. Out of this total, 91 cases whose files were deemed adequate in terms of data accuracy and completeness were reviewed. The following data were collected for the study: age, gender, etiology, anatomical fracture site, treatment modality, relation to other facial bone fractures, hospitalization time and posttrauma complications. Motorcycle accident was the major cause of mandibular fractures followed by physical aggression and height fall. The mandibular anatomical sites of higher fracture incidence were: body, symphysis and condyle. The most commonly performed treatment modes were conservative approach or open reduction and intraosseous fixation. In conclusion, motorcycle accidents were associated with a larger number of facial fractures and most predominantly affect 21-30 year-old males. On the average, motor vehicle accident victims had more (and more severe) fractures than physical aggression victims. Complications were mostly associated with angle fractures and hospitalization period. Polytraumatized patients presented greater morbidity for complications.

O artigo tem como objetivo revisar casos de fraturas de mandíbula atendidos no Serviço de Cirurgia Bucomaxilofacial do Conjunto Hospitalar do Mandaqui (SUS/SP), hospital de referência para trauma na região norte de cidade de São Paulo. De janeiro a dezembro de 2001, foram atendidos 98 pacientes com fraturas de mandíbula no hospital. Dentre estes, 91 casos que dispunham de dados suficientes em prontuários foram analisados. Para o estudo foram considerados: idade, gênero, etiologia, local anatômico da fratura, modalidade de tratamento, relação com fraturas de outros ossos faciais, tempo de hospitalização e complicações. Acidente motociclístico foi a principal causa de fraturas mandibulares, seguido de agressão e queda de altura. Os três locais anatômicos de maior incidência foram: corpo, sínfise e côndilo. O modo de tratamento consistiu de abordagem conservadora ou redução aberta e fixação interna. Conclui-se que acidentes motociclísticos estão associados a um maior número de fraturas mandibulares com predominância em homens de 21 a 30 anos. Vítimas de acidentes com veículos apresentaram, em média, mais fraturas do que vítimas de agressões. As complicações mostraram-se associadas ao maior período de hospitalização e fraturas de ângulo mandibular, e tiveram maior incidência em pacientes politraumatizados.