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.

Comportamiento de las fracturas máxilo-malares / Behavior of maxillo-malar fractures

Introducción: el hueso malar es uno de los huesos más afectados en los traumas faciales. Es fracturado con frecuencia, su tratamiento es común para el cirujano maxilofacial. Objetivo: determinar el comportamiento de las fracturas máxilo-malares según, edad y sexo, signos y síntomas, tipo de fractura, causa y modalidad terapéutica empleada. Métodos: se realizó un estudio descriptivo transversal prospectivo de los pacientes atendidos con fracturas máxilo-malares en el Servicio de Cirugía Maxilofacial del Hospital Universitario General Calixto García en el período comprendido entre noviembre de 2008 a mayo de 2011. Los resultados se mostraron en tablas de simple y doble entrada y como medida resumen se utilizó el porcentaje. Resultados: el comportamiento por grupos de edades mostró 18 pacientes de 31 a 40 años, 14 de 41 a 50 años, 12 de 18 a 30 años, 11 de 51 a 60 y 8 de más de 60 años; 44 pacientes (69,8 por ciento) eran masculinos. La agresión física fue causa de 41,3 por ciento de las fracturas, los accidentes de tránsito el 25,4 por ciento, las caídas el 19 por ciento y los accidentes deportivos el 14,3 por ciento. Presentaron dolor 100 por ciento de los pacientes y asimetría facial el 96,8 por ciento. Las fracturas grado III presentes en 50,8 por ciento, 31,8 por cientogrado II, 9,5 y 7,9 por ciento grado IV y I respectivamente. En 24 pacientes se empleó una técnica terapéutica combinada. En 16 pacientes se utilizó la cola de ceja y sólo en un paciente se optó por el abordaje coronal. Conclusiones: de los 63 pacientes los de mayor número fueron, los del sexo masculino y de edades entre 31 y 40 años; el tipo de fractura más frecuente fue la grado III y se identificaron como causas fundamentales las agresiones físicas seguidas de los accidentes de tránsito. Los signos y síntomas más observados fueron el dolor y la asimetría facial La modalidad terapéutica más empleada fue la combinada(AU)

Introduction: malar bone is one of the most affected bones in facial traumas. It is often fractured and its treatment is common for the maxillofacial surgeon. Objective: to determine the behavior of the maxillo-malar fractures according to age, sex, signs and symptoms, type of fracture, cause, and therapeutic modality used. Methods: a descriptive transversal prospective study was conducted in patients attended with maxillo-malar fractures in the Service of Maxillofacial Surgery of "Calixto García" University Hospital during the period November 2008-May 2011. The results were shown in simple and double-entry tables and percentage was used as summary measure. Results: the behavior by age groups showed 18 patients from 31 to 40 years, 14 from 14 to 50 years, 12 from 18 to 30 years, 11 from 51 to 60 years and 8 of 60 years or older; 44 patients (69.8 percent) were male. Physical aggression was the cause of the 41.3 percent of fractures, traffic accidents reported the 25.4 percent, falls the 19 percent and sports accidents reported the 14. 3 percent of the cases. 100 percent of the patients reported to have pain and the 96.8 percent presented facial asymmetry. Grade III fractures were present in the 50.8 percent, the 31.8 percent had Grade II fractures, and 9,5 and 7.9 percent had Grade IV and I fractures, respectively. A combined therapeutic technique was applied in 24 patients. Eyeball tail was used in 16 patients and only in one patient, the coronal approach was decided. Conclusions: of the 63 patients, the male and aged between 31 and 40 years showed the highest number; the most frequent type of fracture was the Grade III one, and physical aggressions followed by traffic accidents were identified as the main causes. The most observed signs and symptoms were pain and facial asymmetry. The most used therapeutic modality was the combined one(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.

Treatment and complications of orbito-zygomatic fractures / Tratamiento y complicaciones de las fracturas órbito-cigomáticas

The aim of the present study was to analyze the etiology, type and treatment employed in the orbito-zygomatic fractures (OZ). Also, postoperative complications are described and correlated with the type of treatment used. Fifty patients with OZ fractures were evaluated. Orbital fractures in which the zygomatic bone was not involved were excluded. Epidemiologic data and characteristics of treatment such as the type of material used for osteosynthesis, number of anatomical sites on which rigid internal fixation (RIF) was applied, surgical approaches and associated complications were recorded. The main causes of trauma were motorcycle and bicycle accidents, constituting 52 percent of the sample. The osteosynthesis system used was the 2.0 mm, except in four patients in whom the 1.5mm system was used for fixation at the infra-orbital rim. A total of 18 percent of the patients required reconstruction of the internal orbit and in all cases titanium mesh was used. 46 percent of the patients received RIF in three anatomical sites, most in the fronto-zygomatic suture, infra-orbital rim and zygomatic-maxillary buttress. The most frequent complication was paresthesia of the infra-orbital nerve (34 patients, 68 percent). Other findings were also discussed with the intent of better understanding the treatment of the OZ fractures...

El objetivo del presente estudio fue analizar la etiología, tipo y tratamiento empleado en las fracturas órbito-cigomáticas (OC). Además, se describen y correlacionan las complicaciones postoperatorias con el tipo de tratamiento utilizado. Cincuenta pacientes con fracturas OC fueron evaluados. Las fracturas orbitarias en la que el hueso cigomático no participó fueron excluidas. Los datos epidemiológicos y las características de tratamiento, tales como el tipo de material utilizado para la osteosíntesis, número de sitios anatómicos en los que se aplicó la fijación interna rígida (FIR), enfoques quirúrgicos y complicaciones asociadas fueron registrados. Las principales causas de los traumas fueron accidentes de bicicleta y motocicleta, constituyendo el 52 por ciento de la muestra. El sistema de osteosíntesis utilizado fue de 2,0 mm, excepto en cuatro pacientes en los que se utilizó el sistema de 1,5 mm para la fijación en el borde infraorbitario. El 18 por ciento de los pacientes requirieron reconstrucción de la órbita interna y en todos los casos se utilizó malla de titanio. El 46 por ciento de los pacientes recibió FIR en tres sitios anatómicos, la mayoría en la sutura fronto-cigomático, borde infraorbitario y pilar cigomato-maxilar. La complicación más frecuente fue parestesia del nervio infraorbitario (34 pacientes, 68 por ciento). Otros hallazgos fueron discutidos con la intención de comprender mejor el tratamiento de las fracturas OC...

Estudio descriptivo del sistema hospitalario en relación a pacientes sometidos a tratamiento quirúrgico por trauma facial en el Hospital Hernán Henríquez Aravena de Temuco, Chile / Descriptive study of hospital system in relation to patients undergoing surgical treatment of facial trauma in the Hernan Henriquez Aravena Hospital of Temuco, Chile

El trauma maxilofacial conforma una serie de lesiones que involucran tejidos óseos y blandos, provocando alteraciones funcionales y estéticas. El objetivo de este trabajo es determinar el perfil de pacientes que son sometidos a tratamiento quirúrgico por trauma maxilofacial en los pabellones del Hospital Regional de Temuco. De la base de datos del centro de estadísticas del Hospital Regional Hernán Henríquez Aravena, se obtuvieron un total de 145 sujetos con trauma maxilofacial entre los años 2008 y 2009. De la misma base de datos se obtuvieron los datos con los que se determinó la frecuencia según año, etnia, sexo, edad, sistema de previsión, mes, jornada, servicio, diagnóstico de fractura, manejo de tejidos blandos y tratamiento. En este estudio se encontraron 28 casos no diagnosticados (19,3 por ciento), 35 fracturas de cigomático (24,1 por ciento), 17 fracturas de piso de orbita (11,7 por ciento), 22 fracturas de otros huesos del cráneo (15,2 por ciento), 21 fracturas de mandíbula (14,5 por ciento), 11 fracturas múltiples faciales (7,6 por ciento), 3 fracturas de base de cráneo (2,1 por ciento) y 8 otros (5,5 por ciento). Como conclusión podemos decir que las fracturas de cigomático es la más prevalente. Respecto al tratamiento más realizado en el trauma es la reducción con osteosíntesis múltiple.

Maxillofacial trauma constitutes a series of injuries involving bone and soft tissues, causing functional and aesthetic alterations. The aim of this study is to determine the profile of patients subject surgical treatment for maxillofacial trauma in the halls of the Regional Hospital in Temuco. From the central database of statistics Hernan Henriquez Aravena Regional Hospital we obtained a total of 145 patients with maxillofacial trauma between 2008 and 2009. In the same database the data was obtained to determine the frequency by year, ethnicity, sex, age, form of payment, month, day, service, diagnosis of fracture, soft tissue management and treatment. In this study we found 28 cases diagnosed (19.3 percent), 35 fractures of zygomatic (24.1 percent), 17 orbital floor fractures (11.7 percent), 22 fractures of other bones of the skull (15, 2 percent), 21 fractures of the mandible (14.5 percent), 11 multiple facial fractures (7.6 percent), 3 fractures of the skull base (2.1 percent) and 8 others (5.5 percent). In conclusion we can say that zygomatic fractures is the most prevalent, and treatment performed most frequently is the reduction with multiple fixations.

Optimization of management for zygomatic complex fractures: a study at tertiary care teaching hospital in Pakistan

The aim of this study was to determine the incidence, cause and characteristics of the zygomaticomaxillary complex fractures, modalities of treatment used and analysis of post operative complaints at tertiary care teaching hospital in Multan Pakistan and compare the findings with similar studies. Study was conducted on 97 patients treated for zygomatic complex fractures during the period of January 2006 to June 2008 in the oral and maxillofacial surgery unit and trauma centre of a tertiary care, Nishter [teaching] hospital in Multan Pakistan.Out of 277 maxillofacial injuries received at this teaching hospital, 97 individuals were treated for zygomatic fractures. Patients according to treatment modalities were classified into two basic groups; Group-I: open reduction and rigid fixation with mini or micro plates, Group-II: open reduction and fixation with soft stainless steel wire sutures. Data, regarding age, sex, location, etiology of zygomatic complex fracture, modality of treatment used and post operative complaints of patients, were collected, tabulated, analyzed and compared with similar other studies. Total of 97 patients were treated for Zygomaticomaxillary fractures, male to female ratio was 13:1, majority [53.6%] of patients belonged to age group of 16-30 years, isolated zygomatic complex fractures were 35.1% followed by associated fractures with mandible [33%] and with maxilla [25.8%], majority of patients [74.2%] were treated in G-I and [25.8%] were treated in G-II. Uneventful recovery was there in 93 individuals [95.9%], four patients [4.2%] had post operative complications in the form of enophthalmos, limited opening of mouth, facial asymmetry and infection at surgery site. These complications were subsequently treated successfully as a secondary procedure for all the patients. This study has shown that road traffic accidents are responsible for most zygomatic complex fractures in our environment. Zygomatic fractures are commonly associated with other facial fractures mainly mandible, open precise reduction and reliable internal miniplate fixation optimized the esthetic and functional results in treating such fractures

Maxillofacial injuries in a group of Brazilian subjects under 18 years of age

OBJECTIVE: The purpose of this study was to perform a clinical retrospective analysis of the etiology, incidence and treatment of selected oral and maxillofacial injuries in Brazilian children and adolescents. MATERIAL AND METHODS: This study was conducted during a 14-year period between 1986 and 2000. All patients were admitted to Hospital XV in the city of Curitiba, State of Paraná. Age, gender, monthly distribution, etiology, soft injuries, associated injuries, site of fractures and methods of treatment were reviewed. RESULTS: Of the total of 350 patients of all ages treated for facial injuries, 29.42% were within the age range of the study (0 to 18 years). Mean age was 10.61. Of the patients, 63.1% were male. The most common cause of injury was accidental falls (37.87%), followed by bicycle and motorcycle accidents (21.36%). Of the 103 patients, 88.34% had single injuries. Mandibular fractures were the most common and the condylar region was particularly affected. CONCLUSIONS: Facial trauma is a relatively common occurrence in children. The study indicates that fractures in children and adolescents differ quite considerably from an adult population.

Fracturas faciales: análisis retrospectivo. Servicio de Cirugía de Cabeza y Cuello, División Maxilofacial del Hospital Córdoba / Facial fractures: a retrospective analysis. Head and Neck Surgery Service, Maxillofacial Division, Cordoba Hospital

Introducción: el propósito de este estudio es analizar las fracturas maxilofaciales recibidas, a lo largode un año, por el Servicio de Cabeza y Cuello División Maxilofacial del Hospital Córdoba. Materiales y métodos: Se revisaron las historias clínicas de 60 pacientes incluidos en este estudio.Se analizaron las causas del traumatismo, la edad, el sexo, la localización, el tratamiento y el tipode anestesia usado. Resultados: El 77 por ciento fueron hombres de 20 a 29 años de edad. Las localizaciones más frecuentes fueron las mandibulares (60 por ciento). Entre las causas más frecuentes, los accidentes de tránsito (50 por ciento) se ubican en primer lugar, luego le siguen en orden decreciente accidentes domésticos, riñas, accidentes laborales, deportes y, por último, accidentes con armas de fuego. En el 43,33 por ciento se realizaron tratamientos con placas de titanio; en el 30 por ciento, bloqueo intermaxilar; en el 16,67 por ciento no se realizó tratamiento y el 10 por ciento se trataron en forma ortopédica. El 59,1 por ciento de los pacientes tratados recibieron anestesia general; el 40,9 por ciento, local. Discusión: Estudios consultados poseen datos semejantes a los aquí publicados; las diferencias pueden encontrarse sobre las localizaciones más frecuentes de fracturas y las causas de éstas,que pueden relacionarse con la actividad que se desarrolla en cercanía al centro de trauma o su zona de ubicación.

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.

Causes of zygomatic bone fracture reported at mayo hospital, Lahore

To assess the causes, incidence and demographics of zygomatic bane fractures managed at Mayo Hospital Lahore, Pakistan. This study was carried out at the Department of Oral and Maxillofacial Surgery King Edward Medical University/Mayo Hospital, Lahore. A total of 105 cases were studied. A detailed history and clinical examination was performed, and diagnosis confirmed by radiographs. A number of parameters, including the patient's age, gender, occupation, and cause of injury were assessed. In 105 patients majority were male, [M: F=3.5:1] with a peak incidence occurring in age group 21 to 30 years. Road Traffic Accident [RTA] was recorded as the most common cause with 54 patients [51.4%], followed by assault 27 patients [25.7%], fall 19 patients [18.1%] and sports 5 patients [4.8%]. The incidence of fracture as result of fall, sports and road traffic accident was almost equal on both sides of face, but those fracture from assault occurred more often on the left side 77.8%.of the face than the right side 22.2%.The findings of this study will help to provide a clearer understanding of the demographic patterns of zygomatic injuries and will assist health care providers as they plan and manage the treatment of traumatic maxillofacial injuries. Such epidemiological information can also be used to guide the future funding of public health programs geared toward prevention

Fractura órbito-malar: su resolución quirúrgica / Orbito-zygomatic fracture: its surgical resolution

Un buen abordaje y esqueletización en casos de fracturas órbito-malares complejas aseguran una buena reconstrucción tridimensional y anatómica de la región a tratar. Se presenta el caso de un paciente masculino de 35 años, determinándose el grado real de desplazamiento por medios tomográficos y su resolución con abordajes combinados y osteosíntesis rígidas internas, siguiendo la metodología actual.

Fracturas orbitocigomáticas, valor de la clasificación de Knight y North en su terapéutica / Orbitozygomatic fractures and the value of Knight and North´s classification

Se realizó un estudio observacional descriptivo de 230 pacientes intervenidos quirúrgicamente por fracturas orbitocigomáticas en el Servicio de Cirugía Maxilofacial del Hospital Provincial Docente "Manuel Ascunce Domenech" de Camagüey, en el período de enero 1999 a diciembre 2003, con el propósito de describir el valor de la clasificación de Knight y North en la selección de variantes quirúrgicas terapéuticas de las fracturas orbitocigomáticas, a través de la experiencia del servicio. Se utilizó la clasificación de Knight y North para la selección de las variantes de tratamiento, determinándose las variables edad, sexo, clasificación, terapéutica quirúrgica, complicaciones y resultados posoperatorios. Se observó un predominio del sexo masculino con el 75,7 por ciento, y dicha cirugía se realizó con mayor frecuencia entre los 25-34 años (34,3 por ciento). La clase III de Knight y North fue la más frecuente (45,6 por ciento), seguida por la II y IV, con el 31,6 y 10,1 por ciento, respectivamente. Basados en esta clasificación y teniendo en cuenta el grado de inestabilidad posreducción esperado, se seleccionó adecuadamente la variante terapéutica a emplear en el 98,8 por ciento de los casos. Se llega a la conclusión de que la incidencia de fracturas orbitocigomáticas es alta, y dentro de ellas, la clase III de Knight y North es la más frecuente. Se recomienda esta clasificación para su tratamiento, ya que permite seleccionar la variante de tratamiento más adecuada de acuerdo con el grado de inestabilidad posreducción esperado, lográndose resultados estéticos y funcionales adecuados con escasas complicaciones posoperatorias no inherentes a esta(AU)

A descriptive observational study of 250 patients, who were operated on from orbitozygomatic fractures at the Maxillofacial Surgery Service of Manuel Ascunce Domenech provincial teaching hospital in Camaguey from January 1999 to December 2003, was conducted . The objective was to describe the importance of Knight and North´s classification for the selection of therapeutic surgical variants to be applied in orbitozygomatic fractures on the basis of the experience of this service. Knight and North´s classification was used to select treatment variants; besides, age, sex, therapeutic surgical classification, complications and postoperative results were determined as variables. It was observed that males predominated with 75,7 percent of total number and such surgery was mostly performed on 25-34 years-old group (34,3 percent); Knight & North´s class III was the most frequent (45,6 percent) followed by class II and class IV, with 31,3 and 10,1 percent respectively. On the basis sof this classification and taking into account the expected degree of postreduction instability, there was a right selection of the correspondieng therapeutic variant to be used in 98,8 percent of cases, that is, indirect reduction without fixation in 100 percent of cases in class II and V, and in 47,5 percent of class III fractures. Indirection reduction with temporary support was applied to 52,5 percent of the rest of class III cases; 58,3 percent of class VI fractures and 25 percent of class IV whereas direct reduction and osteosynthesis was performed in 75 percent of the rest of class IV cases. It was concluded that incidence of orbitozygomatic fracxtures was high, being Knight & North´s class III the most common. This classification is recommended to treat them since it allows choosing the most suitable therapeutic variant according to the expected degree of postreduction instability, thus achieving positive aesthetic and functional results, with few postoperative complications.(AU)

Epidemiologia das fraturas zigomáticas: uma análise de 10 anos / Zygomatic fractures epidemiology: a 10-year-analysis

Devido a sua localização e projeção no complexo maxilofacial, o osso zigomático apresenta elevado índice de fratura comparando-o às demais fraturas dos ossos da face. Estudos epidemiológicos sempre são de grande importância para o cirurgião BucoMaxiloFacial, pois fornecem dados pelos quais se pode traçar o perfil das fraturas faciais e analisar a efetividade dos métodos de tratamento empregados. No presente trabalho foi realizado um levantamento epidemiológico retrospectivo de 10 anos dos pacientes atendidos no Hospital Infantil Maria Lucinda que apresentavam fratura do complexo zigomático. A amostra foi composta por 153 pacientes portadores de fratura do complexo zigomático, onde foram analisados comparativamente os indicadores gênero, faixa etária, etiologia do trauma e localização topográfica da fratura. Os resultados obtidos mostraram o gênero masculino como o mais acometido (83,6%), a faixa etária de 21 a 40 anos (71,2%) mais freqüente, tendo como causa principal a queda da própria altura (39,9%) e o osso zigomático esquerdo como a localização mais afetada (49,7%).

Prevalencia de fracturas faciales vinculadas con el deporte / Prevalence of facial fractures linked to sports practice

Se realizó una investigación descriptiva y transversal en 57 pacientes con fracturas faciales adquiridas durante la actividad deportiva, los cuales fueron atendidos en el Servicio de Cirugía Maxilofacial del Hospital Provincial Saturnino Lora de Santiago de Cuba, en el quinquenio 1992-1996. Este tipo de lesión representó el 6,2(por ciento) del total de tratadas en dicho período. En los atletas que jugaban con pelota y practicaban técnicas de combate hubo la mayor prevalencia de estas lesiones, fundamentalmente en los deportes de pelota, boxeo, baloncesto, karate y softbol. El impacto contra otro atleta fue el mecanismo de lesión más frecuente, sobre todo en los grupos de combate y juegos con pelota. Las fracturas de mandíbula dentoalveolares y cigomáticas resultaron ser los patrones de fracturas preponderantes. La conducta terapéutica en estos pacientes no difirió sustancialmente de la aplicada en aquellos con lesiones producidas por otras causas. La restricción de la actividad atlética osciló entre 9 y 15 semanas después del tratamiento inicial. En los atletas de alto rendimiento lesionados se impone establecer las estandarizaciones en su proceso rehabilitador para la toma de decisiones con respecto a su incorporación, tanto a la práctica como a la competencia, lo cual es fundamental en este sentido(AU)

A descriptive cross-sectional research study was made on 57 patients with facial fractures suffered during sporting activities. These patients had been seen by the Maxillofacial Surgery Service of "Saturnino Lara" provincial hospital in Santiago de Cuba from 1992 to 1996 and this type of lesions represented 6.2 percent of the fractures treated in this period of time. These lesions were more prevailing in athletes who mainly played ball sports, boxing, basketball, karate and softball. The collision with another sportsman was the most frequent injure mechanism fundamentally fight and ball sports. Dentoalveolar and zygomatic mandibular fractures were the predominant fracture patterns. Therapeutical procedures applied to these patients did not differ significantly from that followed in other types of lesions. Sports practicing interruption ranged from 9 to 15 weeks after the initial treatment. Regarding high performance athletes that get injured, it is necessary to set standards for their rehabilitation process to help in taking decisions as to their re-incorporation to sports practice and competition(AU)

Fraturas zigomático - obrigatórias / Fractures of the zigomatic - orbital region

O objetivo deste trabalho foi realizar um levantamento bibliográfico sobre a epidemiologia, principais meios de diagnóstico e de tratamento de fraturas zigomático - orbitárias, com o intuito de definir a postura adequada que o cirurgião bucomaxilo-facial deve apresentar diante deste tipo de traumatismo. A revisão realizada levou à conclusão que, diante de pacientes com este tipo de lesão, é de suma importância uma anamnese criteriosa, para o correto estabelecimento dos exames complementares a serem solicitados, a fim de permitir o plano de tratamento adequado

Incidência e etiologia das fraturas faciais na regiäo de Araraquara / Incidence and aetiology of facial fractures in the contry of Araraquara

O propósito deste trabalho é analisar as incidências e etiologias das fraturas faciais na regiäo de Araraquara. Entre janeiro de 1994 e dezembro de 1996 foram avaliados 990 pacientes, sendo que 509 apresentavam fraturas faciais. A mandíbula é o osso mais comumente lesado (35,04 por cento), seguida pelo nariz (22,13 por cento), zigoma (19,89 por cento), maxila (7,24 por cento), fraturas alvéolo-dentárias (5 por cento), arco zigomático (4,34 por cento), fraturas naso-órbito-etimoidais (3,42 por cento), e frontal (2,89 por cento). A maior fonte etiológica säo os acidentes automobilísticos/automotores (65,22 por cento), seguidos pelas agreçöes físicas (21,80 por cento), esportes/quedas (11 por cento), acidentes de trabalho (0,98 por cento)

Diagnóstico e tratamento das fraturas do complexo zigomático / Diagnostic and treatment of te fractures of the zygomatic complex

O autor, atraves de revisao da literatura e analise da incidencia e prevalencia das fraturas do complexo zigomatico, faz o estudo das fraturas do complexo zigomatico, dando enfase a incidencia e aos metodos de tratamento. Conclui que as lesoes osseas da face vem aumentando no decorrer dos anos e que o metodo de tratamento deve ser, sempre que possivel, realizado de maneira conservadora, com o intuito de devolver a estetica e a funcao do complexo maxilo-facial ao paciente traumatizado