A study of pattern of maxillofacial fractures and its complications

Background: Incidence of maxillofacial fractures is quite high worldwide. A very important aesthetic function is served by maxillofacial skeleton moreover the prominent position of maxillofacial skeleton makes it more susceptible to fracture.Methods: A prospective study was done to assess the main etiology and pattern of maxillofacial fractures of 60 patients who came to the emergency department of Sri Guru Ram Das Institute of Medical sciences and Research between January 2018 and June 2019.Results: Total number of patients taken for this study were 60. The number of male patients were 56 (93.33%) and number of female patients were 4 (6.66%) and male to female ratio was (14:1). The age range spanned from 11 years to 70 years with (mean age=37.30 years, SD=14.27). Primary etiologic factor for maxillofacial fractures was road traffic accidents (49, 81.66%), followed by fall (8, 13.33%), and assault accounted for (3, 5%). Total 229 fractures were present in 60 patients. Concerning the anatomical site of fractures, it was explored that most common site of fractures is orbit (59, 25.72%) followed by fractures of maxilla (55, 24%) and zygomatic complex (35, 15.28%). Infection was most common complication and was present in 2 (3.33%) of the patients during hospital stay. 21 (35%) of the patients had associated head injury and maximum patients 49 (81.66%) were treated by open reduction and internal fixation.Conclusions: It is concluded, that main etiology of maxillofacial trauma is road side accidents. Therefore, strict compliance of traffic rules can avoid such injuries.

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.

Fractures of the Nasolacrimal Fossa and Canal: CT Findings and Clinical significance

PURPOSE: This study aimed to determine the CT findings of nasolacrimal fossa and their clinical significance. MATERIALS AND METHODS: Twenty-nine of 116 patients who underwent facial CT scanning after trauma showed evidenceof nasolacrimal fracture. We retrospectively analyzed CT findings to evaluate fracture patterns of thenasolacrimal fossa and canal and associated facial fractures. To determine the frequency of associatedcomplications, clinical records were reviewed were reviewed. RESULTS: Three types of fracture were identified:avulsion, comminuted, and linear Forty-one nasolacrimal fractures, 20 of which involved the nasolacrimal fossa and21 the nasolacrimal canal, were found in the 29 patients. Of the 20 fractures involving the nasolacrimal fossa,ten were avulsion, eight were linear, and two were comminuted. Seventeen of 21 fractures involving thenasolacrimal canal were comminuted and four were linear ; all nasolacrimal fractures were associated with otherfacial fractures. Twenty-five of 29 fractures were the complex midfacial-type (naso-ethmoid) ; the remaining fourwere simple and unilateral. Nasolacrimal sac and dvct-related complications were documented in only two patients ;they experienced epiphora associated with avulsion fracture of the nasolacrimal fossa, though the problem wasresolved by conservative treatment without surgery. CONCLUSION: Fractures of the nasolacrimal fossa and canalwere accompanied by simple or complex facial fractures. Injury-associated complications were rare, and all wereassociated with avulsion fractures of the nasolacrimal fossa.

Diagnostic Accuracy and Usefulness of Three Dimensional Image of Helical CT in Maxillofacial Fractures

PURPOSE: The purpose of this study is to compare the diagnostic accuracy and usefelness of three dimensional CT, plain radiography and two-dimensional axial CT in cases of maxillofacial fracture. MATERIALS AND METHODS: Plain radiography, two dimensional axial CT, and three dimensional helical CT images of eighty-two maxillofacial fractures in 45 patients were retrospectively analyzed according to detectability of fracture and displacement. The diagnostic accuracy of each modality was analysed using the Ridit method. RESULTS: Two- and three-dimensional CT were superior to plain radiography in evaluating fracture and displacement (p=0.001, 0.039), though the type of CT used did not cause significantly variation in the accuracy with which fracture and diferrent were diagnosed. CONCLUSION: Three dimensional helical CT is useful not only in the detection of fracture but in the evaluation of displaced maxillofacial fractures, especially if these are multiple and the complex.