O trauma de face submetido a cirurgia: Uma análise epidemiológica de 10 anos no interior do Brasil / Facial trauma undergoing surgery: A 10-year epidemiological analysis in the interior of Brazil

Introdução: O trauma de face representa significativa incapacitação para a vítima, além de um desafio para as equipes de saúde devido a sua complexidade e envolvimento de estruturas nobres. Analisar a sua epidemiologia permite coordenar medidas em saúde pública para melhorar o atendimento e a prevenção. Método: Estudo observacional, descritivo, longitudinal, com abordagem retrospectiva a partir dos prontuários dos pacientes vítimas de trauma de face atendidos pela clínica cirúrgica no período entre 2010 e 2019. Resultados: Dentre os 529 prontuários incluídos no estudo e analisados, 71,08% tratava-se de cirurgias eletivas e o restante, 28,92%, de cirurgias de urgência. O trauma foi mais frequente em indivíduos de 20 a 29 anos, o que corresponde a 31,76% do total de casos. Também foi mais frequente em indivíduos do sexo masculino, correspondendo a 78,45% do total de casos. Acidentes automobilísticos foram a causa mais comum, descrita em 22,31% dos prontuários, e a principal fratura, presente em 85,83% dos casos, foi dos ossos próprios do nariz. Conclusão: As vítimas de traumatismo bucomaxilofacial atendidas no Hospital de Clínicas da Universidade Federal do Triângulo Mineiro são predominantemente homens na terceira década de vida, envolvidos em acidentes automobilísticos, com lesões em ossos do nariz que foram abordadas de forma eletiva.

Introduction: Facial trauma represents significant incapacitation for the victim, as well as a challenge for healthcare teams due to its complexity and involvement of important structures. Analyzing its epidemiology allows us to coordinate public health measures to improve care and prevention. Method: Observational, descriptive, longitudinal study with a retrospective approach based on the medical records of patients who suffered facial trauma treated by the surgical clinic between 2010 and 2019. Results: Among in individuals aged 20 to 29 years, which corresponds to 31.76% of total cases. It was also more common in males, corresponding to 78.45% of total cases. Car accidents were the most common cause, described in 22.31% of medical records, and the main fracture, present in 85.83% of cases, was of the bones of the nose. Conclusion: Victims of oral and maxillofacial trauma treated at the Hospital de Clínicas da Universidade Federal do Triângulo Mineiro are predominantly men in their third decade of life, involved in automobile accidents, with injuries to the bones of the nose that were treated electively.

The profile of patients with maxillofacial trauma due to interpersonal violence treated in a hospital emergency room.

AIM: This study evaluated records of patients with maxillofacial trauma due to interpersonal violence (IPV) being treated in the emergency room of a level I trauma center hospital in São Paulo, Brazil. MATERIAL AND METHODS: Data of patients with maxillofacial trauma due to IPV recorded between January 2019 and December 2019 were retrospectively examined. Personal data, days on which they experienced IPV, and the type of maxillofacial trauma sustained were extracted and statistically analyzed (p < .050). RESULTS: During the analysis, 1034 patients with maxillofacial trauma were identified; of these patients, 292 (28.2%) who experienced trauma due to IPV were included in this study. There was a mean age of 32.6 years and the most common type of trauma was soft tissue injuries (38.7%). Mandible and nose fractures were more prevalent in males and females, respectively. Our data, when compared with other studies on maxillofacial trauma due to IPV, showed a lower prevalence and male-to-female ratio, and a higher presence of dentoalveolar trauma. Additionally, our data when compared with studies on maxillofacial trauma due to other causes showed lower mean age and male-to-female ratios, and a higher occurrence of nose fractures differing from the predominance of mandibular fractures. CONCLUSION: Oral and maxillofacial surgeons must be able to suspect and identify cases due to IPV among their patients with trauma. With our results, although each case has its individuality, we can suggest that cases of maxillofacial trauma in young, female, and nasal fracture patients may be suspicious for IPV.

Clinical evaluation of the perception of post-trauma paresthesia in the mandible, using a biomimetic material: A preliminary study in humans.

There is a great effort from numerous research groups in the development of materials and therapeutic strategies for the functional recovery of patients who have suffered peripheral nerve injuries (PNI). In an article in vivo, the formation of a nerve bridge was observed, reconnecting the distal and proximal stumps, in the sciatic nerve of rats, indicating the effective participation of the biomaterial in the recovery of peripheral nerve injuries. For the current pilot study, 15 cases of multiple fractures of the mandible, with involvement of the inferior alveolar nerve (IAN) were selected and studied: JC (control cases) n = 6 with conventional treatment, and JT (treated cases) n = 9, with the use of biomimetic biomaterial. The evaluation of the return to sensitivity was measured through a self-assessment, where the patients assigned scores from 0 to 10, where zero (0) represented the complete absence of sensitivity and ten (10) the normality of the perception of local sensitivity. Patients were evaluated from the preoperative period to the 360th day. The statistical results obtained by the t-Student, Shapiro-Wilk normality and non-parametric One-Way ANOVA tests indicated statistically significant differences (p < 0.005; 0.005 e 0.5 respectively), between the two treatments, which were reflected in the clinical results observed, we also calculate the size of the effect represented by ϵ2, calculated by Cohen's d. The results indicate a great difference between the treatments performed,ϵ2 = 1.00. In the 6 cases followed up in the JC group, four remained with a significant deficit until the end of the evaluations and two indicated the remission of the lack of sensitivity in this period. In the JT group, in 28 days, all cases indicated complete remission of the lack of sensitivity with healing concentration. In one of the cases where there was a complete rupture of the mental nerve, the (score-10) was observed in 60 days. The observed results indicate the existence of a statistical significance between the groups and an important relationship when using the biomimetic biomaterial during the recovery of the perception of sensitivity in polytraumatized patients, compatible with the results observed in laboratory animals, which may indicate its clinical feasibility in the reduction of sequelae in PNI.

Fracturas maxilofaciales en pacientes atendidos en el Princess Marina Hospital, de Gaborone

RESUMEN Fundamento Las fracturas del complejo maxilofacial constituyen cerca de la mitad de todas las fracturas, y en un gran número de pacientes se asocian a otras fracturas y lesiones. La etiología es variada, y exigen diagnóstico y tratamiento rápidos, precisos y oportunos. Resulta relevante el estudio de esta entidad, para conocer sus características como parte de la atención de urgencias; así como sus implicaciones clínica y social. Objetivo describir el comportamiento de las fracturas maxilofaciales en pacientes atendidos en el servicio de Cirugía Maxilofacial del Princess Marina Hospital, de Gaborone, Botswana. Métodos se realizó un estudio descriptivo y retrospectivo, en el servicio de Cirugía Maxilofacial del Princess Marina Hospital, en Gaborone, Botswana, durante el período de junio de 2018 a junio de 2020. Fueron incluidos todos los pacientes (N=423) con diagnóstico de trauma maxilofacial, y por consiguiente, de algún tipo de fractura de esta parte del cuerpo. Para la presentación de la información se utilizaron tablas de frecuencias absolutas y relativas. Resultados se atendieron 423 pacientes con fracturas maxilofaciales, entre los cuales predominó el sexo masculino. El grupo de edades más afectado fue el de 26-35 años; la violencia interpersonal, la causa más frecuente; y las heridas y fracturas de cráneo, las lesiones asociadas más comunes. Conclusión Se observó similitud de los resultados respecto a otros estudios publicados. La violencia interpersonal superó a los accidentes del tránsito como la causa más frecuente de fracturas maxilofaciales.

ABSTRACT Background Fractures of the maxillofacial complex constitute about half of all fractures, and in a large number of patients they are associated with other fractures and injuries. The etiology is varied, and requires fast, accurate, and timely diagnosis and treatment. The study of this entity is relevant to know its characteristics as part of emergency care; as well as its clinical and social implications. Objective to describe the behavior of maxillofacial fractures in patients treated at the Maxillofacial Surgery service of Princess Marina Hospital, Gaborone, Botswana. Methods a descriptive and retrospective study was carried out in the Maxillofacial Surgery service of the Princess Marina Hospital, in Gaborone, Botswana, from June 2018 to June 2020. All patients (N = 423) with diagnosis were included of maxillofacial trauma, and consequently, of some type of fracture of this part of the body. Absolute and relative frequency tables were used to show the information. Results 423 patients with maxillofacial fractures were attended, among which the male sex predominated. The age group most affected was 26-35 years old; interpersonal violence, the most frequent cause; and skull injuries and fractures, the most common associated injuries. Conclusion Results were similar to other published studies. Interpersonal violence exceeded traffic accidents as the most common cause of maxillofacial fractures.

Multicenter epidemiological study of maxillofacial trauma: a one-year retrospective- descriptive assessment of 1356 cases in a colombian metropolitan region / Estudio epidemiológico multicéntrico de trauma maxilofacial: evaluación retrospectiva-descriptiva de un año, de 1356 casos en una región metropolitana de Colombia

Background: This retrospective study was conducted to identify the epidemiological profile and treatment modalities linked to the maxillofacial trauma (MFT) managed in the Maxillofacial Surgery Departments of seven hospital centers in Antioquia, Colombia. Material and Methods: Clinical records with specific attention to sociodemographic characteristics, mechanisms of injury, type of MFT, location of injuries, and treatment modalities of MFT were collected from January to December 2017. Descriptive analyses using Pearson's chi-square tests were performed. Results: A total of 1356 records were retrieved. Males were significantly more affected, with a male-to-female ratio of 3.85:1. The most susceptible age group involved was young adults (18 to 40 years). A low percentage of alcohol (9.3%) and drugs consumption (2.5%) was recorded. Most common causes of MFT were road traffic accidents (RTA), falls, and interpersonal violence (IPV). Most injuries involved both soft and hard tissues followed by hard tissues and isolated open soft tissue injuries. Among fractures, the middle third was the most commonly affected site and the utmost method of treatment was open reduction and internal fixation. Conclusion: Within the limitations of the evidence available, this study has demonstrated that the gender, age stratum, and etiological factors, such as RTA, falls, and IPV, but no alcohol and/or psychoactive substances consumption, may have a significant influence on the prevalence, patterns, and treatment modalities of MFT in this sample population.

Antecedentes: Este estudio retrospectivo se realizó para identificar el perfil epidemiológico y las modalidades de tratamiento vinculados al Trauma Maxilofacial (TMF) atendido en los Servicios de Cirugía Maxilofacial de siete centros hospitalarios de Antioquia, Colombia. Material y Métodos: Se recopilaron historias clínicas con atención específica a las características sociodemográficas, mecanismos de lesión, tipo de TMF, ubicación de las lesiones y modalidades de tratamiento de TMF de enero a diciembre de 2017. Análisis descriptivos utilizando el chi-cuadrado de Pearson fueron realizados. Resultados: Se recuperaron un total de 1356 registros. Los hombres se vieron significativamente más afectados, con una relación hombre-mujer de 3,85:1. El grupo de edad más susceptible involucrado fue el de los adultos jóvenes (18 a 40 años). Se registró un bajo porcentaje de consumo de alcohol (9,3%) y drogas (2,5%). Las causas más comunes de TMF fueron los accidentes de tránsito (ADT), las caídas y la violencia interpersonal (VIP). La mayoría de las lesiones involucraron tejidos blandos y duros, seguidas de tejidos duros y lesiones abiertas aisladas de tejidos blandos. Entre las fracturas, el tercio medio fue el sitio afectado con mayor frecuencia y el método de tratamiento más utilizado fue la reducción abierta y la fijación interna. Conclusion: Dentro de las limitaciones de la evidencia disponible, este estudio ha demostrado que el género, el estrato etario y los factores etiológicos, como ADT, caídas y VIP , pero no el consumo de alcohol y/o sustancias psicoactivas, pueden tener una influencia significativa en la la prevalencia, los patrones y las modalidades de tratamiento de TMF en esta poblaión muestral.

Fixação funcionalmente estável no tratamento de sequela de fratura cominutiva de mandíbula por PAF / Functionally stable fixation in the treatment of comminuted jaw fracture by firearm projectile

Introdução: em traumas de alta energia por projéteis de arma de fogo (PAF), pode ocorrer a cominuição da mandíbula. Quando não identificadas ou tratadas de maneira equivocada, essas injúrias podem comprometer a saúde do indivíduo, com graves complicações estéticas e funcionais. Objetivo: o objetivo deste trabalho é relatar um caso de tratamento cirúrgico de sequela de ferimento por arma de fogo com fratura cominutiva em região de sínfise mandibular. Relato do caso: paciente procurou o serviço de cirurgia e traumatologia bucomaxilofacial após tratamento cirúrgico insatisfatório de fratura mandibular por PAF. Observou-se clinicamente mobilidade em manipulação, exposição óssea e drenagem purulenta. Na tomografia, observou-se gap ósseo, descontinuidade na base mandibular e material de osteossíntese inadequado. Foi proposta uma abordagem cirúrgica para instalação de placa de reconstrução do sistema 2.4 mm. Em acompanhamento pós-operatório, o paciente evoluiu com abertura bucal funcional e satisfatória, sem mobilidade nos fragmentos ósseos, arcabouço mandibular restabelecido e adequado posicionamento do material de fixação. Considerações finais: os casos de cominuição óssea apresentam características individuais que devem ser levadas em consideração em seu manejo. Nesses casos, a escolha do material de fixação é fundamental para o sucesso terapêutico e o uso de prototipagem soma para uma condução satisfatória do caso, garantindo menor tempo cirúrgico e melhor adaptação da placa. (AU)

Introduction: in high energy traumas caused by firearm projectiles may occur comminutive mandibular fractures. When it is not identified or inappropriately treated, these injuries can compromisse the individual's health, with serious aesthetics and funcional complications. Objective: the aim of this study is report a case of surgical treatment of sequelae from firearm injury with comminutive fracture in the region of mandibular symphysis. Case report: patient sought the service of Oral and Maxillofacial Surgery and Traumatology after 1 month of unsatisfactory surgical treatment of a mandibular fracture caused by firearm projectile. Clinical examination revealed mobility to manipulation and bone exposure with purulent drainage. Computed tomography of the face shows bad fracture consolidation in the anterior region of the mandible with bone gap and discontinuity in the mandibular base and inadequate and poorly positioned osteosynthesis material. It was then proposed a new surgical approach with instalation of the reconstruction plate of 2.4mm locking system. In postoperative follow-up, the patient evolved with a functional and satisfactory mouth opening, with no mobility in bone fragments, restored mandibular framework and adequate positioning of the fixation material. Final considerations: the cases of comminutive bone fractures show particular features that should be considered in their handling. In these cases, the choice of the fixation material is critical to therapeutic success and the use of prototyping sum for a satisfactory conduction of the case, ensuring shorter surgical time and better adaptation of the plate.(AU)

Fratura cominutiva de mandíbula por fogos de artifício: relato de caso / Comminuted mandible fracture by firework: a case report

As fraturas mandibulares são comuns na rotina dos serviços de Cirurgia e Traumatologia Buco-maxilo-facial. Embora sejam raras, as fraturas ocasionadas por fogos de artifício merecem atenção devido ao poder de destruição. O presente trabalho tem como objetivo relatar um caso de fratura mandibular cominutiva, com perda de substância dos tecidos duros e moles da face e cavidade oral. Nesse caso, foi preciso celeridade ao tratamento cirúrgico de urgência, para assegurar as vias aéreas do paciente e, em seguida, reconstruir as áreas destruídas, tendo todo o cuidado em relação ao acompanhamento do caso devido aos riscos de infecção e possíveis sequelas... (AU)

The mandible fractures are common in routine of Oral & Maxillofacial Surgery services. However, the ones occasioned by fireworks are rare. Nevertheless, they deserve attention because of the their destruction power. The present study aims to report a case of comminuted mandible fracture, with loss of substance from hard and soft tissues from the face and mouth. In this case, emergency surgery was urgently needed, to ensure the airways and then to rebuild the destroyed areas, paying attention to the follow-up of the case because of the high risk of infection and possible complications... (AU)

Intubação submento-orotraqueal: estudo retrospectivo de 2 anos / Orotraqueal submental intubation: two years retrospective study

As lesões e mortes no trânsito configuram-se como um grande problema de Saúde Pública, determinando números elevados de pacientes politraumatizados. Muitos deles apresentam injúrias severas na face, tais como as fraturas panfaciais, em que se faz necessário um procedimento cirúrgico bucomaxilofacial. Em muitos desses casos, exista a impossibilidade de manutenção da via aérea oral ou nasal. A intubação submento-orotraqueal (ISMOT) torna-se um procedimento seguro e efetivo para o manejo das vias aéreas. Este trabalho tem como objetivo realizar um estudo epidemiológico, retrospectivo dos prontuários dos pacientes atendidos no Serviço de Cirurgia e Traumatologia Bucomaxilofacial do Hospital de Base de Bauru no período de janeiro de 2011 a janeiro de 2013. A prevalência da ISMOT foi de 2,36%. O gênero masculino foi o mais acometido, com 72%, e a faixa etária da terceira década de vida (42,85%). Em pacientes submetidos à ISMOT, a etiologia mais presente foram acidentes de trânsito (78,56%), sendo as fraturas de mandíbula associadas a fraturas nasais aquelas mais prevalentes (35,71%). Não foi verificada nenhuma complicação. A ISMOT é um procedimento cirúrgico importante para pacientes com fraturas severas da face, em que a intubação orotraqueal e anasotraqueal estão contraindicadas, apresentando baixa morbidez e um índice de complicações mínimo... (AU)

Injuries and traffic deaths are characterized as a major public health problem determing a large number of polytrauma patients. Many of them have severe injuries on the face, such as panfactials fractures where it is necessary an oral and maxillofacial surgical procedure. In many of these cases there is the impossibility of maintaining the oral or nasal airway. The submental intubation(ISMOT), intubation becomes a safe and effective procedure for airway management. This paper aims to performing an epidemiological retrospective of patients treated at the Surgery and Traumatology Maxillofacial the Base Hospital of Bauru from January 2011 to January 2013. The prevalence of ISMOT was 2.36 %. Male gender was the most affected, with 72 %, and the age of the third decade of life (42.85 %). In patients undergoing ISMOT, the etiology was more present traffic accidents (78.56 %), and fractures of the jaw associated with nasal fractures those most prevalent (35.71 %). There was no any complication. The ISMOT is a major surgical procedure for patients with severe fractures of the face, where oro tracheal intubation and nasotracheal intubation are contraindicated, with low morbidity and complication rate minimum... (AU)

[Epidemiology of maxillofacial fractures due to traffic accidents in Medellin (Colombia)]. / Epidemiología de las fracturas maxilofaciales por accidente de tráfico en Medellín (Colombia).

OBJECTIVE: To characterize maxillofacial fractures due to traffic accidents in patients attending the Hospital Universitario San Vicente Fundación (Medellin-Colombia) from 1998 to 2010. METHODS: A descriptive study (n =1609) was carried out with information from the medical records of patients meeting the inclusion criteria established by the general objective of the study. The variables consisted of sex, age, year, type and number of fractures, and type of vehicle. A descriptive analysis of the variables was performed and the frequency of fractures due to traffic accidents was calculated according to year and sex. Crude and adjusted odds ratios (aOR) were estimated to establish associations among age, type of vehicle, and the presence of two or more fractures with stratification by sex. RESULTS: The frequency of maxillofacial fractures due to traffic accidents increased in 2007 (men: n=198, women: n=35) and decreased from 2008 to 2010 in both sexes. Fractures were more frequent in persons aged <35 years (80%) and in men (82%). The highest frequency of fractures was observed in motorists. Male users of motorcycles (aOR=1.41; confidence interval 95% [95%CI]: 1.02- 1.94) and bicycles (aOR=1.61; 95%CI: 1.01- 2.56) were more likely to report two or more fractures compared with pedestrians, after adjustment for other variables. CONCLUSIONS: Most maxillofacial fractures occurred in men and in motorists. Future studies should analyze other determinants affecting the epidemiology of maxillofacial fractures. Strategies should be designed to improve the use of protective elements and drivers' knowledge and practices.

Perfil das Internações de Crianças eAdolescentes com Fraturas do Crânio e Ossos da Face na Região Nordeste do Brasil / Profile of Hospitalization of Children and Adolescents with Fractures of the Skull and Facial Bones in Northeastern Brazil

Analisar o perfil das internações de crianças eadolescentes com fraturas do crânio e ossos da face naregião Nordeste, Brasil, no período de 2008 a 2010. Materiale Métodos: Utilizou-se uma abordagem indutiva comprocedimento comparativo-descritivo e técnica dedocumentação indireta. Os dados foram obtidos medianteconsulta aos sítios do DATASUS para os anos de 2008 a2010, nas faixas etárias de 0 a 19 anos, considerando asinformações disponíveis para cada estado da regiãonordeste, sendo analisados descritivamente por meio defrequências absolutas e percentuais. Resultados: No anode 2008, obteve-se um valor total de 1.418 notificações, commaior prevalência do gênero masculino (77,36%) e faixaetária mais acometida a de 15 a 19 anos, sendo a Bahia oestado com número mais expressivo de internações (n=274;17,42%). No ano de 2010, foram registradas 1.352internações, evidenciando-se maior envolvimento do gêneromasculino (79,66%) e da faixa etária de 15 a 19 anos,constatando-se que o Ceará apresentou valores maiselevados de internação (n=301; 22,26%). Conclusão: Houveuma maior ocorrência de fraturas em indivíduos do sexomasculino e a faixa etária mais acometida foi a de 15 a 19anos. Os estados da Bahia e do Ceará apresentaram o maiornúmero de internações, já os estados de Sergipe e doMaranhão foram os menos acometidos no período estudado...

To analyze the profile of hospitalization of childrenand adolescents with fractures of the skull and facial bonesin the Northeastern Brazil from 2008 to 2010. Material andMethods: We used an inductive approach with descriptivestatisticalprocedure and technique of indirect documentation.Data were obtained by consulting the DATASUS websitesfor the years 2008 to 2010, in the age group 0-19 years.Results: In 2008, we obtained a total of 1,418 notifications,with higher prevalence in males (77.36%); the most affectedage group was 15-19 years, and the state of Bahia had themost significant number of hospitalizations (n = 274; 17.42%).In 2010, there were 1,352 admissions, with greaterinvolvement of males (79.66%) aged 15 to 19 years, and thestate of Ceará showed significantly higher hospitalizationrates (n = 301, 22.26%). Conclusion: There was a higherincidence of fractures in males and the most affected agegroup was 15-19 years. The states of Bahia and Ceará hadthe largest number of admissions and the states of Maranhãoand Sergipe were the least affected in the studied period...

Survey on jaw fractures occurring due to domestic violence against women

Introduction: Violence against women has become a public health problem, and the dentist is the main responsible for the treatment of their victims, since numerous cases with a high incidence of impaired maxillomandibular complex occurred. Objective: The aim of this study was to analyze the prevalence and evolution of jaw fractures in woman due to domestic violence. Material and methods: The medical files from the Hospital and Maternity of São José dos Pinhais/PR (HMSJP) was searched for female patients diagnosed with jaw fractures caused by trauma, considering the aggressor and the prevalence in the period from January 2001 to May 2003. Results: There were 23 women with jaw fractures, aged from 15 to 43 years. Nasal fractures were the most prevalent, followed by the zygomatic complex and mandible fractures. The husbands were the main responsible for the attacks. The fractures treated by reduction had satisfactory bone consolidation. Conclusion: Patients with jaw fractures had favorable bone consolidation after being submitted to surgical treatment. Nasal fractures were the most prevalent type and the husband was most responsible for the attacks.

Perfil epidemiológico dos pacientes com fraturas dos ossos da face em um hospital público do estado de Sergipe / Epidemiological profile of patients with facial bones fractures in a public hospital's state of Sergipe

O propósito desse trabalho foi verificar o perfil epidemiológico das fraturas de ossos da face em um Hospital público do Estado de Sergipe, no período de 2004 a 2006, priorizando os dados epidemiológicos (idade, gênero, etiologia, procedência e ossos acometidos). Do total de 263 prontuários de pacientes com diagnóstico de fratura de ossos da face, 85,17% eram do sexo masculino e 14,83% feminino. A faixa etária mais e menos acometida foi a 3ª e 7ª décadas de vida respectivamente. As causas mais comuns das fraturas dos ossos da face foram os acidentes motociclísticos (22,81%), seguidos da violência interpessoal (14,44%), acidentes automobilísticos (8,36%) e ciclísticos (7,60%). Das 303 fraturas, as de mandíbulas foram as mais comuns (39%), seguidas pelas fraturas dos ossos zigomático (22%), maxilar (21%) e nasal (18%). Concluímos que as principais causas de fraturas dos ossos da face, foram os acidentes por motocicleta e a violência interpessoa.

The purpose of this study was to evaluate the epidemiological profile of fractures of facial bones in a hospital in the state of Sergipe, in the period 2004 to 2006, emphasizing the epidemiological data (age, gender, etiology, origin and fractured bones). Of the 263 medical records of patients diagnosed with fractures of facial bones, 85.17% were male and 14.83% female. The age group most and least affected was the 3rd and 7th decades of life respectively. The most common causes of fractures of facial bones were motorcycle accidents (22.81%), followed by interpersonal violence (14.44%), automobile accidents (8.36%) and cycling (7.60%). Of the 303 fractures of the mandible were the most common (39%), followed by fractures of the zygomatic bone (22%), maxillary (21%) and nasal (18%). We conclude that the main causes of fractures of facial bones, were the accidents caused by motorcycles and interpersonal violence.

Análise epidemiológica das fraturas faciais em um hospital secundário / Epidemiological analysis of facial fractures in a secondary hospital

Introdução: Os traumas de face são diagnósticos frequentes no pronto-socorro. Suas causassão variadas, sendo as principais a violência e os acidentes de trânsito. Os dados epidemiológicossão importantes para o conhecimento do problema e para contribuir na realização demedidas preventivas, educacionais e técnicas. Objetivo: O objetivo do trabalho foi relatar aexperiência do autor no atendimento aos traumatismos de face em um hospital secundário eavaliar as características epidemiológicas durante os primeiros 37 meses do serviço. Método:Estudo observacional, prospectivo, longitudinal dos pacientes atendidos no Pronto-socorro,no período de 1 de março de 2004 a 30 de abril de 2007. Dados dos 136 pacientes do estudoforam registrados em protocolo específico. Resultados: Houve predomínio do sexomasculino (76%) e a idade média foi de 29,67 anos. As principais causas foram as quedas(27,8%) e a as agressões (26,3%). O nariz foi o local mais acometido (50% dos casos),seguido pelas fraturas do complexo órbito-zigomático (24,3%). Nas fraturas de mandíbula,o côndilo foi o local mais afetado (28,6%). A redução nasal com a pinça de Asch foi tratamentomais utilizado (40,2%), seguido das placas e parafusos nos outros tipos de fraturas(31,8%). O índice de complicações foi de 5,8%. O seguimento pós-operatório demonstrouíndice de satisfação dos pacientes de 85%. Conclusão: Os dados de incidência, tratamento ecomplicações obtidos estão de acordo com a literatura científica. Os dados epidemiológicosobtidos serão utilizados na implementação de medidas para a prevenção do trauma facial.

Background: Facial traumas are frequently diagnosed within an emergency hospital. Theircauses vary and the most prevalent are interpersonal violence and traffic accidents. Epidemiologicaldata is important to understand the problem and to propose technical, preventiveand teaching issues. Purpose: The goal of this study was to show the author’s experience withfacial trauma in a small hospital and evaluate the first 37 months of this service. Methods:It was an observational, prospective, longitudinal study of the patients from the emergencyfrom March 1, 2004 to April 30, 2007. Data from the 136 patients were registered in a specificprotocol. Results: There was a male predominance (76%) and the mean age was 29.67years. The main causes were falls (27.8%) and interpersonal violence (26.3%). The nosewas the most affected location with 50% of the cases, followed by orbitozygomatic complex(24.3%). In the mandible fractures the condile was the most affected location (28.6%). Nasalclosed reduction with Asch forceps was the most utilized treatment (40.2%), followed byminiplates and screws for the other fracture locations (31.8%). Complications were presentin 5.8% of the cases. Follow up of the patients has shown a satisfaction rate of 85%. Conclusion:Incidence, treatment and complication data obtained are according to the literature.Epidemiological data collected will be useful to take measures to prevent facial trauma.

Fratura do arco zigomático: relato de caso utilizando o acesso pré-auricular / Zygomatic arch fracture: case report using pre-auricular approach

Neste trabalho, relata-se um caso de fratura isolada do arco zigomático, tratado com redução aberta e osteossíntese com placa e parafusos através do acesso pré-auricular. Será discutida a importância dessa conduta cirúrgica, baseada na literatura vigente.

This paper describes a case of isolated zygomatic arch fracture treated with open reduction and osteosynthesis with a plate and screws using the pre-auricular access. The importance of this surgical management is discussed in the light of current literature.

Análisis de las fracturas maxilofaciales en deportes de combate / Analysis of jaw fractures in fighting sports / Analyse des fractures maxillo-faciales en sports de combat

Se realizó un estudio en el cuatrienio 1992-95 donde se analizó el comportamiento de las fracturas maxilofaciales que tuvieron lugar durante la práctica de deportes de combate con respecto al total de fracturas y de las que se produjeron en otros deportes. Se determinó que éstas se correspondían con el 2,12 % del total, y que en el deporte que más se reportaron fue en el kárate con 8 casos para el 18,6 % siguiéndole el boxeo y el Taekwondo; la fractura nasal fue la más frecuente. Se concluye que se ha demostrado la disminución de este tipo de afección debido al mejoramiento de la protección de los atletas.

A study was conducted from 1992 to 1995 to analyze the behavior of the jaw fractures that occurred during the practice of fighting sports with respect to the total of fractures and to those reported in other sports. It was determined that these fractures accounted for 2.12 % of the total, and that they were mostly found in karate with 8 cases (18.6 %), folbwed by boxing and Taekwondo. The nasal fracture was the most frequent. It was concluded that this type of affection has been reduced due to the improvement of the athletes´ protection.

Une étude entre 1992 et 1995, où l´on a fait l´analyse du comportement des fractures maxillo-faciales ayant eu lieu lors de la pratique de sports de combat, par rapport au total des fractures, et de celles qui se sont produit dans d´autres sports, a été réalisée. On a déterminé que celles-ci avaient correspondance avec 2,12 % du total et que le sport le plus rapporté a été le karate avec 8 caspour 18,6 %, suivi de la boxe et le taekwondo; la fracture du nez a été la plus fréquente. On conclut que la diminution de ce type d´affection, du fait de l´amélioration de la protection des sportifs, est prouvée.

Incidencia de fracturas maxilofaciales en el municipio Artemisa / Incidence of jaw fractures in the municipality of Artemisa / Incidence des fractures maxillo-faciales à Artemisa

Se realiza un estudio sobre la incidencia de las fracturas maxilofaciales tratadas en el Servicio de Cirugía Maxilofacial de Artemisa, entre los años 1994-97. Del total de 167 casos tratados el 62,3 % correspondió al sexo masculino y el 37,7 % al femenino. Las causas más frecuentes fueron los accidentes del tránsito, las caídas, las riñas y los accidentes deportivos y del trabajo. Al igual que en la mayoría de los estudios la fractura nasal fue la más frecuente, siguiéndole en orden las maxilomolares, las dentoalveolares y las mandibulares.

A study on the incidence of jaw fractures treated at the Service of Maxillofacial Surgery, in Artemisa, from 1994 to 1997, was conducted. Of the 167 cases that received treatment 62.3 % were males and 37.7 % females. The most frequent causes were traffic accidents, falls, quarrels, and sports and working accidents. As in most of the studies, nasal fracture was the most frequent, followed by maxillomolar, dento-alveolar and jaw fractures.

Une étude su l´incidence des fractures maxillo-faciales traitées au Service de Chirurgie maxillo-faciale d´Artemisa a été réalisée entre 1994 et 1997. Du total de 167 cas traités, 62,3 % correspond au sexe masculin et 37,7 % au sexe féminin. Les causes les plus fréquentes ont été les accidents du trafit, les chutes, les bagarres et les accidents de sport et de travail. La fracture du nez a été la plus fréquente, de même que la plupart des études, puis les fractures maxillo-molaires, les dento-alvéolaires et les mandibilaires.