Role of environmental and occupational factors in fall-related maxillofacial fractures.

OBJECTIVES: The objective of this study was to determine the frequency and patterns of maxillofacial fractures in falls due to environmental and occupational reasons. MATERIAL AND METHODS: One hundred and nineteen patients were included in this study who presented to the department of Oral and maxillofacial surgery at Khyber College of Dentistry, Peshawar. The duration of study was 3 years from January 1, 2017 to December 31, 2019. Demographic data such as age, gender and data environmental or occupational etiology of falls and pattern of fractures was noted in a customized Performa after detailed history, clinical and radiographic examination. Patients of maxillofacial fractures resulting due to falls with age ranging from 16 to 64 years were included. Those cases of falls that presented with systemic diseases or had chances of pathological fractures were excluded from the study. RESULTS: Male population was affected more than females (60% vs. 39.4%). The mean age was 32.39 SD ± 16.031. Falls due to environmental factors were more common than occupational factors (81.5% vs 18.5%). Fracture of midface was more common (57.1%) than fracture of mandible (36.7%) in patients of falls. 5.5% had both midface and mandible fractures. CONCLUSION: We concluded that Environmental and work-related facial fractures in falls are common in third and fourth decade of life. Falls due to stumbling, tripping and slipping, falls from height and falls from stairs most commonly result in midface fractures. Mandible fractures are commonly seen in sportsmen and laborers. Preventive strategies shall be adopted to prevent morbidity and mortality associated with such injuries.

Postoperative Complications in Genioplasty and Their Association with Age, Gender, and Type of Genioplasty.

OBJECTIVE: The objective of our study was to determine the incidence of postoperative complications associated with different kinds of genioplasties done with or without concomitant orthognathic surgeries. MATERIALS AND METHODS: Patients in whom facial asymmetry was corrected by genioplasty with age ranging from 16 to 55 at the Department of Oral and Maxillofacial Surgery were included in the study. Patients with facial asymmetry due to congenital problems were excluded. RESULTS: 59 patients were included, of which 38 were males and 21 were females with the age range of 16-55 (mean: 27.3729, Std. deviation: 4.70472). Advancement genioplasty was performed in 15.3%, reduction genioplasty was done in 16.9%, and advancement genioplasty with rotation was performed in 67.8% cases. In 28.8% cases, genioplasty was performed as an adjunct procedure with orthognathic surgery, and in 71.2% cases, genioplasty was performed alone. 3.4% patients developed infection, 8.5% had hematoma, and 6.8% had temporary numbness. Postoperative complications were seen more in men than in women. Correction of chin asymmetry by rotation/advancement showed the highest number of complications (84%). CONCLUSION: Temporary neurosensory disturbance of the inferior alveolar nerve is the most common complication that occurs after genioplasty. Patients shall be counselled preoperatively, and informed consent shall be obtained prior to surgery.