A retrospective study of oral and maxillofacial injuries in Seremban Hospital, Malaysia.

INTRODUCTION: Aetiology of oral and maxillofacial injuries in this country includes motorvehicle accident (MVA), fall, industrial accidents and others. Among these causes, MVA accident is the predominant cause of injury in Malaysia. MATERIALS AND METHODS: A retrospective record review was carried out using hospital records of all patients who sustained oral and maxillofacial injury at the Department of Oral Surgery, Seremban Hospital, Negeri Sembilan, Malaysia between 1998 and 2002. Information related to demographics, aetiology of trauma, vehicles involved in collision, location of injuries and treatment modalities were reviewed. RESULTS: Two thousand nine hundred and eighty-six patients sustained oral and maxillofacial injuries. Of these patients, 79.2% were men and the remaining were women. Among all the races, Malays had the highest involvement (50.6%) followed by Indians (24.5%), Chinese (19.6%) and others (5.3%). There were statistically significant results on the association of aetiology and the ethnic groups, in the age group of 30 years or less and male gender (P < 0.001). The most common injury was the soft-tissue injury followed by dental and dentoalveolar injuries and bony fracture. Among all facial fractures, 66.3% were managed conservatively, 13% were treated surgically and 19.7% did not have any intervention. In relation to dental and dentoalveolar injuries, 64.8% had treatment in the form of splinting, restorations or dental extraction. The rest of the patients (35.2%) were referred to their dentists or did not have any active treatment at Seremban Hospital. CONCLUSION: Most of the dental and facial injuries in Seremban Hospital were caused by MVA and were predominantly managed using conservative methods.

Facial trauma in geriatric patients in a selected Malaysian hospital.

BACKGROUND: Road traffic accidents are the main cause of trauma in Malaysia. It has been shown that there was an increase in admissions for trauma patients older than 60 years in the last decade. The purpose of this study was to determine the pattern of maxillofacial injuries in the geriatric patients referred to Seremban Hospital, Malaysia. METHODS: Records of patients aged 60 years or older who sustained oral and maxillofacial injuries between 1998 and 2002 were reviewed. Data related to age, sex, race, etiology, types of injuries and treatment modalities were obtained. RESULTS: A total of 134 geriatric patients with maxillofacial and dental injuries were seen in Seremban Hospital between January 1998 and December 2002. There were 101 (75.4%) men and 33 (24.6%) women. The age ranged 60-92 years with the mean age of 68.3 years (standard deviation, 7.48). Chinese made up the majority of the patients (51.8%), followed by Malays (37.2%), Indian (20.4%) and other ethnic groups (1.5%). The most common cause of injury was due to road traffic accidents (64.2%) However, falls were more common in those aged 76 years and above. The most common bone fracture documented was the mandible (35.7%) followed by fracture of the zygomatic complex (34.0%). The majority of treatment was conservative or closed reduction. CONCLUSION: All the elderly patients with facial trauma were managed conservatively or as closed reduction in this hospital. This was largely because of their comorbid state and financial constraints.

Unilateral coronoid hyperplasia following trauma: a case report.

This case describes surgical correction of unilateral coronoid hyperplasia in a 13-year-old boy due to trauma. Treatment included coronoidectomy by intraoral approach after the diagnosis was confirmed. Computed tomography scan and occipitomental view radiograph were utilized for investigation. The resected coronoid process was sent for histopathological study. The histopathological examination revealed decalcified sections showing osteochondroid hyperplasia at the expanded end. On clinical and radiographic review at 2 years postoperation, the patient was well, completely symptom free and had improved mouth opening. This case report demonstrates the management of sports injury related unilateral coronoid hyperplasia. Emphasis was also placed on postoperational rehabilitation to prevent any relapse.

A prospective study on elderly patients with facial fractures in a developing country.

BACKGROUND: This paper describes the incidence, aetiology, treatment and complications of facial fractures seen among the elderly in a developing country. METHODS: A prospective study evaluated 85 patients over 60 years of age who were diagnosed with facial fractures over a period of 12 months in 23 public hospitals nationwide. RESULTS: The elderly accounted for 4.5% of the total number of patients seen with facial fractures during the study period. Elderly men outnumbered women by a ratio of 4.31:1. Of the elderly patients, 35.3% had at least one medical condition, the commonest of which was hypertension. Road traffic accidents were the main cause of injury. The fractures were treated in only 26.2% of cases. Complications were uncommon. CONCLUSIONS: With a low incidence, and conservative treatment often being practised, the healthcare burden of treating facial fractures among the elderly in Malaysia is at present still low.

Maxillofacial trauma of pediatric patients in Malaysia: a retrospective study from 1999 to 2001 in three hospitals.

OBJECTIVE: Maxillofacial trauma in children is not common worldwide. Domestic injuries are frequently seen in younger children while older children are mostly involved in motor vehicle accidents (MVA). The objective of this study was to analyze the pattern of maxillofacial injuries in pediatric patients referred to three government main hospitals in different areas of West Malaysia. METHODS: Patients' records of three selected hospitals in Malaysia (National University of Malaysia Hospital, Kajang Hospital and Seremban Hospital) from January 1999 to December 2001 were reviewed. Data associated with demographics, etiology of injury in relation to age group, type of injuries whether soft tissues of hard tissue in relation to age group and treatment modalities were collected. RESULTS: A total of 521 pediatric patients' records were reviewed. Malays made up the majority of patients with maxillofacial injuries in the three hospitals. Males outnumbered females in all the three hospitals. Injuries commonly occur in the 11-16 years old. MVA was the most common etiology followed by fall and assault. Soft tissue injuries were the most common type of injuries in all the hospitals. In relation to fractures, mandible was the most common bone to fracture with condyle being the most common site. Orbital fracture was the most common fracture in the midfacial area. Most of the fractures were managed conservatively especially in the younger age groups. Open reduction with or without internal fixation was more frequently carried out in the 11-16 years old group. CONCLUSION: Children exhibit different pattern of clinical features depending on the etiology and stage of their bone maturation. A dedicated team, who is competent in trauma and aware of the unique anatomy, physical and psychological characteristics of children, should manage pediatric patient with trauma.