Profile of Hospitalizations of Children and Adolescents Victims of Transport Accidents: A Retrospective Study

Abstract Objective: To present the profile of hospitalizations due to transport accidents in individuals aged 0-19 years in a reference hospital for urgent and emergency traumatology care. Material and Methods: This retrospective study is grounded on analyzing medical records of children and adolescents hospitalized due to transport accidents in 2016 and 2017. The bivariate analyses included Chi-square and Fischer's exact tests and binary logistic regression, with a 5% significance level. Results: Four hundred and seventy-five (43.7%) of the 1,088 medical records investigated corresponded to transport accidents, and accidents involving motorcycles were the most frequent (68.3%), affecting adolescents (81.3%), while children were more involved in accidents as pedestrians (57.1%). Advancing age increases the likelihood of the outcome, with a significant association in the multivariate analysis (p<0.001). The mandible was most frequently affected in maxillofacial fractures. Conclusion: Transport accidents predominantly affect male adolescents, involving motorcycles, and the lower limbs are the most affected. The mandible was the most affected bone in maxillofacial fractures.

Alcohol consumption and maxillofacial fractures in times of Covid-19: a cross-sectional study in a cuban university hospital / Consumo de alcohol y fracturas maxilofaciales en tiempos de Covid-19: un estudio transversal en un hospital universitario cubano

Introduction: The consumption of alcoholic beverages reduces the body's ability to deal with dangerous situations and exposes people to trauma. Objective: To determine the association between the consumption of alcoholic beverages and the characteristics of maxillofacial fractures treated at a Cuban university hospital in the context of COVID-19. Material and Methods: An observational, analytical, and cross-sectional study was carried out in the Maxillofacial Surgery unit at the "Carlos Manuel de Céspedes" General University Hospital during the year 2020. Prevalence ratios, 95% confidence intervals and p-values were obtained using generalized linear models. Results: In 58.23% of the cases, fractures were related to the consumption of alcoholic beverages. The fundamental etiology was interpersonal violence (47.75%), regardless of the consumption of alcoholic beverages. There was a prevalence of patients with nasal fractures (n=98; 55.06%), among which, 35.71% had consumed alcoholic beverages at the time of the trauma. Being male (p=0.005), the lack of university studies (p=0.007), the need for surgical treatment (p<0.001), the fractures of the zygomaticomaxillary complex (p=0.023), and the traumas that occurred during the weekends (p<0.001) or during the month of June (p=0.029) were factors associated with a higher frequency of fractures related to the consumption of alcoholic beverages. There was a lower frequency of fractures associated with alcohol consumption during the months of January (p=0.006) and March (p=0.001). Conclusion: Six out of ten cases were under the influence of alcoholic beverages. There was a greater number of young and male patients, mainly due to interpersonal violence.

Introducción: La ingestión de bebidas alcohólicas disminuye la capacidad del organismo para enfrentar situaciones de peligro y lo predispone a sufrir traumatismos diversos. Objetivo: Determinar la asociación entre el consumo de bebidas alcohólicas y las características de las fracturas maxilofaciales atendidas en un hospital universitario cubano en el contexto de la COVID-19. Material y Métodos: Estudio observacional, analítico y transversal realizado en el servicio de Cirugía Maxilofacial del Hospital General Universitario "Carlos Manuel de Céspedes" durante el 2020. Se obtuvieron razones de prevalencia, intervalos de confianza a 95% y valores p mediante modelos lineales generalizados. Resultados: En el 58.23% de los casos las fracturas se relacionaron con la ingestión de bebidas alcohólicas. La etiología fundamental fue la violencia interpersonal (47.75%), independientemente del consumo o no de bebidas alcohólicas. Predominaron los pacientes con fracturas nasales (n=98; 55.06%), en los que el 35.71% había consumido bebidas alcohólicas en el momento del trauma. El sexo masculino (p=0.005), la carencia de estudios universitarios (p=0.007), la necesidad de tratamiento quirúrgico (p<0.001), las fracturas del complejo cigomático-maxilar (p=0.023), los traumas sucedidos durante los fines de semanas (p<0.001) o durante el mes de junio (p=0.029) fueron factores asociados a una mayor frecuencia de fracturas relacionadas con el consumo de bebidas alcohólicas. Hubo menor frecuencia de fracturas asociadas a este consumo durante los meses de enero (p=0.006) y marzo (p= 0.001). Conclusión: Seis de cada diez casos estuvieron bajo los efectos de la ingestión de bebidas alcohólicas. Existió una mayor afectación de pacientes jóvenes, masculinos, a causa principalmente de la violencia interpersonal.

Tratamento cirúrgico de fratura Le Fort II: relato de caso / Surgical Treatment of Le Fort II Fracture: Case Report

Fraturas faciais geralmente resultam traumas, e podem ocorrer de forma isolada ou concomitante a outras lesões. O trauma na região facial resulta em danos não só em tecido ósseo, mas também em tecido mole e dentição, causando um prejuízo na função e na estética do paciente. Os acidentes automotores permanecem sendo uma das causas mais significativas de traumas faciais. As fraturas do terço médio da face incluem a maxila, zigoma e o complexo naso órbito etimoidal; podem ser classificadas em: fraturas Le Fort I, II ou III, fraturas do complexo zigomático maxilar, fraturas de arco zigomático ou fraturas naso órbito etimoidais. Elas podem ser unilaterais ou bilaterais, simétricas ou assimétricas. Este estudo objetiva-se em relatar o caso clínico de um paciente do sexo masculino, 31 anos, vítima de acidente automobilístico (carro/ anteparo). O paciente foi diagnosticado com fratura do tipo Le Fort II e nasal onde foi realizado o tratamento de redução e fixação interna rígida das fraturas de maxila e redução incruenta de fratura nasal, resultando em melhora da condição do paciente. As fraturas Le Fort são predominantemente causadas por colisões de alta energia. Portanto o tratamento é imprescindível para a devolução da função, estética e autoestima do paciente... (AU)

Facial fractures usually result from trauma, and may occur in isolation or concomitantly with other injuries. Trauma in the facial region results in damage not only to bone tissue but also to soft tissue and dental elements, which causes a loss in the patient's function and esthetics. Automotive accidents remain one of the most significant causes of facial trauma. Fractures of the middle third of the face include maxilla, zygoma and the nasoorbitoethmoid; may be classified as: Le Fort I, II or III fractures, maxillary zygomatic complex fractures, zygomatic arch fractures, or nasoorbitoethmoid. They can be unilateral or bilateral, symmetrical or asymmetric. The present study aims to report the clinical case of a 31 years, male patient, victim of an automobile accident (car/fixed shield). The patient was diagnosed with le Fort II and nasal fracture, where the treatment of reduction and rigid internal fixation of maxilla fractures and reduction of nasal fracture were performed, resulting in improvement of the patient's condiction. Le Fort fractures are predominantly caused by high energy collisions. Therefore the treatment is essential for the return of the function, aesthetics and increase of the patient's self-esteem... (AU)

Caracterización sociodemográfica y clínica del trauma maxilofacial en un hospital de referencia de Bogotá / Clinical and sociodemographic characteristics of maxillofacial injuries in a tertiary hospital in Bogotá

Introducción: el trauma maxilofacial es un motivo de consulta frecuente, y puede llevar a daño funcional, estético y emocional. Existen estudios previos sobre su epidemiología, sin embargo, sabemos que esta cambia a través del tiempo porque está determinada por diversos factores. El objetivo de este estudio es describir las características del trauma maxilofacial en un hospital de referencia de Bogotá. Diseño: estudio observacional descriptivo. Metodología: Se revisaron historias clínicas de pacientes mayores de 18 años que ingresaron por urgencias a la Unidad de Cirugía Maxilofacial del Hospital San José entre el 2013 y 2017. Se calculó frecuencias absolutas y relativas para las variables cualitativas. Resultados: se obtuvieron 391 pacientes. La mayoría fueron hombres (76,3 %) entre los 30-49 años. Las causas más comunes son la violencia (36,8 %) y los accidentes de tránsito (25 %). Las fracturas más frecuentes fueron las de huesos propios nasales (52 %). De las fracturas mandibulares, las más prevalentes fueron las fracturas condilares y subcondilares, ángulo y cuerpo con 21,4 % cada una. El tratamiento más usado fue el manejo médico (52,9 %). Discusión: el trauma maxilofacial es una patología frecuente en hombres adultos jóvenes. Sin embargo, el tipo de fractura y etiología podría estar influenciado por factores como el sexo y la edad. La causa más común es la violencia y los accidentes de tránsito, las cuales son potencialmente prevenibles. Esto debe servir como referencia para incitar a la realización de medidas preventivas para estas situaciones.

Background: Nowdays, the maxilofacial injuries are a common cause for consultation in the emergency department. These kinds of fractures may cause functional, and emotional damage. There are many publication about the epidemiology of maxilofacial trauma. Nevertheless, this data can change through the time. The aim of this study was to describe the maxilofacial injuries in a tertiary hospital in Bogotá. Desing: observational study. Methods: We retrospectibly assessed 391 medical records from the department of maxilofacial surgery in our Hospital during the period between 2013 to 2017. We include patients over 18 years admitted in the emergency department, we exclude patients seeing in the outpatients clinic. All the cases were assessed according age, sex, etiology and type of the fractures, in addition, we analyzed the treatment modalities. Results: We recolected 391 medical records. The majority of the facial fractures were man (76.3 %) between 30 and 49 years old. The most common cause of maxilofacial fracture was violence (36.8 %). The most common fracture site was nasal bones (52 %). Within the mandibular fractures the most common was the condylar, subcondylar fracture and body (21 % each). 53 % of cases were treated with conservative methods. Conclusion: The maxilofacial injuries are a common in our service especially in young men. Moreover depending on the sex and age we could observed diferents etiologies and typess of fracture. Mostly of the cases were for violence reasons or traffic accidents, which are preventable causes. This information is importante for public health awarness and it can be use as a referral for prevental measures for this situations.

Impact of trauma and surgical treatment on the quality of life of patients with facial fractures.

This study assessed the impact of oral and maxillofacial trauma and surgical treatment on the quality of life of patients. The study included 66 patients (age range 18-65 years) with facial fractures; 33 required surgical treatment and 33 required conservative (non-surgical) treatment. Quality of life was evaluated by applying the Oral Health Impact Profile questionnaire (OHIP-14) immediately after diagnosis of the trauma (T1), 30 days after surgery or trauma (T2), and 90 days after surgery or trauma (T3). For the control group (conservative treatment), there was a change in quality of life at T1 and T2. A change in quality of life was found for all of the surgical patients, regardless of the type of fracture and the observation period analyzed. There was no statistical difference when T1, T2, and T3 were compared in cases of zygomatic, Le Fort I, and nasal fractures, however there was an improvement in the quality of life of patients with mandibular fractures (P=0.0102) and multiple facial fractures (P=0.0097) at T3. Facial trauma caused the greatest impact on the quality of life of surgical patients at T1. The surgical treatment significantly improved quality of life for patients with mandibular and multiple facial fractures.

Reduction and Fixation of Unstable Fractures of the Zygomatic Arch: Report of a Series of Cases.

BACKGROUND: This study evaluated a series of cases of fracture in the zygomatic arch with displacement of the fractured segment. MATERIALS AND METHODS: This prospective cohort study was conducted between May 2008 and February 2009. The study sample which consist of 10 patients of both genders with fractures in the zygomatic arch. The collection instrument included a specific sheet with data concerning the patient's age, cause, side of the fracture, type of treatment performed, recurrence and presence of lesions in the facial nerve. The radiographic indices of Waters and Hirtz were used. The data were presented by means of descriptive statistics (absolute and percentage distributions). RESULTS: Most of the patients were male (90.0%), the most frequent etiology was a motorcycle accident (70.0%) and the left side was more affected (60.0%). There was no recurrence in any of the patients examined; however, 1 patient had a lesion in the facial nerve. The treatment performed for all patients was reduction and fixation with titanium miniplates. CONCLUSION: Fractures in the zygomatic arch are more frequent in young male individuals and the most common cause is a motorcycle accident, with the use of miniplates constituting an effective treatment without recurrence.

The effect of methotrexate on the bone healing of mandibular condylar process fracture: an experimental study in rats.

BACKGROUND: Methotrexate (MTX) is an anti-metabolite used in rheumatology and oncology. High doses are indicated for oncological treatment, whereas low doses are indicated for chronic inflammatory diseases. This study evaluated the effect of two MTX treatment schedules on the bone healing of the temporomandibular joint fracture in rats. METHODS: Seventy-five adult male Wistar rats were used to generate an experimental unilateral medially rotated condylar fracture model that allows an evaluation of bone healing and the articular structures. The animals were subdivided into three groups that each received one of the following treatments intraperitoneally: saline (1 mL/week), low-dose MTX (3 mg/kg/week) and high-dose MTX (30 mg/kg). The histological study comprised fracture site and temporomandibular joint evaluations and bone neoformation was evaluated by histomorphometric analysis. A biochemical parameter of bone formation was also assessed. RESULTS: When compared with saline, high-dose MTX delayed bone fracture repairs. In this latter group, after 90 days, the histological analysis revealed atrophy of the fibrocartilage and the presence of fibrous tissue in the joint space. The histomorphometric analysis revealed diminished bone neoformation. The alkaline phosphatase levels also decreased after MTX treatment. CONCLUSION: It was concluded that high-dose MTX impaired mandibular condyle repair and induced degenerative articular changes.

Uso do acesso retromandibular para tratamento de fratura bilateral de côndilo mandibular: relato de caso / Treatment of bilateral mandibular condylar fractures: a case report

O tratamento da fratura de côndilo mandibular é um assunto de muitas controvérsias na literatura sobre as indicações e contraindicações para o tratamento cirúrgico ou conservador. Além delas, dúvidas ainda permanecem sobre qual o melhor acesso cirúrgico para o tratamento desse tipo de fratura, quando se opta pelo tratamento cirúrgico (aberto). os acessos extrabucais, descritos na literatura para o tratamento das fraturas condilares, são: pré-auricular, submandibular, ritidectomia e retromandibular (hinds). o acesso intraoral, com o auxílio da endoscopia, também pode ser utilizado com a mesma finalidade. Por meio do relato de um caso clínico, os autores apresentam um caso de fratura de côndilo mandibular bilateral em que foi utilizado o acesso retromandibular para redução e fixação da fratura.

The treatment of a mandibular condylar fracture is a subject of much controversy in the literature regarding indications and contraindications to the surgical or conservative approach. In addition, many doubts remain regarding the optimal surgical approach for treating this type of fracture when the open technique is chosen. The extra-oral approaches described in the literature for the treatment of condylar fractures are the preauricular, submandibular, ritidectomy and retromandibular (hinds).The intra-oral access, with the aid of endoscopy, can also be used for the same purpose. In this clinical report, the authors present a case of bilateral mandibular condylar fracture in which the retromandibular approach was used for the reduction and fixation of the fracture.

Facial symmetry evaluation after experimentally displaced condylar process fracture in methotrexate treated rats / Avaliação da simetria facial após fratura experimental com desvio do processo condilar em ratos tratados com metotrexato

PURPOSE: To investigate the facial symmetry of high and low dose methotrexate (MTX) treated rats submitted to experimentally displaced mandibular condyle fracture through the recording of cephalometric measurements. METHODS: One hundred male Wistar rats underwent surgery using an experimental model of right condylar fracture. Animals were divided into four groups: A - saline solution (1mL/week); B - dexamethasone (DEX) (0,15mg/Kg); C - MTX low dose (3 mg/Kg/week); D - MTX high dose (30 mg/Kg). Animals were sacrificed at 1, 7, 15, 30 and 90 days postoperatively (n=5). Body weight was recorded. Specimens were submitted to axial radiographic incidence, and cephalometric mensurations were made using a computer system. Linear measurements of skull and mandible, as well as angular measurements of mandibular deviation were taken. Data were subjected to statistical analyses among the groups, periods of sacrifice and between the sides in each group (α=0.05). RESULTS: Animals regained body weight over time, except in group D. There was reduction in the mandibular length and also changes in the maxilla as well as progressive deviation in the mandible in relation to the skull basis in group D. CONCLUSION: Treatment with high dose methotrexate had deleterious effect on facial symmetry of rats submitted to experimentally displaced condylar process fracture.

OBJETIVO: Avaliar a simetria facial de ratos tratados com metotrexato (MTX), em dose alta e baixa, submetidos à fratura experimental do processo condilar com desvio por meio de mensurações cefalométricas. MÉTODOS: Cem ratos Wistar machos foram submetidos a procedimento cirúrgico utilizando modelo experimental de fratura de côndilo do lado direito. Os animais foram distribuídos em quatro grupos: A - soro fisiológico (1mL/semana); B - dexametasona (DEX) (0,15mg/Kg); C - MTX baixa dose (3mg/Kg/semana); D - MTX alta dose (30mg/Kg). Os períodos de sacrifício foram de 1, 7, 15, 30 e 90 dias de pós-operatório (n=5). O peso dos animais foi documentado. Foram realizadas mensurações lineares da maxila e da mandíbula, bem como angulares do desvio mandibular. Os dados foram submetidos a análises estatísticas entre os grupos, períodos de sacrifício e entre os lados em cada grupo (α=0,05). RESULTADOS: Os animais recuperaram peso ao longo do tempo, exceto no grupo D. Houve redução no comprimento mandibular com alterações também na maxila e desvio progressivo da mandíbula em relação à base do crânio no grupo D. CONCLUSÃO: O tratamento com metotrexato em alta dose teve efeito deletério na simetria facial de ratos submetidos à fratura do processo condilar.

Facial symmetry evaluation after experimentally displaced condylar process fracture in methotrexate treated rats / Avaliação da simetria facial após fratura experimental com desvio do processo condilar em ratos tratados com metotrexato

PURPOSE: To investigate the facial symmetry of high and low dose methotrexate (MTX) treated rats submitted to experimentally displaced mandibular condyle fracture through the recording of cephalometric measurements. METHODS: One hundred male Wistar rats underwent surgery using an experimental model of right condylar fracture. Animals were divided into four groups: A - saline solution (1mL/week); B - dexamethasone (DEX) (0,15mg/Kg); C - MTX low dose (3 mg/Kg/week); D - MTX high dose (30 mg/Kg). Animals were sacrificed at 1, 7, 15, 30 and 90 days postoperatively (n=5). Body weight was recorded. Specimens were submitted to axial radiographic incidence, and cephalometric mensurations were made using a computer system. Linear measurements of skull and mandible, as well as angular measurements of mandibular deviation were taken. Data were subjected to statistical analyses among the groups, periods of sacrifice and between the sides in each group (α=0.05). RESULTS: Animals regained body weight over time, except in group D. There was reduction in the mandibular length and also changes in the maxilla as well as progressive deviation in the mandible in relation to the skull basis in group D. CONCLUSION: Treatment with high dose methotrexate had deleterious effect on facial symmetry of rats submitted to experimentally displaced condylar process fracture.(AU)

OBJETIVO: Avaliar a simetria facial de ratos tratados com metotrexato (MTX), em dose alta e baixa, submetidos à fratura experimental do processo condilar com desvio por meio de mensurações cefalométricas. MÉTODOS: Cem ratos Wistar machos foram submetidos a procedimento cirúrgico utilizando modelo experimental de fratura de côndilo do lado direito. Os animais foram distribuídos em quatro grupos: A - soro fisiológico (1mL/semana); B - dexametasona (DEX) (0,15mg/Kg); C - MTX baixa dose (3mg/Kg/semana); D - MTX alta dose (30mg/Kg). Os períodos de sacrifício foram de 1, 7, 15, 30 e 90 dias de pós-operatório (n=5). O peso dos animais foi documentado. Foram realizadas mensurações lineares da maxila e da mandíbula, bem como angulares do desvio mandibular. Os dados foram submetidos a análises estatísticas entre os grupos, períodos de sacrifício e entre os lados em cada grupo (α=0,05). RESULTADOS: Os animais recuperaram peso ao longo do tempo, exceto no grupo D. Houve redução no comprimento mandibular com alterações também na maxila e desvio progressivo da mandíbula em relação à base do crânio no grupo D. CONCLUSÃO: O tratamento com metotrexato em alta dose teve efeito deletério na simetria facial de ratos submetidos à fratura do processo condilar.(AU)

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.

Estudo epidemiológico das fraturas faciais ocorridas na cidade de Montes Claros/MG / Epidemiology study of facial fractures in the city of Montes Claros/MG

Introdução: O trauma facial apresenta incidência crescente, principalmente devido ao aumento dos acidentes automobilísticos, que continuam sendo sua principal causa. Objetivo: Descrever o perfil dos traumas faciais e dos indivíduos traumatizados atendidos em 2006 e 2007. Métodos: Foram avaliadas as seguintes variáveis: gênero, faixa etária, localização da lesão, motivo do trauma, tipo de tratamento instituído, profissional que realizou o atendimento e a cidade de origem do paciente. Os dados foram coletados por meio de pesquisa em prontuários nos Hospitais Santa Casa de Misericórdia e Hospital Aroldo Tourinho. Uma análise descritiva foi realizada empregando o pacote SPSS v.12.0. Resultados: Observou-se que (81%) dos acidentados eram do gênero masculino. Os traumas mais comuns foram os mandibulares (45%), malar (22%) e maxila (16%). A maioria dos casos (73%) foi atendida pelo médico e o cirurgião-dentista atendeu (27%) dos acidentados. Os acidentes automobilísticos foram responsáveis pela maioria dos traumatismos (17%). Os pacientes eram, na sua maioria (49%), oriundos de Montes Claros/MG. Conclusão: O trauma facial acontece com freqüência e o acidente automobilístico é a principal causa.

Introduction: The facial trauma has presented an increasing occurrence, due especially to the growth of automobile accidents, which continue being its main cause. Objective: Tto describe the facial trauma and injured individual profile that were seen in 2006 and 2007. Methods: The following variables were assessed: gender, age, location of the lesion, the trauma reason, the kind of treatment, the professional who saw the patient and the city where the patient was from. The data were collected through a research in patients chats at Santa Casa de Misericórdia and Aroldo Tourinho Hospital. A descriptive analysis was carried out using the SPSS package v.12.0. Results: It was noticed that 81% of the injured were men. The most common trauma places were mandibular (45%), malar (22%) and maxilla (16%). A rate of 73% of the cases was seen by a doctor and 27% were seen by dental surgeon. The car accident was charged with the majority of the injuries (17%). Most patients were from Montes Claros/MG (49%). Conclusions: Facial trauma presented an increasing occurrence and automobile accidents was the main cause.

Análise da concordância intra e inter-observadores na detecção das fraturas da face por meio da tomografia computadorizada / Intra and interobservers concordance analysis of face fractures detection through computed tomography

Introdução: A face está sujeita a agressões externas, encontrando-se em uma região propícia a ferimentos leves e graves, através de acidentes automobilísticos, esportivos, além de agressões, sendo a primeira zona de impacto do organismo a sofrer determinadas injúrias. A Traumatologia apresentou um importante desenvolvimento na área diagnóstica, com grandes avanços na tecnologia de obtenção de imagens para diagnóstico das fraturas faciais, como o desenvolvimento de novas técnicas de tomografia computadorizada como exame complementar no tratamento dos pacientes vítimas de traumas faciais. Objetivos: Avaliar a importância da tomografia computadorizada de face como meio diagnóstico dos traumatismos faciais através da análise de concordância intra e inter-observadores na detecção de fraturas da face por em pacientes vítimas de traumatismos faciais. Métodos: Para realização da análise de concordância foram utilizados 40 exames de tomografias computadorizadas de 40 pacientes vítimas de trauma facial atendidos entre os anos de 2000 e 2006. Os exames foram apresentados a dois observadores, em duas películas tomográficas para cada paciente observado, sendo uma contendo apenas cortes coronais e a outra com cortes axiais e foram interpretadas, com o objetivo de identificar a concordância intra e inter-observadores para a detecção das fraturas da face em dois intervalos diferentes (inicial e final ou A e B), com diferença de 30 dias do período inicial (A) para o período final(B). Para a análise da concordância intra e inter-observadores foi empregado o Índice Kappa (K) de Cohen (1960). Resultados: A eqüidade de valores encontrados nos dois intervalos de observação (A e B) reproduziu uma concordância considerada excelente para os observadores 1 e 2. Devido ao fato de que todos os valores serem exatamente iguais nos dois intervalos para o observador 1 e 2, mas diferentes entre eles, não se aplicou o índice Kappa para a análise intra-observadores 1 e 2. Na análise de...

Introduction: The face is subject to external aggressions since it is very liKely to minor as well as serious injuries. Such injuries can happen in a car accident or when practicing sports besides aggressions, because it is the first zone of impact of the organism bound to suffer certain injuries. The Traumatology presented an important development in the diagnostic area by achieving a significant breaKthrough in obtaining images for diagnosis of facial fractures, such as the development of new computerized tomography techniques as a complementary examination in the treatment of patients suffering from facial trauma. Objectives: To assess the importance of computed tomography of face as a means of diagnosing facial injuries through the analysis of concordance intra and inter-observers in the detection of fractures of the face of patients suffering from facial injuries. Methods: In order to do the concordance analysis 40 computed tomography scans were used from 40 patients victims of facial trauma attended between 2000 and 2006. The 40 computed tomography of face were presented to 2 observers, in two tomographic films for each patient observed, one containing only coronal sections and the other with axial images. Then they were interpreted, to identify the intra and inter observers concordance for the detection of fractures of the face in two different intervals (initial and final or A and B), with a thirty-day difference of the initial period (A) and the final period (B). For the analysis of the inter and intra-observers? concordance, the index Kappa (K) form Cohen (1960) was used. Results: The equality of values found in both intervals of observation (A and B) reproduced a concordance considered excellent for the observers 1 and 2. Due to the fact that all values are exactly equal in both intervals for observer 1 and 2, but different between them, the Kappa index was not applied for the analysis intra-observer 1 and 2. In the analysis of inter-observer...

Traumas faciais: estudo retrospectivo de 1190 casos na região de Araçatuba / Facial injuries: a retrospective study of 1190 cases in the region of Araçatuba

Introdução: As populações apresentam variações na epidemiologia de fraturas faciais de acordo com a área geográfica, condição socioeconômica e cultural, época e injúria. Objetivo: Avaliar e determinar a ocorrência dos traumas faciais - fraturas mandibulares (FM), nasais (FN), zigomáticas (FZ), do seio frontal (FF), traumatismos dento alveolares (TDA) e ferimentos por arma de fogo (FAF) - em pacientes atendidos pelo serviço de Cirurgia e Traumatologia da Faculdade de Odontologia de Araçatuba - UNESP. Métodos: Foi realizado o estudo dos prontuários de pacientes admitidos no intervalo de 1999 a 2005. Resultados: Dentre os 4112 pacientes atendidos durante o período, 1190 (29%) apresentaram os traumas selecionados no estudo, dos quais 913 (76,7%) eram do gênero masculino e 277 (23,3%) do feminino. A faixa etária mais acometida foi de 21 a 25 anos (17%), sendo as causas mais freqüentes: agressão física (17,6%), acidentes ciclísticos (16,6%) e acidentes motociclísticos (15,8%). A fratura nasal foi o trauma mais freqüente (26,89%), seguida das fraturas do zigomático (25,38%), TDA (22,35%), fraturas mandibulares (21,26%), do seio frontal (2,78%) e os FAF (1,34%). Setenta e dois por cento dos casos foram tratados cirurgicamente. Conclusões: O trauma facial ocorreu com mais freqüência no gênero masculino, na faixa etária entre 21 e 25 anos, em consequência de agressão física e a fratura nasal foi a injúria mais prevalente.

Introduction: General population have variations in the epidemiology of facial fractures, according to geographical areas, socioeconomic and cultural differences, season and type of injury. Objective: To evaluate and determinate facial trauma incidence - mandible fractures (MF), nasal fractures (NF), zygomatic (ZF), the frontal sinus (FS), alveolar dental trauma (ADT) and injuries by a firearm (FA) - in patients seen at the Department of Surgery and Integrated Clinics, Dental School Araçatuba, São Paulo State University (UNESP), Araçatuba, SP, Brazil. Methods: A retrospective study of medical charts of patients admitted between 1999 to 2005 was performed. Results: Among the 4112 patients evaluated during this period, 1190 (29%) showed the selected traumas for this study, of whom 913 (76.7%) were mem and 277 (23.3%) were women. The most affected age group was from 21 to 25 (17%), whereas the most frequent causes were: physical aggression (17.6%), cycling accidents (16.6%), and motorcycle accidents (15.8%). The most frequent trauma was nasal fracture (26.89%), followed by zygomatic fractures (25.38%), ADT (22.35%), mandible fractures (21.26%), the frontal sinus (2, 78%) and the FA (1.34%). Seventy two percent of the cases were treated surgically. Conclusions: The facial trauma occurred more in men between the ages of 21 and 25, as a result of physical aggression and nasal fracture was the most prevalent injury.