Dental Trauma in a Pediatric Emergency Department Referral Center.

OBJECTIVE: The purpose of this study was to describe dental and associated oral injuries in a pediatric population that presents to an emergency department. METHODS: We performed a retrospective study and identified children from January 2007 to September 2011. Charts were reviewed for any subject, age from newborn to younger than 19 years, based on International Classification of Diseases, Ninth Revision codes for any dental or oral injury. Data abstraction included demographics, time of day of presentation, location and identification of tooth (s) injured, management, and disposition. RESULTS: We identified 108 children with dental and if present, associated oral injuries. The median age was 12.3 years, the most common tooth injured were the primary (25.9%) or permanent (62%) upper central incisors, and the majority of subjects presented in the afternoon (mean time was 3:50 PM, SD ±24 minutes). A large proportion of dental injuries occurred in patients with permanent dentation (62%) and half of all children had more than 1 tooth injury. The majority of children (75%) were evaluated by either pediatric dental, oral surgery, or otolaryngology services, whereas 3.7% of the cases required multiple services. Twenty-five percent of children had an associated jaw fracture. Eighty-three percent of children were discharged home, of those, 49.1% were prescribed opioids, and 38.3% oral antibiotics. CONCLUSIONS: Emergency departments are often relied upon to evaluate and treat simple and complex dental and oral injuries. The ability to use a multidisciplinary team to manage pediatric oral and dental trauma is essential for care.

Maxillofacial injuries in infants and preschools: a 2.5-year study.

PURPOSE: This study aims to evaluate the epidemiology of maxillofacial injuries in infants and preschools. PATIENTS AND METHODS: The data from 110 infants and preschools with maxillofacial injuries from October 2010 to March 2013 were analyzed retrospectively. RESULTS: The male-to-female ratio was 1.89:1. The peak age was 1 to 3 years (53.64%). Accident falls (76.36%) were the major cause. A total of 166 soft-tissue injuries were found in 103 patients, 102 dental traumas in 36 patients, and 53 maxillofacial fractures in 33 patients. The most common sites of soft-tissue injuries included the gingiva (17.47%), lower lip (13.86%), upper lip (13.25%), and chin (12.05%), and the majority were lacerations (77.71%). Dental traumas occurred mainly in incisors (81.37%) and the lower arch (60.78%). Of the 53 fractures, the most common sites were the condyle (45.28%), symphysis (22.64%), and mandibular body (16.98%); 28 (52.83%) were treated by operation and 25 (47.17%) by conservative treatment. CONCLUSIONS: Maxillofacial injuries in infants and preschools exhibit specific epidemiological features. These are related to anatomic, physiologic, and psychologic development in infants and preschools.

Dental trauma in patients with maxillofacial fractures.

PURPOSE: The purpose of this study was to analyze and evaluate the correlation between dental injuries and the pattern of maxillofacial fractures. The correlation with age, gender, trauma mechanism and type of maxillofacial fracture was also investigated. MATERIALS AND METHODS: From January 2000 to December 2009, 1131 patients with facial fractures were registered. Of these, 473 presented with associated dental trauma. The information and data collected and analyzed included: age, gender, mechanism of injury, type of facial fracture, type of dental injury, and the relationship between dental injury and facial fracture. RESULTS: Dental injury was sustained by 473 patients (41.8%), with a total of 2215 injured teeth. Of the 2215 injured teeth, 1191 (53.8%) were in the maxilla and 1024 (46.2%) in the mandible. Fall from a height had the highest risk of dental injuries (OR = 4.145, P = 0.002). The central incisor was the most injured tooth for both the maxilla (388, 36.2%) and mandible (284, 27.7%). The most common type of dental injury was avulsion (1070, 47.4%). More anterior teeth in the maxilla were of crown fracture, avulsion, and intrusion than that in the mandible, whereas more anterior teeth in the mandible were of subluxation and concussion than that in the maxilla. Dental injuries were more prone to occur in patients who sustained only symphysis fractures (OR = 2.817, P < 0.001), only 0.236-fold risk in patients who sustained only mandible angle fracture (P < 0.001). CONCLUSIONS: The occurrence of dental trauma is significantly related to the pattern and position of the maxillofacial fractures.

Management of maxillofacial injuries in Iraq.

These clinical studies reflect the experience of the author in managing 673 patients treated during the last 8 years. All patients were treated in the Maxillofacial Unit, Surgical Specialties Hospital, Medical City, Baghdad, and in the author's private clinic. Included patients were 530 males and 143 females; patients' age ranged between 1 year and 75 years (mean, 38 y). Distribution of injuries was as follows: fracture of the mandible, 287 (42.64%); middle third injuries, 39 (5.79%); orbital injuries, 236 (35.07%; including 12 cases with cranioorbital injuries); injuries in children, 27 (4.0%); fracture of the zygoma, 52 (7.73%); and fracture of the nose, 40 (5.94%).Maxillofacial injuries in this study were classified as follows: (1) craniomaxillofacial with head injuries and cerebrospinal fluid leak; (2) fracture of the middle third including Le Fort I, II, and III and midline split in the face; (3) fracture of the mandible as an isolated injury or as part of a facial skeleton injury; and (4) isolated complex injuries of the zygoma, the orbital skeleton, and the nasoethmoidal region.The technique used for treating middle third injuries was external fixation either by halo frame (with vertical rods and cheek wires) or by box frame (using 4 external pins connected by rods) or internal fixation by suspending the middle third with internal wires (0.5 mm stainless steel) from the zygomatic process of the frontal bone beneath the zygomatic arch down the lower arch bar. Fractures of the mandible were treated by gunning splint with intermaxillary fixation (IMF) or with open reduction and fixation by stainless steel wire with IMF or by IMF screw or by an arch bar and IMF. Other fractures such as fracture of the orbit were treated by bone graft, sialastic, or lyophilized dura with open reduction. Fractures of the zygoma were treated by open reduction and fixation with stainless steel wire and bone graft or by reduction without fixation. Fractures of the nose were treated by reduction with straightening of the septum with a splint (lead splint or polythene) or by external splint with plaster of Paris. With the techniques used, results from managing these cases were satisfactory.

Eye injuries and orofacial traumas in floorball--a survey in Switzerland and Sweden.

The objective of this study was to investigate the occurrence of eye injuries and orofacial traumas in floorball. In addition, the athletes' habits of wearing protective goggles and mouthguards was surveyed, and an assessment was made of the general level of knowledge amongst athletes and coaches about preventive and first aid measures after a dental trauma and the resulting consequences. The study was conducted by the same interviewer in Switzerland and Sweden during the 2009/2010 season using a standardized questionnaire. A total of 608 individuals (565 athletes and 43 coaches) belonging to the amateur and semi-professional leagues in the two countries were individually interviewed. Although 72.7% of all athletes had observed and 27.7% of field players had sustained an injury to the eye or its vicinity, only 25 athletes (4.9%) wore protective eyewear. Similarly, despite 31.7% of all players having observed a dental or jaw injury and 11.3% of interviewed field players having suffered one, only one athlete wore a mouthguard on a regular basis. Participants from Switzerland were significantly better informed than participants from Sweden with regard to first aid measures. The results of this study show that floorball has an equally high risk for dental trauma as handball. Further investigations of dental injuries in floorball would be valuable in order to provide players, coaches, parents and sporting federations with the necessary information to make decisions regarding the use of mouthguards. It is strongly recommended that protective eyewear should be made mandatory.

Maxillofacial injuries in Calabar south-south, Nigeria: a 5 year study of jawbone fractures.

OBJECTIVES: The aim of this study is to highlight the overall uniqueness of the pattern of presentation of maxillofacial injuries seen at the Department of Oral and Maxillofacial Surgery of the University of Calabar Teaching Hospital, Calabar south-south Nigeria between January 2000 and December 2004 and to share our experience in terms of occurrence, seasonal fluctuations and the adequacy of treatment methods in our environment. MATERIALS AND METHODS: Case notes of all. the 200 maxillofacial trauma patients were retrieved, examined and analyzed with regards to age, gender and cause of injury, socio-demographic data, diagnosis, pattern of presentation, distribution and treatment. RESULTS: A male-to-female ratio of 3.65:1 was obtained. Out of the 200 patients the highest incidence of injury was in the 20-30 year age group 85 (n=85; 42.5%). The major causes of injuries were motorcycle (n=74; 37%), vehicle (n=62; 31.5%) and assault (n=40; 20%). Six (3%) river-related or boat accidents were recorded. Industrial and sports related accidents contributed the least (n=5; 2.5%). CONCLUSION: Road traffic accident had the highest proportion of the entire maxillofacial injuries with more males affected than females. Seasonal distribution showed a bimodal peak variation of May-June and September-January. This paper calls for the reinforcement of measures for the prevention of automobile accident and the establishment of more maxillofacial specialist centers with modern equipment for effective management of maxillofacial injuries.

Retrospective study on the occurrence of primary incisor trauma in preschool children of a low-income area in Brazil.

AIM: The objective of this study was to investigate the occurrence of trauma in primary incisors in a sample of preschool Brazilian children living in a low-income area of Rio de Janeiro, Brazil. METHODS: For the study 527 dental records of a Municipal Children's Hospital were evaluated, and the following related factors were recorded: gender age, tooth affected, type and cause of trauma. Data were tabulated and subjected to statistical analysis (chi-square test). RESULTS: There were no significant differences in the prevalence of injuries among boys and girls. Children 10 to 24 months-old were the most affected (p < 0.05). The maxillary central incisor was the most affected tooth (p < 0.05), with predominance of lateral luxation and concussions (p > 0.05). The most common cause of trauma was associated with child's own-height fall (p < 0.05). CONCLUSION: Based on the results, it was concluded that the high incidence of incisor trauma in deciduous teeth should be viewed with concern, requiring the implementation of health policies aimed primarily at the prevention of such accidents.

Geographic modelling of jaw fracture rates in Australia: a methodological model for healthcare planning.

BACKGROUND/AIM: While Australians are one of the healthiest populations in the world, inequalities in access to health care and health outcomes exist for Indigenous Australians and Australians living in rural or urban areas of the country. Hence, the purpose of this study was to develop an innovative methodological approach for predicting the incidence rates of jaw fractures and estimating the demand for oral health services within Australia. MATERIALS AND METHODS: Population data were obtained from the Australian Bureau of Statistics and was divided across Australia by statistical local area and related to a validated remoteness index. Every episode of discharge from all hospitals in Western Australia for the financial years 1999/2000 to 2004/2005 indicating a jaw fracture as the principle oral condition, as classified by the International Classification of Disease (ICD-10AM), was the inclusion criterion for the study. Hospitalization data were obtained from the Western Australian Hospital Morbidity Data System. RESULTS: The model estimated almost 10 times higher jaw fracture rates for Indigenous populations than their non-Indigenous counterparts. Moreover, incidence of jaw fractures was higher among Indigenous people living in rural and remote areas compared with their urban and semi-urban counterparts. In contrast, in the non-Indigenous population, higher rates of jaw fractures were estimated for urban and semi-urban inhabitants compared with their rural and remote counterparts. CONCLUSIONS: This geographic modelling technique could be improved by methodological refinements and further research. It will be useful in developing strategies for health management and reducing the burden of jaw fractures and the cost of treatment within Australia. This model will also have direct implications for strategic planning for prevention and management policies in Australia aimed at reducing the inequalities gap both in terms of geography as well as Aboriginality.

Incidencia de consultas por fracturas maxilofaciales en un servicio de urgencias odontológicas del Área Metropolitana de Buenos Aires / Incidence of consultations for maxillofacial fractures in a dental emergency department in the Metropolitan Area of Buenos Aires

Objetivo: Describir la incidencia, la causa, el patrón y el tratamiento de fracturas maxilofaciales en sujetos que solici- taron atención en un Servicio de Urgencias Odontológicas del Área Metropolitana de Buenos Aires. Materiales y métodos: Se analizaron las historias clíni- cas de los individuos que concurrieron al Servicio de Urgencias y Orientación de Pacientes de la Facultad de Odontología de la Universidad de Buenos Aires (SUyOP) en el período compren- dido entre marzo de 2018 y diciembre de 2019. Se registró la fre- cuencia de consultas vinculadas con diagnóstico de algún tipo de fractura del esqueleto maxilofacial y en el caso de estos pacien- tes, se registraron sexo, edad, etiología, ubicación y tratamiento. Resultados: Durante el periodo evaluado asistieron al SUyOP un total de 13.919 pacientes por algún tipo de urgen- cia odontológica, entre los cuales 47 (0,33%) se presentaron con traumatismos en la región bucomaxilofacial; 39 fueron del sexo masculino (83%). En total fueron diagnosticadas 66 frac- turas. La edad media se extendió entre los 30 y los 51 años. Las fracturas se encontraron con mayor frecuencia en la mandíbu- la (95,45%). La agresión interpersonal fue la principal causa (53,19%). El tratamiento realizado con mayor frecuencia fue el bloqueo intermaxilar en el 57,44% de los pacientes. Conclusión: Las fracturas de maxilar inferior fueron las que se registraron con mayor frecuencia. Si bien estas fracturas no ponen en riesgo la vida del paciente, la falla en el diagnóstico y el tratamiento apropiados puede derivar en la pérdida de fun- ciones del sistema estomatognático, y desarrollar deformidades secundarias que requieren de un tratamiento más complejo (AU)

Aim: To describe the incidence, etiology, pattern and treat- ment of maxillofacial fractures in a dental emergency department of the Buenos Aires Metropolitan Area. Materials and methods: A study was conducted, re- cording sex, age, etiology, location and treatment of maxillofa- cial fractures in patients who visited the Emergency and Patient Orientation Service of the School of Dentistry of the University of Buenos Aires (SUyOP) from March 2018 to December 2019. Data were obtained from dental medical records. Results: During the evaluated period, a total 13,919 pa- tients visited the SUyOP for dental emergencies, of whom 47 (0.33%) presented with trauma in the oral-maxillofacial region, and 39 were male (83%). Age range was 30 to 51 years. Over- all, 66 fractures were diagnosed. Fractures were most frequent in the mandible (95.45%). Interpersonal aggression was the most prevalent cause (53.19%). The most frequent treatment was inter- maxillary fixation, which was performed in 57.44% of the cases. Conclusion: Fractures of the lower jaw were the most fre- quently reported. Although these fractures are not life-threaten- ing, failure to diagnose and treat them properly can lead to loss of function of the stomatognathic system and development of sec- ondary deformities requiring more complex treatment (AU)

Jaw fractures in the indigenous and non-indigenous populations of Western Australia: 1999-2003.

Little data exist on the analysis of jaw fractures in Australia, and none in Western Australia. This study was a retrospective analysis of all hospitalizations for jaw fractures in Western Australia between the years 1999-2000 and 2002-2003. The aims were to determine the incidence, distribution between males and females, different age groups, aboriginal and non-aboriginal groups, and rural and urban populations. The economic impact of jaw fracture hospitalizations was also determined. Males were more likely (80.4%) than females to be admitted for a jaw fracture. Fractures of the mandible were more common (61.9%) than maxillary fractures (38.1%). Aboriginal persons had nearly 10 times more hospitalization rate than that of non-aboriginal persons. Fracture rates were significantly (P<0.05) higher in rural (61.9 per 100,000) than in urban areas. Over the 4-year study period the total costs for all jaw fracture hospitalizations exceeded US$ 7.6 million. This study clearly indicates the burden of jaw fractures on the Western Australian population, in terms of physical and economic impact.

A four-year retrospective study of adult hospitalization for oral diseases in Western Australia.

BACKGROUND: This analysis provides an insight into bed demand for adults for oral health related conditions in Western Australia. METHODS: Data were obtained from the Western Australian Hospital Morbidity Data System for the four financial years 1999-2000 to 2002-2003. This retrospective study analysed the principal diagnosis (ICD-10AM) obtained for all 53 646 adult patients diagnosed with an oral health related condition. Primary place of residency, gender and Indigenous status were analysed. RESULTS: More males (52.6 per cent) were hospitalized than females and Indigenous patients were hospitalized 1.5 times more than non-Indigenous patients. "Caries" were most common in non-Indigenous patients, with "jaw fractures" most prevalent in Indigenous patients. The majority of patients were hospitalized in a private metropolitan hospital (57.2 per cent). Total costs of hospitalization, both public and private, were in excess of dollar 85 million over four years with dollar 44 million in the public sector. CONCLUSIONS: This study indicates the burden of oral health related conditions on the Western Australian population and the hospital system in terms of health and economical impact.

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.

Soccer-Related Facial Trauma: A Nationwide Perspective.

PURPOSE: Soccer participation continues to increase among all ages in the US. Our objective was to analyze trends in soccer-related facial injury epidemiology, demographics, and mechanisms of injury. MATERIALS AND METHODS: The National Electronic Injury Surveillance System was evaluated for soccer-related facial injuries from 2010 through 2014. Results for product code "soccer" were filtered for injures to the face. Number of injuries was extrapolated, and data were analyzed for age, sex, specific injury diagnoses, locations, and mechanisms. RESULTS: In all, 2054 soccer-related facial trauma entries were analyzed. During this time, the number of injures remained relatively stable. Lacerations were the most common diagnosis (44.2%), followed by contusions and fractures. The most common sites of fracture were the nose (75.1%). Of fractures with a reported mechanism of injury, the most common was head-to-head collisions (39.0%). Patients <19 years accounted for 66.9% of injuries, and athletes over 18 years old had a higher risk of fractures. CONCLUSIONS: The incidence of soccer-related facial trauma has remained stable, but the severity of such injuries remain a danger. Facial protection in soccer is virtually absent, and our findings reinforce the need to educate athletes, families, and physicians on injury awareness and prevention.

Traumatic dental injury.

BACKGROUND: The aim of this study was to retrospectively evaluate the incidence of traumatic dental injury and consequential dental impairment following road traffic accidents and to examine the factors that can affect the monetary value of compensation for bodily injury payable pursuant to current insurance regulations. METHODS: From 2004 to 2014, 7233 persons involved in road traffic accidents in the province of Messina, eastern Sicily, were examined by insurance physicians to assess bodily injury damage. Data were collected from cases of traumatic dental injury causing malocclusion and temporomandibular joint dysfunction, either alone or concomitant with injuries to other parts of the body. Injury characteristics and consequential bodily injury damage were classified and the incidence calculated using Microsoft Excel software. RESULTS: The incidence of traumatic dental injuries was 3% of the total population (195 subjects - 127 males and 68 females); the majority of cases (56%) involved riders of two-wheeled vehicles. A high percentage of riders received injury to one or more teeth, i.e. fractures and dislocations, more frequently to the anterior teeth (68%) than the posterior teeth because of their position in the dental arch. Temporomandibular joint injuries were far fewer (8%) and resulted from either direct or indirect trauma associated with severe head and/or neck injury. The incidence of permanent bodily damage consequential to these injuries was fairly low. CONCLUSIONS: Although the incidence of dental trauma following road traffic accidents is low, the monetary compensation for consequential dental impairment based on current insurance regulatory law is far from negligible.

A comparative study of maxillo-facial trauma in Bristol and Bordeaux.

Consecutive patients with maxillofacial fractures who attended departments of maxillofacial surgery in Bristol and Bordeaux during 1985-1986 were surveyed prospectively to determine differences in demography and aetiology and patterns of injury. 1,652 patients were included: 1,146 in Bordeaux and 506 in Bristol. Significantly more patients with nasal complex fractures were treated in Bordeaux reflecting management of these injuries by oto-rhino-laryngologists in Bristol. Maxillary fractures were comparatively more frequent in Bordeaux, reflecting a higher incidence of road accidents. Significantly more assault victims were treated by maxillofacial surgeons in Bristol, though per capita alcohol consumption by age and sex matched individuals was greater in France than in the U.K. Incidence of fracture was 18/100,000 hospital catchment population/year in Bordeaux, compared to 32/100,000 population/year in Bristol; reflecting that in contrast to Bristol, specialists in private practice outside the regional centre treated patients with fractures in S. W. France. Differences in aetiology of injury could be explained by cultural factors. Formal twinning arrangements and EEC membership provide excellent opportunities for postgraduate education, training and collaborative clinical research.

The pattern and aetiology of maxillofacial injuries in Greece. A retrospective study of 25 years and a comparison with other countries.

In comparison with other countries, Greece demonstrates a high incidence of road traffic accidents (RTA's). Most are the result of violation of the highway code. Violence as a causative agent of fractures of the facial skeleton is still a minor factor in comparison with other countries. Most of the people involved are young. In a 25-year period we have treated 6,847 fractures of the facial skeleton. Fractures of the mandibular condyle, the genial symphysis and the zygomatico-maxillary complex were the most numerous. 25% of the patients were women and 75% men. 56% were treated conservatively; an open reduction was the treatment of choice in 37%, while no treatment was considered necessary in 7%. In the period under study, K.A.T. Hospital admitted 60% of the maxillofacial trauma in the whole country.

Maxillofacial fractures related to work accidents.

Work-related maxillofacial fractures were studied retrospectively over a six-year period. There were 98 cases accounting for 4.5% of all facial bone fractures treated in our hospital between 1981 and 1986. Of the patients, 89.8% were male. The mean age of the injured was 36.4 years. The incidence of work-related maxillofacial fractures was 0.37 per 1000 workers. Most of the injuries (66%) occurred in factories and construction work. Such work was associated with an to 15 times higher risk of maxillofacial fracture than service and office work. Of the fractures, 20.4% were sustained on the way to or coming from work. At the place of work, the commonest causes of injury were blows from objects or falls from a height (70%). On the way to or coming from work, the aetiological factor was most often a traffic accident. Assault and battery had caused facial bone fractures in 11.2% of cases. Fifty-five patients with midface and 45 patients with mandibular fractures were found, of these, 8 patients had bimaxillary fractures. In 6 cases, only dentoalveolar fractures were found. Of the patients, 55.1% were treated operatively. Sixty-six patients were hospitalized, the mean length of hospital stay being 3.2 days (range 1-12 days).

Sports-related maxillofacial fractures in a hospital material.

Sports-related maxillofacial fractures were analysed in 80 patients, accounting for 5.6% of all patients with facial bone fractures, treated during the 5-year period 1981-1985. 55% of the patients had 1 or more mandibular fractures and 45% had midface fractures. 6% of the patients had multiple injuries. The most common causes of injury were collision and fall. Soccer and ice hockey turned out to be the most hazardous sports, although sports-related maxillofacial fractures were less severe than those related to other causes. The need for oral and facial protection among athletes involved in contact sports is discussed.

Maxillofacial fractures sustained in bicycle accidents.

The present report is an analysis of 93 patients (52 male; 41 female) treated in 1981-1983 for maxillofacial fractures sustained in bicycle accidents. These accidents accounted for 7.1% of all facial bone fractures treated during the same period. Most accidents were single vehicle accidents (88%) and took place during the summer months. Of the patients, 65% had mandibular fractures, 35% had midface fractures and 5% had fractures in both the middle and lower thirds of the face. Condylar fractures were by far the most common of the mandibular fractures (67%)--a result which differs from studies concerning the profile of mandibular fractures in general. The majority of the middle third fractures were zygomatic (65%). Multiple injuries were diagnosed in 38% of the cyclists and other head injuries were the most common associated injury. Mean hospitalization of the in-patients (38%) was 4.1 days and the average sick leave was 14 days. The results of the study indicate that the use of protective helmets should be strongly recommended to cyclists, although most commercially available helmets do not protect the whole facial area and especially not the chin.

Maxillofacial fractures in a semi-urban Nigerian teaching hospital. A review of 442 cases.

A retrospective review of 442 patients, seen by one maxillofacial unit over a twelve-year period, is presented. Data concerning the patients' demographics and the aetiology, pattern, treatment and complications of the fractures were obtained and evaluated. Approximately 72% of the patients sustained fractures from road traffic accidents and 39% of the fractures occurred in the 21-30-year range. There was a male preponderence and 8% of all cases had postoperative infections. Over 20% of the patients sustained associated body injuries and only one-third reported for treatment within 24 hours of injury. Road traffic accidents continue to be the leading cause of maxillofacial fractures. The late presentation for treatment appears to be related to the rural and semi-urban dwelling of the patients and the attendant transportation and economic difficulties.