Trauma maxilofacial en el Servicio de Urgencias del Hospital Universitario "General Calixto García". 2016-2017 / Maxillofacial Trauma in the Emergency Service of General Calixto García University Hospital. 2016-2017

Introducción: La región maxilofacial es vulnerable a lesiones. En Cuba son escasos los estudios realizados sobre la atención en la urgencia dentro de la traumatología maxilofacial, por lo que surgió la motivación para realizar esta investigación. Objetivo: Caracterizar desde el punto de vista clínico-epidemiológico el trauma maxilofacial en el Servicio de Urgencias del Hospital General Calixto García en el período de junio 2016 a junio 2017. Material y Métodos: Se realizó un estudio descriptivo de corte transversal del universo de pacientes (2412 pacientes) atendidos en el Servicio de Urgencias del Hospital Universitario General Calixto García, desde junio del 2016 a junio del 2017; que tuvieron como diagnóstico trauma maxilofacial. Las variables empleadas fueron: grupos de edad, sexo, factor etiológico, tipo de lesión, conducta terapéutica. Resultados: En el estudio los pacientes con edades comprendidas entre 19 y 30 años representaron 41,0 por ciento; el sexo masculino 69,0 por ciento y los accidentes de tránsito 34,6 por ciento. Las lesiones de tejido duro más frecuentes fueron las fracturas nasales (13,9 por ciento); y de tejidos blandos las heridas puramente tegumentarias (82,1 por ciento). La colocación de vendajes se utilizó en 89,1 por ciento, y la sutura de heridas en 84,1 por ciento. Conclusiones: El comportamiento del trauma maxilofacial en el Servicio de Urgencias del Hospital Universitario General Calixto García, muestra que es predominante en hombres de edad intermedia y debido a accidentes de tránsito. Hay superioridad de lesiones de tejido blando y dentro de estas, de heridas puramente tegumentarias. La conducta conservadora, en su modalidad de colocación de vendaje, es la más empleada(AU)

Introduction: The maxillofacial region is vulnerable to injuries. In Cuba, few studies related to urgent care services have been carried out in maxillofacial traumatology, which led to an increase of motivation to conduct this research. Objective: To characterize maxillofacial trauma from a clinical and epidemiological point of view in patients treated in General Calixto García Hospital from June 2016 to June 2017. Material and Methods: A descriptive cross-sectional study was conducted with the universe of patients (2412 ones) that were treated in the Emergency Service of General Calixto García University Hospital with the diagnosis of maxillofacial trauma from June 2016 to June 2017. The variables used were: age groups, sex, etiological factor, type of injury, and therapeutic behavior. Results: In the study, the patients aged between 19 and 30 years represented 41.0 percent; the male sex 69.0 percent; and the traffic accidents 34.6 percent. The most frequent hard tissue injuries were nasal fractures (13.9 percent); and the soft tissue injuries were purely integumentary wounds (82.1 percent). Bandage placement was used in 89.1 percent, and wound suture in 84.1 percent. Conclusions: The behavior of the maxillofacial trauma in the Emergency Service of General Calixto García University Hospital, showed that it predominates in men of middle age due to traffic accidents. Soft tissue injuries were the predominant type of injuries, among them, the purely integumentary wounds. The conservative behavior in its modality of bandage placement was the most commonly used(AU)

Retrospective Analysis Of Types And Prevalence Of Maxillofacial Injuries : A Cross-sectional Computed Tomographic Study

Background: The incidence and epidemiological causes of maxillofacial trauma and facial fractures varieswidely in different regions of the world. To reduce morbidity and mortality, early recognition of severe headtrauma and concomitant injuries remains an important part of the initial assessment and treatment plan ofseverely injured patients.Purpose of the study: To find out the demographic trends, etiology, pattern of trauma, site and severity offractures and coexisting injuries in patients presented with maxillofacial injury.Materials and Methods: The study was conducted on 88 patients during the period from may 2017 to april 2018on patients presented with facio-maxillary injury at S.C.B Medical College & Ashwini Hospital, Cuttack, Govt.Medical College & Hosppital, Balasore, Odisha, India.Results: In this study maxillofacial injuries are more in compare to female (7.8:1). Majority of the cases areobservesd in tha age group 21-30 yr followed by 31 – 40 yr and no cases in more than 70 yr age group. Mostcommon cause is road traffic accident (82.9%) followed by assult (6.8%). Maximum number of patients havefracture of mandible (46.6%) followed by maxilla (31.8%). Mandibular fractures occurred most commonly in theparasymphyseal region (35.2%), followed by body (23.8%). Fracture of maxilla bone was present commonly atbody in 15 (53.6%) cases followed by blow out fracture (21.5%). Most of the faciomaxillary trauma patients haveassociated injuries like head injury (52.3%) followed by Extremities injury (36.4%).Conclusion: Maxillofacial injuries commonly due to road traffic accidents are more frequent in male. The routineuse of a head as well as full-body CT scan for all severely injured patients is recommended to ensure that noconcomitant injury is overlooked.

Padrão espacial e diferencial de renda dos domicílios de adolescentes e adultos jovens vítimas de traumatismo maxilofacial por agressão com arma de fogo / Spatial and differential income pattern of households of adolescents and young adults who are victims of maxillofacial injuries resulting from firearm aggression

Resumo O estudo investigou o padrão espacial dos casos de traumatismo maxilofacial decorrentes de agressão com arma de fogo em adolescentes e adultos jovens a partir do local de domicílio das vítimas e analisou comparativamente os diferenciais de renda dessas áreas. Estudo transversal com dados de vítimas atendidas em três hospitais de Belo Horizonte-MG, entre janeiro de 2008 e dezembro de 2010. Endereços foram georeferenciados por geocodificação. Tendências de aleatoriedade e densidade de pontos foram analisadas por Função K de Ripley e mapas de Kernel. A interação espacial entre os domicílios de adolescentes e adultos jovens foi verificada através da Função K12. Encontrouse registros de 218 casos de agressão com arma de fogo, com predomínio do sexo masculino (89,9%) e adultos jovens (70,6%). Os domicílios se distribuíram de forma agregada no espaço urbano com nível de confiança de 99% e níveis de agregação espacial semelhantes. Os clusters de domicílios convergiram para 7 favelas ou regiões vizinhas com população de maior renda revelando propagação de eventos. Os hotspots se concentraram em favelas com histórico de crimes ligados ao narcotráfico. A incorporação do espaço na dinâmica dos eventos mostrou que a condição econômica isoladamente não limitou a vitimização.

Abstract The study investigated the spatial pattern of cases of maxillofacial injury resulting from firearm aggression among teenagers and young adults and analyzed the comparison of income differentials in these areas based on the residence of the victims. This is a cross-sectional study with data from victims attended in three hospitals in Belo Horizonte, State of Minas Gerais, from January 2008 to December 2010. The addresses of the victims were georeferenced by geocoding. Randomness and point density trends were analyzed using Ripley's K function and Kernel maps. The spatial interaction between the homes of adolescents and young adults was verified through the K12 function. Records of 218 cases of assault with a male predominance (89.9%) and young adults (70.6%) were found. Household clusters were distributed on an aggregate basis in the urban space with a confidence level of 99% and similar spatial aggregation levels. The hotspots converged on 7 shantytowns or neighboring regions with higher income population revealing spread of events. Hotspots focused on slums with a history of crimes linked to drug trafficking. The incorporation of space in the dynamics of events showed that the economic condition in isolation did not limit victimization.

Clinical analysis of 314 children with maxillofacial fracture / 中华口腔医学杂志

A total of three hundred and fourteen patients with maxillofacial fracture under 14 years old were treated at Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University from October 2010 to October 2017 were collected and retrospective analysis was conducted. Age, gender, injury factors, type of fracture, associated injuries and treatment has been analysed. There were 196 male and 118 female. The most common injury factor was fall (148 cases), accounting for 47.1% of all patients. The most common fracture type was mandible fracture (221 cases). Children are not very cooperative with clinical examination, which often leading to misdiagnosis. Age, gender, fracture injury factors, comorbidity and treatment were analyzed to provide the reference for the prevention, diagnosis and treatment.

Effect of low dose of dexamethasone combined with mannitol on early swelling of oral and maxillofacial injuries / 中国生化药物杂志

Objective To explore the effect of low dose of dexamethasone and mannitol on the early swelling of oral and maxillofacial injuries.Methods A total of 100 patients with oral and maxillofacial injuries who were treated in Huanggang City Center Hospital from February 2015 to January 2016 were divided into two groups by means of an envelope randomized group.Group 50 patients, group A patients received low doses of dexamethasone treatment, B group of patients on the basis of increased mannitol for treatment, compared the efficacy of both groups of patients with maxillofacial swelling improved.Results The clinical general improvement probability of group B was significantly higher than that of group A, and the distance between the horizontal direction and the vertical direction of group B was significantly higher than that of group A (P<0.05).Conclusion The combination of low dose dexamethasone and mannitol has a great effect on the early swelling of oral and maxillofacial injury, and it is worthy to be further implemented in the future clinical practice.

Maxillofacial Trauma Resulting from Physical Violence against Older Adults: A 4-year Study in a Brazilian Forensic Service

Objective: To evaluate the prevalence of maxillofacial trauma resulting from physical violence against older adults, describe patterns and identify factors associated with its occurrence. Material and Methods: This is a cross-sectional study conducted from the assessment of 7,132 reports of victims of violence who sought a Brazilian Service of Forensic Medicine and Dentistry, during the period from January 2008 to December 2011. Descriptive statistics, Pearson's chi-test square test and Poisson's univariate and multivariate regression (with robust variance) were performed using SPSS software version 20.0. The significance level was set at p <0.05. Results: A total of 259 older adults suffered physical violence. The occurrence of maxillofacial trauma was observed in 42.9% of the sample. Lesions in soft tissue (90.1%) affecting more than one region of the face (40.4%) were the most frequent. The prevalence of maxillofacial trauma was more frequent among individuals older than 66 years (PR = 1.166; 95% CI = 0.865- 1.572), males (PR = 1.119; 95% CI = 0.807-1.550), victims of violence occurred within the community (PR = 1.431; 95% CI = 0.951- 2.153), during the night shift (PR = 1.226; 95% CI = 0.911-1.651) and weekends (PR = 1.279; 95% CI = 0.955-1.714) performed without using blunt instrument (PR = 1.311; 95% CI = 0.932-1.846). Conclusion: The prevalence of maxillofacial trauma resulting from physical violence against older adults was high and soft tissue lesions affecting more than one face region were predominant.

Delayed Foreign Body Reaction Caused by Bioabsorbable Plates Used for Maxillofacial Fractures

BACKGROUND: Bioabsorbable plates and screws are commonly used to reduce maxillofacial bones, particularly in pediatric patients because they degrade completely without complications after bone healing. In this study, we encountered eight cases of a delayed foreign body reaction after surgical fixation with bioabsorbable plates and screws. METHODS: A total of 234 patients with a maxillofacial fracture underwent surgical treatment from March 2006 to October 2013, in which rigid fixation was achieved with the Inion CPS (Inion, Tampere, Finland) plating system in 173 patients and Rapidsorb (Synthes, West Chester, PA, USA) in 61 patients. Their mean age was 35.2 years (range, 15-84 years). Most patients were stabilized with two- or three-point fixation at the frontozygomatic suture, infraorbital rim, and anterior wall of the maxilla. RESULTS: Complications occurred in eight (3.4%) of 234 patients, including palpable, fixed masses in six patients and focal swelling in two patients. The period from surgical fixation to the onset of symptoms was 9-23 months. Six patients with a mass underwent secondary surgery for mass removal. The masses contained fibrous tissue with a yellow, grainy, cloudy fluid and remnants of an incompletely degraded bioabsorbable plate and screws. Their histological findings demonstrated a foreign body reaction. CONCLUSIONS: Inadequate degradation of bioabsorbable plates caused a delayed inflammatory foreign body reaction requiring secondary surgery. Therefore, it is prudent to consider the possibility of delayed complications when using bioabsorbable plates and surgeons must conduct longer and closer follow-up observations.

Pattern of Maxillofacial Fractures in Severe Multiple Trauma Patients: A 7-year Prospective Study

The incidence of facial trauma is high. This study has the primary objective of documenting and cataloging maxillofacial fractures in polytrauma patients. From a total of 1229 multiple trauma cases treated at the Emergency Room of the Santo Antonio Hospital - Oporto Hospital Center, Portugal, between August 2001 and December 2007, 251 patients had facial wounds and 209 had maxillofacial fractures. Aged ranged form 13 to 86 years. The applied selective method was based on the presence of facial wound with Abbreviated Injury Scale ≥1. Men had a higher incidence of maxillofacial fractures among multiple trauma patients (86.6%) and road traffic accidents were the primary cause of injuries (69.38%). Nasoorbitoethmoid complex was the most affected region (67.46%) followed by the maxilla (57.42%). The pattern and presentation of maxillofacial fractures had been studied in many parts of the world with varying results. Severe multiple trauma patients had different patterns of maxillofacial injuries. The number of maxillofacial trauma is on the rise worldwide as well as the incidence of associated sequelae. Maxillofacial fractures on multiple trauma patients were more frequent among males and in road traffic crashes. Knowing such data is elementary. The society should have a key role in the awareness of individuals and in prevention of road traffic accidents.

É alta a incidência de traumas na face. Este estudo teve por objetivo documentar e catalogar as fraturas maxilofaciais em pacientes com politraumatismos. De um total de 1229 casos de politraumatizados tratados na Sala de Emergência do Hospital de Santo António - Centro Hospitalar do Porto, Portugal, entre Agosto de 2001 e Dezembro de 2007, 251 pacientes tiveram ferimentos na face e 209 apresentaram fraturas maxilofaciais. As idades variaram de 13 a 86 anos. O método de seleção baseou-se na presença de ferimentos na face com Abreviated Injury Scale ≥1. Os homens apresentaram maior incidência de fraturas maxilofaciais (86,6%) entre os pacientes com múltiplos traumatismos na face e os acidentes de trânsito foram a causa principal dos traumatismos (69,38%). A região mais afetada foi o complexo naso-órbito-etmoidal (67,46%), seguido pela maxila (57,42%). O padrão e a apresentação das fraturas maxilofaciais tem sido estudado em muitas regiões do mundo com resultados variados. Pacientes com politraumatizados graves apresentaram padrões diferentes de traumatismos maxilofaciais. O número de traumatismos maxilofaciais tem aumentado à escala mundial, assim como a incidência das sequelas associadas. Entre os pacientes com traumatismos múltiplos, a maioria pertencia ao sexo masculino, assim como a causa mais frequente foram os acidentes automobilísticos. É elementar o conhecimento destes dados. A sociedade tem um papel primordial nos cuidados individuais e na prevenção dos acidentes de trânsito.

Perfil de gravedad lesional en el politraumatismo maxilofacial / Injuries severity profile in maxillofacial polytraumatism

Se realizó un estudio descriptivo y transversal de 525 pacientes con politraumatismo maxilofacial, atendidos en el Servicio de Cirugía Maxilofacial del Hospital Provincial Docente Clinicoquirúrgico "Saturnino Lora Torres", desde octubre de 2007 hasta septiembre de 2010, con vistas a determinar los niveles de gravedad lesional de estos politraumatismos, para lo cual se aplicó la nueva escala descriptora de lesión maxilofacial como soporte de la nueva puntuación de gravedad lesional. Hubo una elevada incidencia de los polilesionados por accidentes con participación de vehículos motorizados bajo ingestión de bebidas alcohólicas; la mayoría de ellos resultaron afectados en sus tejidos blandos o en una combinación de tejidos. Primaron las lesiones extendidas a más de un tercio de la cara, de 2 o más regiones afectadas, así como el nivel grave sin riesgo vital, que tributó a estadías y complicaciones mayores. Los pacientes operados tuvieron una gravedad lesional superior (20,7puntos) a los tratados con modalidad no quirúrgica (11,2 puntos).

A descriptive and cross-sectional study of 525 patients with maxillofacial polytraumatism, assisted in the Maxillofacial Surgery Service at "Saturnino Lora Torres" Teaching Clinical Surgical Provincial Hospital was carried out from October, 2007 to September, 2010, with the aim of determining the levels of injuries severity of these polytraumatism, for which the new descriptive scale of maxillofacial injuries was applied as a support to the new punctuation of injuries severity. There was a high incidence of poly-injured patients under the effects of alcohol due to motor vehicles accidents; most of them were affected in their soft tissues or had a tissue combination. The extended lesions to more than one third of the face, or of 2 or more affected regions prevailed, as well as the severe level without vital risk as a consequence of greater complications. The operated patients had a higher lesion severity (20,7puntos) to those treated with a non-surgical modality (11,2 points).

Maxillofacial Trauma Trends at a Tertiary Care Hospital: A Retrospective Study / 대한악안면성형재건외과학회지

PURPOSE: Maxillofacial fractures are rapidly increasing from car accidents, industrial accidents, teenaged criminal activity, and sports injuries. Accurate assessment, appropriate diagnosis, and preparing individual treatment plans are necessary to reduce surgical complications. We investigated recent trends of facial bone fracture by period, cause, and type, with the objective of reducing surgical complications. METHODS: To investigate time trends of maxillofacial fractures, we reviewed medical records from 2,196 patients with maxillofacial fractures in 1981~1987 (Group A), 1995~1999 (Group B), and 2008~2012 (Group C). We analyzed each group, comparing the number of patients, sex ratio, age, fracture site, and etiology. RESULTS: The number of patients in each period was 418, 516, and 1,262 in Groups A to C. Of note is the increase in the number of patients from Group A to C. The sex ratios were 5.6:1, 3.5:1, and 3.8:1 in Groups A, B, and C. The most affected age group for fracture is 20~29 in all three groups. Traffic accidents are the most common cause in Groups A and B, while there were somewhat different causes of fracture in Group C. Sports-induced facial trauma was twice as high in Group C compared with Group A and B. Mandible fracture accounts for a large portion of facial bone fractures overall. CONCLUSION: We observed an increase in facial bone fracture patients at Kyungpook National University Dental Hospital over the years. Although facial injury caused by traffic accidents was still a major cause of facial bone fracture in all periods, the percentage decreased. In recent years, isolated mandible fracture increased but mandible and mid-facial complex fracture decreased, possibly because of a reduction in traffic accidents.

Perfil dos traumas maxilofaciais em vítimas de violência interpessoal: uma análise retrospectiva dos casos registrados em um hospital público de Belo Horizonte (MG). / Profile of maxillofacial injury in victims of interpersonal violence: an analysis of retrospective cases registered in a public hospital in Belo Horizonte (MG), Brazil.

A violência está presente no cotidiano de cada brasileiro produzindo muitas vítimas com sequelas físicas e emocionais. O trauma maxilofacial é um tipo de trauma ocorrido na face e na cabeça e pode ser associado à exposição dessa região do corpo e a uma tentativa de desfigurar a face das vítimas de agressão. Este estudo avaliou o perfil dos traumas maxilofaciais resultantes de violência interpessoal em vítimas atendidas em um hospital público de referência para esse tipo de trauma em Belo Horizonte (MG). Foi executada coleta retrospectiva dos registros de vítimas atendidas no período de janeiro a dezembro de 2007. Foram encontrados registros de 484 vítimas, sendo que 61,6% eram homens e 38,4% mulheres. O principal evento foi agressão física (98,5%) e o tipo de trauma mais comum foi o trauma de partes moles (50,1%). Encontrou-se diferença significativa entre os gêneros; os homens estavam associados aos traumas causados por arma de fogo e as mulheres aos traumas decorrentes de agressão física (p=0,047). Predominaram as vítimas com idade entre 21 e 34 anos (46,0%) e o maior número de casos estavam concentrados nos finais de semana (44,6%).

Violence is present in the everyday life of every Brazilian, producing many casualties with severe physical and emotional consequences. The maxillofacial trauma is a type of trauma occurring in the face and head and can be associated with the exposure of this region of the body and with an attempt to disfigure the faces of the victims of aggression. This study evaluated the profile of maxillofacial injuries resulting from interpersonal violence of victims treated in a public hospital of reference for this kind of trauma in Belo Horizonte (MG), Brazil. The data was based on the retrospective collection of records of victims treated in the period of January to December 2007. There were records of 484 victims, of which 61.6% were men and 38.4% were women. The main event was physical aggression (98.5%) and the most common type of trauma was soft tissue trauma (50.1%). There was a significant difference between genders; men were associated with the trauma caused by firearms and women to physical injuries from physical aggression (p=0.047). The victims were between the ages of 21 and 34 (46.0%) and the highest number of cases happened on the weekends (44.6%).

The survey on oral health and maxillofacial trauma incidence of the sports players in Korea / 대한치과보철학회지

STATEMENT OF PROBLEM: In spite of increasing sports injury, there was no collected data on the rate and type of dental injuries for athletes in Korea. PURPOSE: The purpose of this study was to investigate the occurrence of maxillofacial injuries and attitude of college sports player in Korea towards mouthguard. MATERIAL AND METHODS: Total 617 athletes answered a series of questionnaire concerning their sports injury and using mouthguard. RESULTS: 1. 81%(502) of athletes had, playing or training a sports, suffered an injury. Female athletes suffered an injury more than male athletes(p<0.05). Contact sports athletes were injured more than non contact sports athletes(p<0.05). 2. 335 athletes(54.8%) had suffered maxillofacial injuries while playing or training. 81.8% of athletes suffered an maxillofacial injury in contact sports(p<0.05). 3. Laceration of oral area, wrick in neck, fracture or avulsion on upper incisors, concussion, TMJ injury, fracture or avulsion on lower incisors, fracture or avulsion on lower molars were frequently injured area. 4. 67.2% of athletes answered that mouthguard could prevent sports injury especially high in contact sports(p<0.05). But only 39.1% of athletes required mouthguard while playing. 44.6% of athletes showed their intention of using mouthguard. CONCLUSION: This study shows that the incidence of maxillofacial injuries is very high while the actual use of mouthguard is very low. To prevent sports injury, a dentist must inform sports players and coaches of accurate information about mouthguard so that they can use it well. A dentist also has to provide them with better mouthguard on the basis of user's complaint.