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1.
J Craniofac Surg ; 32(4): 1500-1503, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33852515

RESUMO

ABSTRACT: Oral and maxillofacial fractures are the most common injuries among multiple trauma. About 5% to 10% of trauma patients having facial fractures. The objectives of this case study are to focus the most common mid-face fractures types' and to determine the relationship of the midface fracture in maxillofacial trauma among the patient who attended the outpatient clinic in a Hospital Universiti Sains Malaysia. In this research paper, an advanced statistical tool was chosen through the multilayer perceptron neural network methodology (MLPNN). Multilayer perceptron neural network methodology was applied to determine the most associated predictor important toward maxillary bone injury. Through the predictor important classification analysis, the relationship of each bone will be determined, and sorting according to their contribution. After sorting the most associated predictor important toward maxillary bone injury, the validation process will be applied through the value of training, testing, and validation. The input variables of MLPNN were zygomatic complex fracture, orbital wall fracture, nasal bone fracture, frontal bone fracture, and zygomatic arch fracture. The performance of MLPNN having high accuracy with 82.2%. As a conclusion, the zygomatic complex fracture is the most common fracture trauma among the patient, having the most important association toward maxillary bone fracture. This finding has the highest potential for further statistical modeling for education purposes and the decision-maker among the surgeon.


Assuntos
Fraturas Maxilares , Traumatismos Maxilofaciais , Fraturas Cranianas , Fraturas Zigomáticas , Ossos Faciais , Humanos , Fraturas Maxilares/epidemiologia , Traumatismos Maxilofaciais/epidemiologia , Estudos Retrospectivos , Fraturas Cranianas/epidemiologia , Fraturas Zigomáticas/epidemiologia
2.
Rev Col Bras Cir ; 48: e20202581, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33470368

RESUMO

Understanding the cause, severity, and elapsed time for the restoration of the functions of maxillofacial injuries can contribute to the establishment of clinical priorities aiming at effective treatment and further prevention of facial trauma. The objective of this study was to understand the factors associated with the restoration of mastication, ocular, and nasal functions in the face of trauma victims, estimating their recovery time after surgical treatment. We analyzed 114 medical records of patients treated at the Hospital Montenegro, who attended follow-up consultations for up to 180 days. For analysis of the recovery time, we performed survival analysis, followed by COX analysis. We observed that half of the patients recovered their functions within 20 days. The average time for recovery from trauma in the zygomatic-orbital-malar-nasal complex was 11 days, and in the maxillary-mandibular complex, 21 days (HR: 1.5 [0.99 2.3], p = 0.055). Although functional reestablishment has reached high rates after the surgical approach, it is necessary to analyze the failing cases, as well as the economic impacts and the prevention strategies associated with facial trauma, to improve the service to the population.


Assuntos
Ossos Faciais/lesões , Fixação Interna de Fraturas , Fraturas Mandibulares/cirurgia , Fraturas Maxilares/cirurgia , Osso Nasal/cirurgia , Fraturas Orbitárias/cirurgia , Fraturas Cranianas/cirurgia , Fraturas Zigomáticas/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Criança , Ossos Faciais/cirurgia , Feminino , Humanos , Masculino , Fraturas Mandibulares/epidemiologia , Fraturas Mandibulares/etiologia , Fraturas Maxilares/epidemiologia , Fraturas Maxilares/etiologia , Pessoa de Meia-Idade , Osso Nasal/lesões , Fraturas Orbitárias/epidemiologia , Fraturas Orbitárias/etiologia , Recuperação de Função Fisiológica , Estudos Retrospectivos , Fraturas Cranianas/epidemiologia , Fraturas Cranianas/etiologia , Análise de Sobrevida , Adulto Jovem , Fraturas Zigomáticas/epidemiologia , Fraturas Zigomáticas/etiologia
3.
Facial Plast Surg Aesthet Med ; 22(4): 249-254, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32250646

RESUMO

Importance: The nasal bone is one of the most commonly fractured bones of the midface. However, the frequency of coincident fractures of adjacent bones such as the frontal process of the maxillary bone, nasal septum, and medial or inferior orbital walls has not been fully evaluated. Objective: The purpose of this study was to investigate the incidence of fractures of adjacent structures in the setting of a nasal bone fracture. Second, we propose a new classification system of nasal bone fractures with involvement of adjacent bony structures. Design, Setting, and Participants: One thousand, one hundred ninety-three patients with midfacial fractures were retrospectively reviewed. The characteristics of fractures of the nasal bone and the incidence of coincident fractures of the frontal process of maxilla, bony nasal septum, medial, or inferior orbital walls were analyzed. Exposure: All patients included in the study presented with nasal trauma. Main Outcomes and Measures: The coincident fractures of adjacent midfacial structures were assessed, and a new classification of midfacial fractures based on computed tomography (CT) scan images was proposed. Results: Among the 1193 cases, bilateral fractures of the nasal bone were most common (69.24%), and coexistent fracture of the frontal process of the maxilla and bony nasal septum was 66.89% and 42.25%, respectively. Coincident fracture of the orbital walls was observed in 16.51% of cases. The major etiology of fracture for the younger and elderly groups was falls, compared with assault as the most common etiology in the adult group. A classification scheme was generated in which fractures of the nasal bone were divided into five types depending on coexisting fractures of adjacent structures. Conclusions and Relevance: External force applied to the nasal bone can also lead to coexistent fracture of adjacent bony structures including the frontal process of the maxilla, nasal septum, and orbital walls. The proposed classification of nasal fracture based on CT imaging helps to incorporate coincident disruption of adjacent structures.


Assuntos
Traumatismo Múltiplo/diagnóstico , Osso Nasal/lesões , Fraturas Cranianas/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Incidência , Masculino , Fraturas Maxilares/classificação , Fraturas Maxilares/diagnóstico , Fraturas Maxilares/epidemiologia , Fraturas Maxilares/etiologia , Pessoa de Meia-Idade , Traumatismo Múltiplo/classificação , Traumatismo Múltiplo/epidemiologia , Traumatismo Múltiplo/etiologia , Septo Nasal/lesões , Fraturas Orbitárias/classificação , Fraturas Orbitárias/diagnóstico , Fraturas Orbitárias/epidemiologia , Fraturas Orbitárias/etiologia , Estudos Retrospectivos , Fraturas Cranianas/classificação , Fraturas Cranianas/epidemiologia , Fraturas Cranianas/etiologia , Tomografia Computadorizada por Raios X , Índices de Gravidade do Trauma , Adulto Jovem
5.
Biomed Res Int ; 2019: 9024763, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30895196

RESUMO

Background/Aim: Epidemiology of maxillofacial fractures (MFF) varies between populations. This study investigated the epidemiology of MFF treated at the Oral and Maxillofacial Surgery (OMFS) Unit, Hospital Universiti Sains Malaysia (USM). Methods: A retrospective review of 473 medical records of patients with MFF treated from June 2013 to December 2015 was conducted. Information on demographic characteristics of patients, aetiology of injury, types of MFF, and treatment was obtained. Descriptive analysis, Pearson's chi-squared test, and multiple logistic regression analysis were conducted. The level of significance was set at 0.05. Results: Most patients treated for MFF were males (82.2%), aged 30 and below (63.1%), and from Malay ethnic (97.4%). Road traffic accident was the most common cause of MFF (83.1%), with motorcycle accident accounting for most injuries (73.6%). Orbital wall fracture was the most frequent MFF type (51.2%). About half of MFF patients (51.4%) were treated conservatively. Patients aged more than 20 years old were at higher odds of sustaining orbital wall fracture (AOR= 1.76; 95% CI: 1.214-2.558; P= 0.003) but were at lower odds of sustaining mandibular fracture (AOR= 0.47; 95% CI: 0.315-0.695; P= 0.001) than patients who are 20 years old and younger. Helmet use among motorcyclists was significantly associated with the nasal, orbital wall, and maxillary sinus wall fractures (P= 0.006, 0.010, and 0.004, respectively). Conclusion: Motorcycle accident was the most common cause of MFF in Kelantan, Malaysia. Ages of patient and helmet use were associated with the type of MFF sustained. This study provides important information to facilitate the planning of MFF prevention strategies among motorcyclists and emphasizes the importance of using a helmet when riding a motorcycle.


Assuntos
Hospitais de Ensino/estatística & dados numéricos , Fraturas Mandibulares/epidemiologia , Fraturas Maxilares/epidemiologia , Acidentes de Trânsito , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Modelos Logísticos , Malásia/epidemiologia , Masculino , Fraturas Mandibulares/etiologia , Fraturas Mandibulares/terapia , Fraturas Maxilares/etiologia , Fraturas Maxilares/terapia , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
6.
J Feline Med Surg ; 21(4): 322-328, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-29792378

RESUMO

OBJECTIVES: The aim of this retrospective study was to describe the location and distribution of craniomaxillofacial (CMF) fractures in 45 cats presented to a veterinary referral centre between 2012 and 2017. METHODS: Cats with a history of head trauma, one or more CMF fractures and a pretreatment CT scan of the CMF region were included in this study. For the purpose of the study, the CMF skeleton was divided into 15 functional anatomical regions and the fracture sites were allocated to one of these functional regions. Statistical analysis was performed using R. RESULTS: Skull fractures were evident in 80.0% of cats, and mandibular fractures in 86.7% of cats in this study. The median number of anatomical functional regions affected was eight and there was evidence of moderate or strong correlation between fractures of different regions of the mid-face. Where fractures were recorded in the nasopharynx and orbit they were bilateral in 93.5% and 89.7%, respectively. Twenty-six (57.8%) of the cats had fractures affecting one or both temporomandibular joints, which included fractures of the mandibular fossa, condylar neck and condyle. Twenty-nine cats (64.4%) had tooth fractures and seven cats (15.6%) had significant eye injuries. CONCLUSIONS AND RELEVANCE: Cats presenting with a single symphyseal separation or parasymphyseal fracture are very likely to have further fractures at other locations. Fractures in the nasopharynx, orbit, nose, upper jaw, intermaxillary suture and zygomatic arch regions (the 'mid-face') are likely to occur together. The pattern of distribution of mandibular fractures is not as predictable as that for maxillary fractures. CT imaging is required to achieve a complete diagnosis of the location and distribution of skull fractures in cats after head trauma.


Assuntos
Doenças do Gato , Traumatismos Faciais , Fraturas Maxilares , Animais , Doenças do Gato/epidemiologia , Doenças do Gato/patologia , Gatos , Traumatismos Faciais/epidemiologia , Traumatismos Faciais/patologia , Traumatismos Faciais/veterinária , Fraturas Maxilares/epidemiologia , Fraturas Maxilares/patologia , Fraturas Maxilares/veterinária
7.
Niger J Clin Pract ; 21(12): 1570-1575, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30560819

RESUMO

Introduction: Midfacial fractures are extremely important oral and maxillofacial problems because they take varied forms and are frequently accompanied by major long-term esthetic or functional complications. Their etiology and epidemiology vary significantly in the literature, and the main causes are varied by population. The aim of this study is to identify the main traumatic etiology of midfacial fractures, along with the main categories of affected patients in our geographical area, in order to establish the need for measures that can prevent fractures in the future. Materials and Methods: We conducted a retrospective study over a 10-year period in 379 patients. Data were extracted from the patients' charts, and the following variables were taken into consideration: sex, age, environment of origin, education level, and traumatic etiology. Results: Midfacial fractures most frequently affected the 20-29 years age group (31.93%), male sex (n = 333, 87.86%, M:F = 7.23:1), patients from urban areas (n = 206, 54.35%), and patients without education (46.70%). The most frequent etiology was interpersonal violence (44.85%), followed by fall trauma (16.62%) and road traffic accidents (15.30%). Statistical correlations evidenced that urban environment favors midfacial fractures caused by interpersonal violence and road traffic accidents or sports injuries, while in rural areas, domestic accidents and animal attacks are predominant (P = 0.000). Conclusions: The overwhelming incidence of interpersonal violence in our population is currently a major public health problem. Implementing laws and initiating national programs for the prevention of interpersonal violence would lead to a considerable reduction of midfacial fractures in the Western Romanian population.


Assuntos
Ossos Faciais/lesões , Traumatismos Faciais/etiologia , Fraturas Ósseas/etiologia , Fraturas Maxilares/etiologia , Fraturas Orbitárias/etiologia , Violência/estatística & dados numéricos , Acidentes por Quedas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/etiologia , Criança , Traumatismos Oculares/epidemiologia , Traumatismos Oculares/etiologia , Traumatismos Faciais/epidemiologia , Feminino , Fraturas Ósseas/epidemiologia , Humanos , Incidência , Masculino , Fraturas Maxilares/epidemiologia , Pessoa de Meia-Idade , Fraturas Orbitárias/epidemiologia , Estudos Retrospectivos , Romênia/epidemiologia , Distribuição por Sexo
8.
Ulus Travma Acil Cerrahi Derg ; 24(3): 239-243, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29786819

RESUMO

BACKGROUND: This study aims to describe the major pterygoid plate fractures (PPFs) patterns unrelated to Le Fort fractures (LFFs) using maxillofacial computed tomography (CT). METHODS: After obtaining our hospital ethics committee approval (37-05), data for PPF were acquired from the medical records of all the trauma patients who were diagnosed using CT at our hospital from April 2014 to April 2017. RESULTS: Of the 178 patients, 135 (male/female = 86/49; mean age = 37.2 years) had LFF and 43 (male/female = 35/8; mean age = 38.6 years) had PPF without associated LFF. PPF patterns unrelated to LFF included temporal bone (11.6%), sphenotemporal buttress (25.5%), zygomaticomaxillary complex (30.2%), displaced mandible (23.3%), nasal (4.7%), and isolated fractures (4.7%). The etiologies of facial fractures were not significantly different between both sexes (p=0.576). No significant difference between Le Fort and non-Le Fort groups was found for age (p=0.603) and the causes of trauma (p=0.183). CONCLUSION: PPF is most commonly seen with LFF, but it may also be seen alone or with other non-LFF indicating that all PPF are not related to LFF. Axial reformatted CT images can easily display PPF and the degree of displacement of the fragments, and they can be used to guide surgical reduction of the fractures.


Assuntos
Fraturas Maxilares , Tomografia Computadorizada por Raios X , Adulto , Feminino , Humanos , Masculino , Fraturas Maxilares/diagnóstico por imagem , Fraturas Maxilares/epidemiologia , Estudos Retrospectivos
9.
Aust Dent J ; 63 Suppl 1: S35-S47, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29574816

RESUMO

The oral and maxillofacial region has a complex regional anatomy including hard and soft tissues. Trauma in this region may affect the airway, cause potentially life threatening bleeding and head injuries. The senses of olfaction, sight and hearing can also be disrupted as well as a profound psychological impact following disfigurement. This oral and maxillofacial trauma update provides information on demographics, incidence, pathophysiology, diagnosis, fracture patterns and management of facial trauma. It also discusses the role of new advancements in the management of facial trauma.


Assuntos
Traumatismos Maxilofaciais/terapia , Fraturas Cranianas/terapia , Adolescente , Adulto , Idoso , Austrália/epidemiologia , Criança , Feminino , Humanos , Incidência , Masculino , Fraturas Mandibulares/diagnóstico por imagem , Fraturas Mandibulares/epidemiologia , Fraturas Mandibulares/terapia , Fraturas Maxilares/diagnóstico por imagem , Fraturas Maxilares/epidemiologia , Fraturas Maxilares/terapia , Traumatismos Maxilofaciais/diagnóstico por imagem , Traumatismos Maxilofaciais/epidemiologia , Pessoa de Meia-Idade , Grupo com Ancestrais Oceânicos , Órbita/diagnóstico por imagem , Assunção de Riscos , Fraturas Cranianas/diagnóstico por imagem , Fraturas Cranianas/epidemiologia , Cirurgia Bucal , Tomografia Computadorizada por Raios X , Adulto Jovem , Zigoma/diagnóstico por imagem
10.
Med Oral Patol Oral Cir Bucal ; 23(2): e248-e255, 2018 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-29476683

RESUMO

BACKGROUND: The purpose of the present study was to evaluate changing pattern in characteristics of maxillofacial fractures and concomitant injuries in Western Libya During revolution and to assess the association between mechanism of injury and fracture patterns. MATERIAL AND METHODS: A retrospective review of medical records and radiographs of 187 patients treated for maxillofacial fractures from January 2010 to December 2012 was performed, there were 326 fractures in 187 patients. RESULTS: The male: female ratio was 6:1. Most fractures occurred in patients aged 11 to 40 years, and few injuries occurred in patients aged > 50 years. Most fractures occurred from motor vehicle accidents, and other most frequent causes included assault, gunshot, and fall injuries. Most maxillofacial fractures involved the mandible, zygomatic complex, or maxilla. Most mandibular fractures occurred at the parasymphysis, angle, or condyle. Associated injuries most frequently involved the head, chest, and extremities. Most patients were treated with open reduction (132 patients [71%]), and 26 patients (14%) were treated nonoperatively. There were 21 complications (11%). CONCLUSIONS: In summary, motor vehicle accidents were the most frequent cause of maxillofacial fracture in western Libya, possibly because of the lack of seat belt legislation. Interpersonal violence was a less frequent cause of maxillofacial fracture, possibly because of the religious restriction on alcohol consumption.


Assuntos
Ossos Faciais/lesões , Fraturas Mandibulares/epidemiologia , Fraturas Maxilares/epidemiologia , Traumatismos Maxilofaciais/epidemiologia , Fraturas Cranianas/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Distúrbios Civis , Feminino , Humanos , Lactente , Líbia , Masculino , Fraturas Mandibulares/etiologia , Fraturas Maxilares/etiologia , Traumatismos Maxilofaciais/etiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Fraturas Cranianas/etiologia , Adulto Jovem
11.
J Oral Maxillofac Surg ; 76(5): 1044-1054, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29291388

RESUMO

PURPOSE: Le Fort-type fractures are very rare in children, and there is a paucity of literature presenting their frequency and characteristics. The purpose of this study was to determine the etiology, frequency, and fracture patterns of children with severe facial trauma associated with pterygoid plate fractures in a pediatric cohort. PATIENTS AND METHODS: We performed a retrospective cohort study of all children aged younger than 16 years with pterygoid plate and facial fractures who presented to our institute between 1990 and 2010. Patient charts and radiologic records were reviewed for demographic and fracture characteristics. Patients were categorized into 2 groups as per facial fracture pattern: non-Le Fort-type fractures (group A) and Le Fort-type fractures (group B). Other variables including dentition age, frontal sinus development, mechanism of injury, injury severity, and concomitant injuries were recorded. Univariate methods were used to compare groups. RESULTS: We identified 24 children; 25% were girls, and 20.8% were of nonwhite race. Most presented with Le Fort-type fracture patterns (group B, 66.7%). Age was significantly different between group A and group B (mean, 5.9 years and 9.9 years, respectively; P = .009). No significant differences in Injury Severity Score, rate of operative repair, and length of stay were found between groups. CONCLUSIONS: Most children with severe facial fractures and pterygoid plate fractures presented with Le Fort-type fracture patterns in our cohort. The mean age of children with Le Fort-type fractures was greater than in those with non-Le Fort-type patterns. However, Le Fort-type fractures did occur in younger children with deciduous and mixed dentition.


Assuntos
Fraturas Maxilares/diagnóstico , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Maryland/epidemiologia , Fraturas Maxilares/epidemiologia , Fraturas Maxilares/etiologia , Estudos Retrospectivos
12.
J Craniomaxillofac Surg ; 46(2): 269-273, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29233697

RESUMO

PURPOSE: Zygomaticomaxillary complex (ZMC) fractures are frequent in facial trauma; only fractures of the mandible are more common. Although the frequency of these fractures is geographically consistent, the aetiology differs widely among countries and even regions. Differences in socio-economic status and the ageing population seem to be two causes. This retrospective epidemiological study evaluates patients who were surgically treated for ZMC fractures at a Swiss university clinic. MATERIALS AND METHODS: This study included 471 patients who were surgically treated for ZMC fractures in an oral and maxillofacial surgery clinic at a Swiss university hospital between January 2004 and December 2012. Complicated fractures such as LeFort II/III and bilateral ZMC fractures were excluded. Data on gender, age, and type of trauma were recorded. Fractures were classified by aetiology: motorised road traffic (car or motorcycle), bicycle, interpersonal violence, sports, falls (both less than and greater than 3 m in height) and other causes. RESULTS: A total of 350 patients were male (74%), and 121 were female (26%). The ZMC fractures were most likely to occur in the third decade (117 cases, 25%). A predominance of male patients was found in the young age groups, but an equal ratio was found in the elderly groups. Etiologically, falls of less than 3 m were the most common cause of ZMC fractures (125 cases, 27%). Interpersonal violence was second (88 patients, 19%); male patients dominated this group, which had a male-to-female ratio of 21:1. A predominance of male patients was found in every subdivision when analysing by aetiology and gender. The lowest proportion of males (57%) was found for falls of less than 3 m. CONCLUSION: In our study, interpersonal violence and falls outnumbered road traffic accidents among causes of maxillofacial fractures. This is probably a consequence of strict road and work laws. Additionally, the older and more active populations accounted for the highest proportion of falls, and young male patients were the predominant victims of ZMC fractures.


Assuntos
Fraturas Maxilares/etiologia , Fraturas Zigomáticas/etiologia , Acidentes por Quedas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Traumatismos em Atletas/epidemiologia , Criança , Feminino , Humanos , Masculino , Fraturas Maxilares/epidemiologia , Fraturas Maxilares/patologia , Fraturas Maxilares/cirurgia , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Suíça/epidemiologia , Violência/estatística & dados numéricos , Adulto Jovem , Fraturas Zigomáticas/epidemiologia , Fraturas Zigomáticas/patologia , Fraturas Zigomáticas/cirurgia
13.
Med Oral Patol Oral Cir Bucal ; 22(5): e616-e624, 2017 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-28809369

RESUMO

BACKGROUND: The epidemiology of facial injuries varies based on lifestyle, cultural background and socioeconomic status in different countries and geographic zones. This study evaluated the epidemiology of maxillofacial fractures and treatment plans in hospitalized patients in Northeast of Iran (2015-2016). MATERIAL AND METHODS: In this retrospective study, the medical records of 502 hospitalized patients were evaluated in the Department of Maxillofacial Surgery in Kamyab Hospital in Mashhad, Iran. The type and cause of fractures and treatment plans were recorded in a checklist. Data were analyzed with Mann-Whitney test, chi-squared test and Fisher's exact test, using SPSS 21. RESULTS: The majority of patients were male (80.3%). Most subjects were in 20-30-year age range (43.2%). The fractures were mostly caused by accidents, particularly motorcycle accidents (MCAs), and the most common site of involvement was the body of the mandible. There was a significant association between the type of treatment and age. In fact, the age range of 16-59 years underwent open reduction internal fixation (ORIF) more than other age ranges (P=0.001). Also, there was a significant association between gender and fractures (P=0.002). CONCLUSIONS: It was concluded that patient age and gender and trauma significantly affected the prevalence of maxillofacial traumas, fracture types and treatment plans. This information would be useful for making better health policy strategies.


Assuntos
Ossos Faciais/lesões , Ossos Faciais/cirurgia , Fraturas Maxilares/epidemiologia , Fraturas Maxilares/cirurgia , Fraturas Cranianas/epidemiologia , Fraturas Cranianas/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Planejamento de Assistência ao Paciente , Estudos Retrospectivos , Adulto Jovem
14.
J Craniomaxillofac Surg ; 45(8): 1319-1326, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28606439

RESUMO

PURPOSE: Maxillofacial fractures represent a serious public health problem. Their epidemiology is extremely variable, and its analysis is crucial to establish effective treatment and prevention of these injuries. However only two works have been published about maxillofacial fracture epidemiology in Italy. MATERIALS AND METHODS: The records of 1720 patients diagnosed with maxillofacial fractures in a 15-years period (2001-2015) in our department were retrospectively reviewed. RESULTS: A total of 1108 male and 612 female patients were included in the study. The most frequent aetiology of fracture was road traffic injuries (57.1%), followed by assault (21.7%), falls (14.2%), work accidents (3.5%), sport accidents (3.3%) and other causes (0.2%). Significant variations of aetiology were detected between males and females and between Italians and individuals from other countries. The most frequently observed fracture involved the mandible (861 cases, 36%), followed by zygoma (489 cases, 20.4%), orbital walls (386 cases, 16.1%) and maxilla (282 cases, 11.8%). CONCLUSION: Road traffic legislation enforcement and continuous public education regarding the use of security devices remain an ongoing problem in our region and should be encouraged. In the same way, as migration flows influence and change the epidemiology of facial traumas, it is crucial to establish social support programs that avoid these disadvantaged categories of victims of violence and crime.


Assuntos
Ossos Faciais/lesões , Fraturas Maxilares/epidemiologia , Fraturas Cranianas/epidemiologia , Adulto , Estudos Epidemiológicos , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Centros de Atenção Terciária , Fatores de Tempo
15.
Plast Reconstr Surg ; 139(6): 1453-1457, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28538576

RESUMO

BACKGROUND: Motorcycle helmet legislation has been a contentious topic for over a half-century. Benefits of helmet use in motorcycle trauma patients are well documented. In 2012, Michigan repealed its universal motorcycle helmet law in favor of a partial helmet law. The authors describe the early clinical effects on facial injuries throughout Michigan. METHODS: Retrospective data from the Michigan Trauma Quality Improvement Program trauma database were evaluated. Included were 4643 motorcycle trauma patients presenting to 29 Level I and II trauma centers throughout Michigan 3 years before and after the law repeal (2009 to 2014). Demographics, external cause of injury codes, International Classification of Diseases, Ninth Revision diagnosis codes, and injury details were gathered. RESULTS: The proportion of unhelmeted trauma patients increased from 20 percent to 44 percent. Compared with helmeted trauma patients, unhelmeted patients were nearly twice as likely to sustain craniomaxillofacial injuries (relative risk, 1.90), including fractures (relative risk, 2.02) and soft-tissue injuries (relative risk, 1.94). Unhelmeted patients had a lower Glasgow Coma Scale score and higher Injury Severity Scores. Patients presenting after helmet law repeal were more likely to sustain craniomaxillofacial injuries (relative risk, 1.46), including fractures (relative risk, 1.28) and soft-tissue injuries (relative risk, 1.56). No significant differences were observed for age, sex, Injury Severity Score, or Glasgow Coma Scale score (p > 0.05). CONCLUSIONS: This study highlights the significant negative impact of relaxed motorcycle helmet laws leading to an increase in craniomaxillofacial injuries. The authors urge state and national legislators to reestablish universal motorcycle helmet laws.


Assuntos
Traumatismos Craniocerebrais/epidemiologia , Traumatismos Craniocerebrais/prevenção & controle , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Motocicletas/legislação & jurisprudência , Prevenção de Acidentes/legislação & jurisprudência , Adulto , Estudos de Coortes , Bases de Dados Factuais , Traumatismos Faciais/epidemiologia , Traumatismos Faciais/prevenção & controle , Feminino , Escala de Coma de Glasgow , Humanos , Incidência , Masculino , Fraturas Maxilares/epidemiologia , Fraturas Maxilares/prevenção & controle , Michigan , Pessoa de Meia-Idade , Melhoria de Qualidade , Estudos Retrospectivos , Medição de Risco , Centros de Traumatologia , Adulto Jovem
16.
Oral Maxillofac Surg ; 20(4): 377-383, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27663240

RESUMO

BACKGROUND: Maxillofacial fractures occur in a significant proportion worldwide and can occur as an isolated injury or in combination with other severe injuries including cranial, spinal, and upper and lower body injuries requiring prompt diagnosis with possible emergency interventions. The epidemiology of facial fractures varies with regard to injury type, severity, and cause and depends on the population studied. Hence, understanding of these factors can aid in establishing clinical and research priorities for effective treatment and prevention of these injuries. MATERIALS AND METHODS: In this present retrospective study, we provide a comprehensive overview regarding cranio-maxillofacial trauma on 3611 patients to assist the clinician in assessment and management of this unique highly specialized area of traumatology. A preformed pro forma was used to analyze the medical records of patients treated for facial trauma in The Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai. The distribution according to age, gender, etiology, type of injury, time interval between accident and treatment, loss of consciousness, facial bones involved, pattern of fracture lines, treatment offered, and postoperative complications were recorded and evaluated. RESULTS: We inferred male patients sustained more injuries mostly in the third decade of age. Road traffic accidents were the most common cause of injury. Mandible was the most commonly fractured bone in the facial skeleton. Soft tissue injuries occurred more in road traffic accidents and upper lip was the commonest site of injury. CONCLUSION: Our study provides insights into the epidemiology of facial injuries and associated factors and can be useful not only in developing prevention strategies but also for grading the existing legal regulations and also for framing a more effective treatment protocol.


Assuntos
Traumatismos Maxilofaciais/diagnóstico , Traumatismos Maxilofaciais/epidemiologia , Fraturas Cranianas/diagnóstico , Fraturas Cranianas/epidemiologia , Acidentes de Trânsito , Adulto , Ossos Faciais/lesões , Ossos Faciais/cirurgia , Feminino , Fixação Interna de Fraturas , Humanos , Incidência , Masculino , Fraturas Mandibulares/classificação , Fraturas Mandibulares/diagnóstico , Fraturas Mandibulares/epidemiologia , Fraturas Mandibulares/cirurgia , Fraturas Maxilares/classificação , Fraturas Maxilares/diagnóstico , Fraturas Maxilares/epidemiologia , Fraturas Maxilares/cirurgia , Traumatismos Maxilofaciais/classificação , Traumatismos Maxilofaciais/cirurgia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Fraturas Cranianas/classificação , Fraturas Cranianas/cirurgia , Lesões dos Tecidos Moles/classificação , Lesões dos Tecidos Moles/diagnóstico , Lesões dos Tecidos Moles/epidemiologia , Lesões dos Tecidos Moles/cirurgia
17.
BMC Res Notes ; 9: 120, 2016 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-26905310

RESUMO

BACKGROUND: Maxillofacial fractures in children are less frequent compared to adults but result in special complications affecting the growth, function and esthetics. AIM: The study aimed at assessing the characteristics and the pattern of facial fractures among children seen at Khartoum Teaching Dental Hospital (KTDH). METHOD: The study included 390 patients presenting with maxillofacial trauma at KTDH during a year period (2010-2011). RESULTS: A total of 390 patients, diagnosed with facial fractures, were seen at KTDH; 14.1% (55) were children below 16 years of age with the mean age of 10 years (SD ± 3.9). The ratio of males to females was 2.2:1. Most fractures were due to road traffic accidents (RTA) 56.4%, followed by daily living activities 21.8% and assault 16.4%. The most prevalent anatomic sites of fractures were mandible 77%; combination fractures i.e. more than one site 32.7% and zygomatic-complex (13.5%). Concomitant injuries were found in 9.1%. Almost half of the patients were managed conservatively 49.1%, closed reduction 34.5% and surgical open reduction 16.4%. CONCLUSIONS: The findings of this study indicated that pediatric facial fractures constitute 14.1% of the total number of facial fractures. RTA was the main cause, which should be considered in legislative and preventive strategies.


Assuntos
Hospitais de Ensino/estatística & dados numéricos , Fraturas Mandibulares/epidemiologia , Fraturas Maxilares/epidemiologia , Fraturas Zigomáticas/epidemiologia , Acidentes Domésticos , Acidentes de Trânsito , Adolescente , Criança , Vítimas de Crime , Feminino , Humanos , Masculino , Fraturas Mandibulares/diagnóstico , Fraturas Mandibulares/cirurgia , Fraturas Maxilares/diagnóstico , Fraturas Maxilares/cirurgia , Estudos Retrospectivos , Sudão/epidemiologia , Fraturas Zigomáticas/diagnóstico , Fraturas Zigomáticas/cirurgia
18.
J Craniofac Surg ; 27(1): 109-11, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26703049

RESUMO

OVERVIEW: Cervical spine injury may present with pediatric patients having sustained fractures of the craniofacial skeleton. Management considerations of the cervical spine often take priority to the fractures of the facial skeleton. The goal of this study was to examine this subset of patients with a focus on initial presentation and need for intervention. METHODS: A retrospective review from 2000 to 2012 of all facial fractures in patients ≤ 18 years at a level 1 trauma center was performed. Patient demographics, location of fractures, and the presence of a cervical spine injury were collected. RESULTS: During this time period, 285 patients met inclusion criteria. Ten patients were found to have a cervical spine injury. Fractures of the zygoma and orbit were significantly associated with a cervical spine injury. Patients with a cervical spine injury had a Glasgow Coma Scale of 11.2 compared with 13.8 in those without (P < 0.05). C1 was injured in 4 patients, C2 in 2 patients, and C3 to C7 in 4 patients. A surgical airway was required in 1 patient, and 6 were intubated in the trauma bay. Fractures of the mandible were significantly associated with injury to C2. Le Fort fractures and palate fractures approached significance with injury to C1. Only 1 patient had neurologic impairment at presentation, manifested as upper extremity parasthesias, and underwent decompression and fusion in the operating room. Those patients admitted (90%) were all admitted for reasons other than management of the cervical spine injury. The majority of patients (70%) were treated with collar immobilization. One patient expired. No patients had a neurologic deficit at the time of discharge. CONCLUSIONS: In this study only 1 cervical spine injury necessitated intervention, with an eventual full recovery. Cervical spine injuries presenting with fractures of the facial skeleton appear to be relatively benign in this series; however, care must be taken to identify all such injuries to avoid exacerbation during maneuvers commonly used for facial fracture treatment. Special caution should be used when examining patients with a depressed Glasgow Coma Scale or in those with upper midface fractures.


Assuntos
Vértebras Cervicais/lesões , Ossos Faciais/lesões , Fraturas Cranianas/epidemiologia , Adolescente , Vértebra Cervical Áxis/lesões , Atlas Cervical/lesões , Criança , Feminino , Fixação de Fratura/instrumentação , Escala de Coma de Glasgow , Humanos , Masculino , Fraturas Mandibulares/epidemiologia , Fraturas Maxilares/epidemiologia , New Jersey/epidemiologia , Fraturas Orbitárias/epidemiologia , Palato Duro/lesões , Parestesia/epidemiologia , Estudos Retrospectivos , Fraturas Zigomáticas/epidemiologia
19.
J Craniomaxillofac Surg ; 43(10): 1948-51, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26427620

RESUMO

OBJECTIVE: The aim of the present study was to illustrate the injury patterns and the etiology of accident victims with maxillofacial fractures in the state of Mecklenburg-Western Pomerania (M-P), Germany. MATERIAL AND METHODS: Between 2010 and 2013, patients with maxillofacial fractures from the Department of Oral and Maxillofacial Surgery at the Helios Kliniken Schwerin, were evaluated with a specially constructed data set in a retrospective analysis. After review of the patient records, a case-related data collection was performed with the pre-set characteristics: age, gender, age group, maxillofacial fracture, and cause of injury. RESULTS: Of 409 patients, 79% (n = 323) were male and 21% (n = 86) were female. A fracture of the zygomaticomaxillary complex was most frequently observed (31%; n = 240). Midface fractures with orbital floor involvement were the most common fracture types (48.4%; n = 137). A significant percentage of the fractures (45.2%; n = 185) were caused by interpersonal violence; 70.8% (n = 131), and thus the majority of the patients who were treated due to a brutal offense, had consumed alcohol. Within this group, men in the age group of 20-29 years were most prevalent (38.7%; n = 125). Etiologically, 25.2% (n = 103) of fractures were caused by a fall. CONCLUSION: The regionalization of data on the distribution, emergence, and localization of maxillofacial fractures in M-P allows not only a national comparison but also an international comparison with areas that are in a similar strong socio-demographic change, as it applies to the East German population. This provides the opportunity to develop the global preventive measures and to apply suitable quality management.


Assuntos
Fraturas Maxilares/etiologia , Traumatismos Maxilofaciais/etiologia , Acidentes por Quedas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Adulto , Idoso , Feminino , Fraturas Ósseas/epidemiologia , Fraturas Ósseas/etiologia , Alemanha/epidemiologia , Humanos , Masculino , Fraturas Maxilares/epidemiologia , Traumatismos Maxilofaciais/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Violência/estatística & dados numéricos , Adulto Jovem
20.
Gac Sanit ; 29 Suppl 1: 30-5, 2015 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-26342421

RESUMO

OBJECTIVE: To characterize maxillofacial fractures due to traffic accidents in patients attending the Hospital Universitario San Vicente Fundación (Medellin-Colombia) from 1998 to 2010. METHODS: A descriptive study (n =1609) was carried out with information from the medical records of patients meeting the inclusion criteria established by the general objective of the study. The variables consisted of sex, age, year, type and number of fractures, and type of vehicle. A descriptive analysis of the variables was performed and the frequency of fractures due to traffic accidents was calculated according to year and sex. Crude and adjusted odds ratios (aOR) were estimated to establish associations among age, type of vehicle, and the presence of two or more fractures with stratification by sex. RESULTS: The frequency of maxillofacial fractures due to traffic accidents increased in 2007 (men: n=198, women: n=35) and decreased from 2008 to 2010 in both sexes. Fractures were more frequent in persons aged <35 years (80%) and in men (82%). The highest frequency of fractures was observed in motorists. Male users of motorcycles (aOR=1.41; confidence interval 95% [95%CI]: 1.02- 1.94) and bicycles (aOR=1.61; 95%CI: 1.01- 2.56) were more likely to report two or more fractures compared with pedestrians, after adjustment for other variables. CONCLUSIONS: Most maxillofacial fractures occurred in men and in motorists. Future studies should analyze other determinants affecting the epidemiology of maxillofacial fractures. Strategies should be designed to improve the use of protective elements and drivers' knowledge and practices.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Fraturas Mandibulares/epidemiologia , Fraturas Maxilares/epidemiologia , Fraturas Zigomáticas/epidemiologia , Adolescente , Adulto , Condução de Veículo/estatística & dados numéricos , Ciclismo/lesões , Colômbia/epidemiologia , Feminino , Fraturas Múltiplas/epidemiologia , Fraturas Múltiplas/etiologia , Humanos , Masculino , Fraturas Mandibulares/etiologia , Fraturas Maxilares/etiologia , Pessoa de Meia-Idade , Motocicletas/estatística & dados numéricos , Caminhada/lesões , Fraturas Zigomáticas/etiologia
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