Pattern of maxillofacial fractures

TLDR

In Iran, the pattern of maxillofacial fractures has remained unchanged over the past decade despite improvements in traffic safety. The study aimed to evaluate the demographics, prevalence, causes, fracture types, treatments, and complications of maxillofacial fractures in a nationwide multicenter cohort of 8,818 patients over five years. Researchers performed a retrospective chart review of 8,818 patients from 2007–2012 at 11 centers, collecting demographic and injury data, and analyzed the variables with t‑tests or chi‑square tests in SPSS, considering p < 0.05 significant. Mandibular fractures constituted 65.1 % of cases, were most common in males aged 21–30, predominantly caused by road‑traffic accidents, and were associated with neurosensory disturbances of the inferior alveolar and infraorbital nerves and other ocular complications.

Abstract

This multicenter study assessed the demographics, prevalence, causes, types, treatment, and complications of maxillofacial (MF) fractures managed by MF surgeons nationwide.This 5-year retrospective descriptive analytical chart study evaluated 8,818 patients treated for MF fractures from 2007 to 2012 at 11 medical centers. Parameters, including age, sex, cause of injury, site of injury, type of injury, fracture patterns, treatment modalities, and complications, were evaluated from patient charts and radiographs. Collected data were analyzed via t test or χ test using SPSS 20 (Chicago, IL). A p value of less than 0.05 was considered statistically significant. This retrospective chart study was exempt from institutional review board approval.There were 7,369 male patients (83.6%), 1,376 female patients (15.7%), and 73 patients (0.8%) of unknown sex (aged 6 months to 112 years); 39.54% (3,457 patients) were in the 21-year to 30-year age group (mean, 28.18 years). We found 5,737 mandibular fractures (65.1%); mandible fracture was the most common (p < 0.05), followed by maxillary (1,641, 18.6%), zygomatic (3,240, 36.0%), orbital floor (743, 8.4%), naso-orbitoethmoidal (472, 5.4%), nasal (848, 9.6%), and frontal (344, 3.9%) fractures. Road traffic accidents were the most common cause. Posttreatment documented complications included remaining neurosensory disturbance of the inferior alveolar nerve (16.01%) and the infraorbital nerve (15.5%), remaining neuromotor disturbance of the facial nerve (2.3%), blurred vision (2.43%), diplopia (3.2%), limitation of eye movement (1.6%), exophthalmoses (1.88%), blindness (0.8%), as well as postoperative infection and chronic osteomyelitis (1.0%).On the basis of our study, mandibular fractures, in males and resulting from road traffic accidents in the third decade of life, were significant findings. Although the prevalence of MF fractures, demographics, and causes vary from one country to another and awareness of these patterns can provide insight to prevention protocols, this study shows that, despite better law enforcement of traffic regulations, better roads, better automobiles, and the like, the pattern of MF fractures in Iran has not changed significantly during the past 10 years.Epidemiologic study, level IV.