The Pattern of Maxillofacial Trauma & its Management

Abstract

Purpose: The descriptive study was undertaken to determine the pattern and different methods of treatment of maxillofacial fractures. Materials and Methods: Three hundred and twenty consecutive patients with maxillofacial trauma were treated in a tertiary care hospital in last three years. A review of patients' records and radiographs was conducted. Data regarding age, gender, cause of fracture, anatomic site and treatment modalities were reviewed. Results: The age range was 2-76 years (25±8) with peak frequency occurring in age group 21-30 years. The male to female ratio was 5.4: 1. The study indicated that (n=206; 64.7%) resulted from road traffic accidents (rtas) followed by fall (n=60; 18.8%), assault (n=26; 8.1%), sports (n=17; 5.3%), firearm injury [FAI (n=3; 0.9%)], industrial trauma (n=2; 0.6%) while 5cases (1.65%) were associated with other causes such as bomb blast, animal injury etc. The mandible was the most commonly involved (69.7%) followed by zygomatic complex [ZC (8.4%)], maxilla (5.3%), nasal bone (1.3%) and nasoethmoidal fractures (0.9%); in 14.4% of cases, more than one facial bone fracture occurred. Of mandibular fractures, body (30.3%) was the most common site followed by condylar region (24.2%). In midface fractures the ZC was the most susceptible area (48.2% of midface); of maxillary fractures, Le Fort I was the most common fracture (34.5%); the frequency of nasal (7.1%) & nasoethmoidal (5.4%) remained low. Most patients with mandibular fractures were treated by closed reduction surgery [eyelet wiring, arch bars with inter maxillary fixation (IMF) &splint fixation], only 18.9% of patients were treated with open reduction surgery (Interosseous &miniplates fixation). The maxillary fractures were mostly treated with suspension wiring while in ZC fractures Gillies' approach (37.9%) was the common method of management. Conclusion: This study reflects trauma patterns within the community and, as such, can provide a guide to the design of programs geared toward prevention and treatment.