Facial fractures may be associated with concomitant lesions of other parts of body with some of these injuries being life-threatening. This retrospective study reports the types of associated injury and the factors influencing their occurrence, in patients with facial fractures. In 18.2% of 604 patients, one associated injury at least was recorded. The most common associated injury was cranial trauma (9.9%), followed by limbs fractures (9.1%), chest trauma (2%), spine injury (0.5%) and eye ball rupture (0.5%). A poly trauma was recorded in 3.2% of the patients who had sustained a cerebral trauma, a spinal injury or a thoracic trauma. Death occurred in two patients (0.3%) who had respectively a spinal injury and a chest trauma. The occurrence of associated injuries correlated significantly with the fracture type with solitary mandibular fracture being a significant predictor of associated injuries. Although not statistically significant, multiple facial fractures and violence were more associated with concomitant injuries. The findings of this study recall the need for initial full examination of the trauma patients particularly victims of violence, patients presenting with multiple facial fractures or single facial bone fracture involving the mandible, the trauma patients? multidisciplinary management as well as trauma prevention.

The method is easy to perform and is reproducible.

Education programs must focus on picking fruits and leaves in order to make them safe and prevent injuries related to these traditional or professional activities.

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Bilateral shoulder dislocations are a rare occurrence. 1-6 The two humeral heads dislocate from the scapular glenoid fossa in the same direction (bilateral symmetric shoulder dislocations or BSSD) or in different directions (bilateral asymmetric shoulder dislocations or BASD). There are three subtypes of BSSD (posterior, 1,2 anterior, 3 and inferior 4). BASD are classified as anteroposterior (one side anterior and the other side posterior) 5 or anteroinferior (one side anterior and the other side inferior). 6 Dislocations are acute or recent when recognized in the 21 days from the trauma. After 21 days, dislocations are called chronic or old. Bilateral symmetric posterior shoulder dislocations are the most common type since Cooper in 1839 1 and Myenter in 1902 2 reported the first cases. The literature found less commonly bilateral symmetric anterior shoulder dislocations (BSASD). 7 We report two cases of BSASD, one acute and one chronic case, both after epileptic seizures. We discuss the epidemiology, etiology, mechanism of injury, treatment, and outcome features through an extensive literature review of 133 BSASD reported cases. 3,7-118 2 | CASE HISTORY 2.1 | Case 1 A 30-year-old male patient complained of bilateral shoulder pain at our ED. The patient woke up at night on the ground, a few minutes after falling from bed, but with no recollection of the fall. He had no prior history of epilepsy nor diabetes. An inaugural epileptic grand mal seizure was suspected. At admission, he presented with bilateral shoulder sulcus signs with an inability to rotate his arm internally (Figure 1). The neurovascular status was normal at both shoulders. Bilateral shoulder AP and Bloom-Obata views revealed bilateral subcoracoid anteromedial glenohumeral dislocation without associated fracture (Figure 2). Closed reduction of both shoulders was performed under general anesthesia. With the patient in the supine position,

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-Introduction: Facial fractures epidemiology varies with geographic region. Patients and methods:This study reports the frequency, demographic characteristics and aetiologies of facial fractures in a 5-year retrospective survey, in Burkina Faso. Results: In 349 patients, the fracture involved the mandible (44.5%), the zygomatic complex (38.9%), the maxilla (13.8%) or the naso-fronto-orbito-ethmoidal complex (2.8%). The peak of frequency (58.2%) was recorded between 20 and 39 years and the male to female ratio was 7.1:1. The aetiologies of the fractures were road traffic crashes (80.5%), assaults (9.7%), falls (8.3%), and sport accidents (1.5%). In 80% of the road traffic accidents, a two-wheeled vehicle was involved and 75.9% of falls were from a tree height. There was a significant association between multiple facial fractures and road traffic accidents. Discussion: Epidemiology of facial fractures in this study is similar to that generally reported in developing countries. Frequency of falls from trees height constitutes however a particularity. These findings illustrate the necessity of enforcement of road traffic security, as well as a development of program of prevention of falls from trees, in Burkina Faso.Résumé -Épidémiologie des fractures faciales : l'analyse de 349 patients. Introduction : L'épidémiologie des fractures a une variation géographique. Patients et méthodes : Une étude rétrospective sur 5 ans rapporte la fré-quence, les caractéristiques démographiques et les étiologies des fractures faciales au Burkina Faso. Résultats : Chez 349 patients, la fracture intéressait la mandibule (44,5 %), le complexe zygomatique (38,9 %), le maxillaire (13,8 %) ou le complexe ethmoido-naso-fronto-orbitaire (2,8 %). Le pic de fréquence (58,2 %) était observé entre 20 et 39 ans et le rapport homme/femme était de 7.1:1. Les étiologies des fractures étaient les accidents de la circulation routière (80,5 %), les agressions (9,7 %), les chutes (8,3 %) et les accidents de sport (1,5 %). Dans 80 % des accidents de trafic, un véhicule à 2 roues était impliqué et 75,9 % des accidents par chute étaient des chutes du haut d'un arbre. Les fractures faciales multiples étaient significativement associées aux accidents de la route. Discussion : L'épidémiologie des fractures faciales dans cette étude est similaire à celle généralement rapportée dans les pays en développement. La fréquence des accidents par chute du haut d'un arbre constitue cependant une particularité. Ces résultats illustrent la nécessité d'un renforcement de la sécurité routière ainsi que d'un déve-loppement de programmes de prévention des accidents par chute du haut d'un arbres, au Burkina Faso.

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