A cross-sectional study of the prevalence and severity of maxillofacial fractures resulting from motor vehicle accidents in Riyadh, Saudi Arabia

Abstract

Objectives To investigate the prevalence and severity of maxillofacial fractures resulting from motor vehicle accidents (MVAs) at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia. Materials and methods A cross-sectional study of 325 males (89%) and 47 females (9%) was conducted that retrospectively reviewed records of patients referred to oral and maxillofacial surgery department from emergency department from 1st January 2016 to 31st December 2017 at KAMC, Riyadh. Results A total of 372 subjects were included in the study. MVAs (80%) were the most prevalent cause of trauma. The age range most susceptible to MVAs was between 20 and 24 years old (28%). The most common site of fracture was the midface (64%), specifically orbit (32%). For mandibular fractures, the subcondylar was the most common site of fractures (19%). The most common treatment approach was conservative (65%). In terms of severity, approximately half of patients needed admission to the intensive care unit (ICU) (50%); the mean score on the Glasgow Coma Scale (GCS) was 11.34, but most scores fell in the mild range; and (68%) of subjects presented with other associated systemic injuries, especially orthopedic injuries (36%). Conclusions MVAs were the main cause of trauma and affected mainly young males. The most common site of fracture was midface, specifically orbit. Subcondylar was the most prevalent fracture site for mandibular fractures. The severity of MVAs injuries was significantly higher compared to non-MVAs injuries. We suggest enforcing legislation and regulations on road safety such as the use of compulsory seat belts.

The Impact of Traffic Law Enforcement Regulations on the Incidence and Severity of Maxillofacial Injuries

“…9,10,18-20 Such high prevalence was attributed to the fact that men are more empowered in society, involved in more outdoor activities, and more likely to be involved in reckless driving compared to female drivers. 10,20 Furthermore, our reported mean age of the involved patient was 29.9 years, which is very much similar to the findings of published studies concluding that this age group is associated with increased self-dependence, high activity, and social interactions that may increase their susceptibility to reckless driving and more road usage. 9,10,[17][18][19][20] Regarding the location of the injury, published data from Saudi Arabia reported that most maxillofacial injuries were in the lower face with no reported occurrence in the upper face during both study periods, before and after the implementation of the Saher law enforcement system.…”

“…10,20 Furthermore, our reported mean age of the involved patient was 29.9 years, which is very much similar to the findings of published studies concluding that this age group is associated with increased self-dependence, high activity, and social interactions that may increase their susceptibility to reckless driving and more road usage. 9,10,[17][18][19][20] Regarding the location of the injury, published data from Saudi Arabia reported that most maxillofacial injuries were in the lower face with no reported occurrence in the upper face during both study periods, before and after the implementation of the Saher law enforcement system. 10 Our findings are in contrast to the work of Alasseri et al in that before the implementation of TLERs, lower face and mid-face injuries have an equal occurrence of 38.2% each and after the TLERs adoption, most of the injuries were of mid-face accounting for 57.3% followed by lower face at 36.4%.…”

“…[17][18][19][20][21] If we consider the injury location-based on the International Classification of Diseases (ICD-10) diagnosis, the mandible was the most commonly involved maxillofacial bone at both study periods, and this finding is supported by other published scientific data. 9,10,17,20,21 Assessing the severity of trauma is an important tool to estimate the risks of injury, survival probability and outcome prediction, plan for emergency and definitive treatment, predict health cost, and hospital length of stay (LOS). 10,21,22 For this purpose, many trauma severity scoring systems have been proposed and adopted over the past few decades.…”

“…This finding is in line with other published work indicating that more stringent traffic law regulations resulted in a significant reduction of RTAs and their related injuries. 8,10,[17][18][19][20] The present study showed a male predominance concerning RTA-related maxillofacial injuries during both study periods (mean 78.6%). This finding is similar to previously published regional and international studies that reported men being commonly involved in RTA accounting for almost up to 80% of these injuries.…”

Maxillofacial Bone Fracture Profiling amongst Adults and Elderly Population in Najran City, Southern Region of Saudi Arabia: A 20-Year Single Institutional Experience

“…Orbital fractures were observed as the fourth most common maxillofacial bone fractures with majority presenting as isolated orbital floor fractures. Similar findings have been reported in the literature [5,11,46]. Maxillofacial fractures can be treated with either closed reduction, ORIF or a combination of these methods.…”