Changing Pattern of Pediatric Maxillofacial Injuries at the Accident and Emergency Department of the University Teaching Hospital, Ibadan–A Four-Year Experience

Abstract

Introduction: Maxillofacial injuries are common among polytraumatized patients, and in Nigeria, the incidence seems to be on the increase. This probably is related to the drive of industrialization and the increase in the number of road traffic accidents. Delays in attending to severe maxillofacial injuries can be grave because of concomitant injuries that can be life threatening. Methods: This is a prospective review of maxillofacial injuries in patients <16 years of age who were seen at the Accident and Emergency Department between October 2002 and December 2006. In all the patients, the accident and emergency physicians carried out initial resuscitation, and thereafter, they were referred to the maxillofacial unit on call. Results: A total of 611 patients with maxillofacial injuries were seen during the study period and of this, 134 (22%) were <16 years old. The male:female ratio was 1.1:1.0. Road traffic accident (RTA) was the most common etiological factor in 73 (54.5%) cases, while gunshot injuries accounted for 6 (4.4%) cases. Soft tissue lacerations were the most common maxillofacial injuries occurring in 90 (55.9%) cases; mandibular fractures were the most common bony injury in 17 (13.4%). Conclusions:The upsurge in maxillofacial gunshot injuries in the pediatric age group is alarming and this may be a reflection of the global changes (westernization and drug-related offenses like armed robberies) and the harsh economic conditions in this community. Okoje VN, Alonge TO, Oluteye OA, Denloye OO: Changing pattern of pediatric maxillofacial injuries at the Accident and Emergency Department of the University Teaching Hospital, Ibadan-A four-year experience. Prehosp Disaster Med 2010;25(l):68-71.

Demographic and socioeconomic inequalities in the risk of emergency hospital admission for violence: cross-sectional analysis of a national database in Wales

“…In a Finnish study examining types of maxillofacial injury,39 74% of patients had a fracture, with nasal and orbital fractures the main type. Other studies of maxillofacial injuries have reported contusions and abrasions to be of frequent occurrence,40 41 while lacerations were reported more frequently in severe trauma episodes resulting from traffic accidents and gunshot injuries 42. In the present study, head injuries were more common among males, a finding supported by studies in India,37 Japan,43 Iran,44 Turkey45 and Finland39 among other countries 38…”

Distribution of Some Risk Factors Related to Soft Tissue Injuries in Dentoalveolar Traumas

“…Also, there was a statistically significant difference in the arrival time of the children with and without soft tissue injuries. Vuletić et al (20) reported that children with soft tissue injuries presented earlier for dental treatment (18). However, there was no difference in the presentation time of those with soft tissue injuries in our study.…”

“…In our study, soft tissue injuries and dentoalveolar injuries were common in mixed dentition, with the highest frequency found in children aged 8-10 years. As reported in the literature, children aged 1-4 years are most susceptible (among all ages) to accidents and have the highest number of soft tissue injuries (3,6,12,14,16,18). Studies have also reported that younger children who have a higher cranial vs. facial skeletal size, softer and more elastic bones, and protective thick soft tissues are more likely to be exposed to minor injuries, such as soft tissue injuries, whereas older children tend to be more susceptible to serious injuries (6,17,19).…”

“…Studies have also reported that younger children who have a higher cranial vs. facial skeletal size, softer and more elastic bones, and protective thick soft tissues are more likely to be exposed to minor injuries, such as soft tissue injuries, whereas older children tend to be more susceptible to serious injuries (6,17,19). Vuletić et al (20), found that soft tissue injuries peaked among preschool children aged two years (18). After the preschool period, the superego develops, and the child is exposed to disciplined training at school (19,21).…”

Pattern, severity, and management of cranio-maxillofacial soft-tissue injuries in Port Harcourt, Nigeria

“…[1] Causal factors of these injuries include road traffic accidents, interpersonal violence/homicidal injuries, domestic accidents, falls, gun-shots, bomb blasts, industrial accidents and other work/occupational related injuries, sports related injuries, animal injuries, suicidal, earthquake, and iatrogenic injuries. [1234567] However, the prevalence of the causes varies in different places and countries and also in prevailing circumstances. Motor cycle accidents occur more within the cities of many parts of Nigeria than vehicular accidents[4] because of the high unemployment rate, depressed economy and the struggle for survival, likewise for same reasons, gunshot injuries are usually on the increase especially toward the festive periods.…”