Complicated Maxillofacial Fractures

Pullos, Alissa N.; Krishnan, Deepak G.

doi:10.1016/j.cxom.2019.05.003

Cited by 7 publications

(3 citation statements)

References 19 publications

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“…In 161 of the 231 patients with falls, the main fall mechanism was slipping, tripping or stumbling. As reported in the literature, the elderly tend to fall at home and experience low‐energy trauma 27,28,34 . In addition, the following causes, combined with the physiological consequences of ageing, lead to a greater frequency of falls: systemic comorbidities, drug intake, reduction of strength, balance and ability to avoid obstacles, reduced visual acuity and age‐related dementia 19,24,27,33 .…”

Section: Discussionmentioning

confidence: 99%

“…As reported in the literature, the elderly tend to fall at home and experience low-energy trauma. 27,28,34 In addition, the following causes, combined with the physiological consequences of ageing, lead to a greater frequency of falls: systemic comorbidities, drug intake, reduction of strength, balance and ability to avoid obstacles, reduced visual acuity and age-related dementia. 19,24,27,33 In addition, for any particular type of fall, skeletal injuries tend to have greater consequences in older patients than in younger patients.…”

Section: Ta B L Ementioning

confidence: 99%

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A multicentric prospective analysis of maxillofacial trauma in the elderly population

Bojino

Roccia

Carlaw

et al. 2022

Dental Traumatology

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Background/Aims The growth of the global elderly population will lead to an increase in traumatic injuries in this group, including those affecting the maxillofacial area, with a heavier load on health systems. The aim of this multicentric prospective study was to understand and evaluate the incidences, causes and patterns of oral and maxillofacial injuries in patients aged over 60 years admitted to 14 maxillofacial surgical departments around the world. Methods The following data were collected: gender, cause and mechanism of maxillofacial fracture, alcohol and drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score, associated injury, day of trauma, timing and type of treatment and length of hospitalization. Statistical analyses were performed using non‐parametric and association tests, as well as linear regression. Results Between 30 September 2019 and 4 October 2020, 348 out of 2387 patients (14.6%), 197 men and 151 women (ratio 1.3:1; mean age 72.7 years), were hospitalized. The main causes of the maxillofacial fractures were falls (66.4%), followed by road traffic accidents (21.5%) and assaults (5.2%). Of the 472 maxillofacial fractures, 69.7% were in the middle third of the face, 28% in the lower third and 2.3% in the upper third. Patients with middle third fractures were on average 4.2 years older than patients with lower third fractures (95% CI 1.2–7.2). Statistical analysis showed that women were more involved in fall‐related trauma compared with males (p < .001). It was also shown that road traffic accidents cause more fractures in the lower third (p < .001) and in the middle third‐lower third complex compared with upper third (p < .001). Conclusions Maxillofacial fractures in the elderly were more frequent in European and Australian centres and affected men slightly more than women. Falls were the leading cause of fractures, especially among women. The middle third of the face was most often affected, and conservative treatment was the most common choice for the management of such patients.

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Section: Discussionmentioning

confidence: 99%

Section: Ta B L Ementioning

confidence: 99%

A multicentric prospective analysis of maxillofacial trauma in the elderly population

Bojino

Roccia

Carlaw

et al. 2022

Dental Traumatology

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“…The second most frequent cause of facial trauma in our study was bicycle accidents, and this is consistent with earlier studies [ 39 ]. Indeed, bicycle-related accidents often lead to head and facial injuries, with facial injuries observed in 34% of cyclists admitted to the ED for their trauma [ 42 ]. In our study, bike accidents were significantly more frequent in men than in women.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of maxillofacial trauma in elderly patients receiving oral anticoagulant or antithrombotic medication; a Swiss retrospective study

Bettschen,

Tsichlaki,

Chatzimichail

et al. 2024

BMC Emerg Med

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Background The percentage of elderly trauma patients under anticoagulation and antiplatelet agents has been rising lately. As newer agents are introduced, each comes with its own advantages and precautions. Our study covered elderly patients admitted to the ED with maxillofacial trauma while on anticoagulation (AC) or antiplatelet therapy (APT). We aimed to investigate the demographic characteristics, causes, and types of maxillofacial trauma, along with concomitant injuries, duration of hospitalisation, haemorrhagic complications, and the overall costs of care in the emergency department (ED). Methods Data were gathered from the ED of Bern University Hospital. In this retrospective analysis, patients over 65 of age were included, who presented at our ED with maxillofacial trauma between 2013 and 2019 while undergoing treatment with therapeutic AC/APT. Results The study involved 188 patients with a median age of 81 years (IQR: 81 [74; 87]), of whom 55.3% (n=104) were male. More than half (54.8%, n=103) were aged 80 years or older. Cardiovascular diseases were present in 69.7% (n=131) of the patients, with the most common indications for AC/APT use being previous thromboembolic events (41.5%, n=78) and atrial fibrillation (25.5%, n=48). The predominant cause of facial injury was falls, accounting for 83.5% (n=157) of cases, followed by bicycle accidents (6.9%, n=13) and road-traffic accidents (5.3%, n=10). The most common primary injuries were fractures of the orbital floor and/or medial/lateral wall (60.1%, n=113), zygomatic bone (30.3%, n=57), followed by isolated orbital floor fractures (23.4%, n=44) and nasal bone fractures (19.1%, n=36). Fractures of the mandible occurred in 14.9% (n=28). Facial hematomas occurred in 68.6% of patients (129 cases), primarily in the midface area. Relevant facial bleeding complications were intracerebral haemorrhage being the most frequent (28.2%, n=53), followed by epistaxis (12.2%, n=23) and retrobulbar/intraorbital hematoma (9%, n=17). Sixteen patients (8.5%) experienced heavy bleeding that required emergency treatment. The in-hospital mortality rate was 2.1% (4 cases). Conclusions This study indicates that falls are the leading cause of maxillofacial trauma in the elderly, with the most common diagnoses being orbital, zygomatic, and nasal fractures. Haemorrhagic complications primarily involve facial hematomas, especially in the middle third of the face, with intracerebral haemorrhage being the second most frequent. Surgical intervention for bleeding was required in 8.5% of cases. Given the aging population, it is essential to improve prevention strategies and update safety protocols, particularly for patients on anticoagulant/antiplatelet therapy (AC/APT). This can ensure rapid diagnostic imaging and prompt treatment in emergencies.

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Evaluation of the SEVERITY of FACIAL and GENERAL TRAUMA in child and adolescent victims of traffic accidents

Xavier¹,

Meira²,

Lemos³

et al. 2023

Heliyon

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Complicated Maxillofacial Fractures

Cited by 7 publications

References 19 publications

A multicentric prospective analysis of maxillofacial trauma in the elderly population

A multicentric prospective analysis of maxillofacial trauma in the elderly population

Epidemiology of maxillofacial trauma in elderly patients receiving oral anticoagulant or antithrombotic medication; a Swiss retrospective study

Evaluation of the SEVERITY of FACIAL and GENERAL TRAUMA in child and adolescent victims of traffic accidents

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