Maxillofacial Fractures: A Three-Year Survey

Abstract

Background: Maxillofacial fractures constitute a substantial proportion of trauma globally. The main causes worldwide are road traffic accidents (RTAs), falls, assaults, sports, firearm injuries and industrial trauma. The highest incidence is commonly seen in the young age group with majority being male. The most common site in maxillofacial injuries is the mandible followed by the zygomatic complex, maxilla, and alveolar process. Maxillofacial trauma also poses a significant socioeconomic burden on affected individuals. Hence appropriate treatment and prevention of these morbidities and possible mortality is necessary. This study is therefore aimed at analyzing the prevalence, pattern of presentation of maxillofacial injuries at Lagos State University Teaching Hospital (LASUTH) in Western Nigeria.Methods: A retrospective review of 182 patients diagnosed and treated for maxillofacial injuries at the Oral and Maxillofacial Department of the LASUTH was conducted. Data were obtained from clinical notes and records of radiological findings noting patient's age, gender, etiologic factors (RTA, assault, sport, and fall), anatomic site of injury and different definitive treatment modalities. The data were analyzed by SPSS version 20 using various descriptive statistical tools. Mean and standard deviation were calculated for quantitative variable like age while frequency and percentage were calculated for qualitative variables like gender and site of fracture.Results: Majority of patients were male (72.0%) with a male to female ratio of 1:0.4. Most patients were between 31 and 40 (34.1%) years of age. RTA accounting for 73.1% of the injuries was the most common cause for maxillofacial injury followed by assault (19.2%). Majority of injuries due to RTA were of motorcycles accidents (33.6%). The most common sites of fracture out of 226 sites were in the mandible (62.8%, P = 0.003). Among the mandibular fracture sites, 28.2% affected the body of the mandible. Majority (31.9%) of the studied patients presented within 24 h (≤ 1 day). Out of the 182 patients, 68.1% were treated by close reduction.Conclusions: RTA represented the major etiological factor of maxillofacial injuries. The mandible remains the most affected bone of the facial skeleton. Closed reduction is the most common approach used for treatment.

Systematic Review and Meta-analysis of the Pattern, Distribution, Etiology, and Treatment of Maxillofacial Injuries From Different Geopolitical Zones in Nigeria

“…Earlier Nigerian workers reported the low rate of use of that treatment modality with reasons including scarcity of the equipment and materials for rigid xation and the prohibitive cost that contributes to treatment delay. 18,21 Table 1 showed that most patients were treated using closed reduction techniques such as intermaxillary xation, suspension wiring and other conservative measures alone [11][12][13]30,31 while a few utilized it in combination with rigid xation 21,41 often with satisfactory healing of the fractures. The goal of functionally, stable xation of facial bone fractures is a spectrum that varies based on anatomic factors and fracture morphology.…”

“…Additional ve full articles that met all inclusion criteria were identi ed from independent searches. A total of 35 articles 11,12,[21][22][23][24][25][26][27][28][29][30]13,[31][32][33][34][35][36][37][38][39][40]14,[41][42][43][44][15][16][17][18][19][20] met all inclusion criteria and were included in the qualitative analysis. Two articles 43,44 were excluded from the meta-analysis because they did not report on any one geopolitical zone, and therefore could not be combined with other studies.…”

“…Seventeen studies 11,12,[21][22][23][24][25][26][27][13][14][15][16][17][18][19][20] included participants from South-west (SW)Nigeria, eleven (11) 28,29,45,30-37 from South-south (SS) Nigeria, four [38][39][40][41] from North-west (NW) Nigeria, and one 42 from Southeast (SE) Nigeria. Among the seventeen studies from SW, one 13 included participants from both SW and NC but majority of participants (over 70%) were from SW, therefore the study was included in the SW group.…”

Maxillofacial Fractures: A Four-Year Retrospective Study of 1828 Cases in West China

“…In this study, mandibular fractures were the most common type of fracture, consistent with the findings of Soundarya et al [ 35 ]. and Adesina et al [ 36 ]. This may be related to the protruding nature of the mandible and its arch shape in the facial position [ 37 ].…”

Fractures of the mandible: Epidemiological study of 519 Nigerian cases

“…A prevalence rate of 15.9% in delayed presentation (8 days and above) was noted in this study, and this is similar to a prevalence rate of 16.6% in delayed facial fracture presentation previously reported. [ 16 ] However, a higher delayed presentation rate of 42.5%[ 17 ] and 41.2%[ 18 ] has been reported. Late presentation following mandibular fracture is influenced by several factors including late or nonrecognition by nonspecialist doctors, the ability of patient to maintain function such as chewing, the presence of associated injuries, financial limitations and distance to the nearest specialist health facility.…”