The Epidemiology and Management of Maxillofacial Fractures at a Tertiary Care Hospital in a Conflict-Torn Region in Somalia

Abstract

The etiology of maxillofacial fractures (MFFs) varies according to the geographical location and density of the population. This study aimed to analyze the etiology, pattern, and treatment of MFFs. Epidemiological characteristics and treatment modalities of MFFs have never been evaluated in Somalia. The study included 45 patients who were operated on for MFFs at a tertiary care hospital in Somalia (2018Somalia ( -2019. Patient demographics, fracture causes, types, associated non-facial injuries, treatment modalities, and hospitalization-time were evaluated. The most common etiological factors of the MFFs were explosion (24.4%) and assault (24.4%), followed by gunshot (22.2%), sports accident (15.6%), motor vehicle accident (11.1%), and fall from height (2.2%) patients, respectively. The main site of injury was the mandible bone (64.4%) followed by nasal bone, maxilla, zygomatic, and orbital region. The most common non-facial injuries of the MFFs were soft tissue laceration (37.8%) followed by femoral fracture (6.7%), clavicle fracture (4.4%), and femoral fracture with chest injuries (2.2%). The most applied treatment was open reduction microplate þ/À intermaxillary fixation (77.8%). Due to the size of the mandible fractures, an iliac autograft (6.7%) was performed. The mean length of the hospital stay was 11.8 AE 8.4 days (range, 1-45 days), and some patients (15.6%) needed intensive care due to severe injuries. This will be the first study aiming to analyze the etiology, pattern, and treatment of MFFs in Somalia. This study deals with the social aspects of Somalia, and it shows that MFFs develop as a result of highly interpersonal violence in a young man.

Repercussions of the COVID-19 pandemic on the epidemiology of facial fractures: a retrospective cohort study

“…Facial fractures were more frequent in males in both cohorts, 84.2% in 2019 and 81.19% in 2020, corroborating with other authors [ 16 , 21 ]. Activities performed by men are more likely to incidents, high-risk driving, interpersonal conflicts, and radical sports, leading to greater risks of facial fractures [ 7 , 22 ].…”

Endoscopic Endonasal Removal of Stray Bullets in the Fossa Pterygopalatine in Innocent Young Bystanders of Conflicts in Somalia in a Period of Six Months

“…21 Tekin et al stated in another study conducted in a Conflict-torn region in Somalia that 22.2% of the maxillofacial fractures were caused by bullets. 5 Bullet injuries are generally seen in those who are actively involved in conflict regions and where firearm injuries occur. Besides, there are children and young people affected by stray bullets.…”

“…In a study conducted in 2003, it was stated that 19.7% of the maxillofacial injuries that occurred during the war between Iran and Iraq were caused by bullets 21 . Tekin et al stated in another study conducted in a Conflict-torn region in Somalia that 22.2% of the maxillofacial fractures were caused by bullets 5 . Bullet injuries are generally seen in those who are actively involved in conflict regions and where firearm injuries occur.…”

“…4 In Somalia, 22.2% of facial fractures are caused by firearm injuries. 5 As a result of such firearm injuries, removal of foreign bodies is usually a surgical challenge due to either difficult access or close anatomical relationship of the foreign body with vital structures, or both. Moreover, normal anatomy is often altered due to tissue damage in firearm injuries, tearing of surrounding tissues along the path of the bullet, tissue compression, and temporary cavitation.…”

“…The death rate due to current civil aggression, conflicts, and terrorist attacks in Somalia is 4.1%, 3 and the life expectancy is 52 years 4 . In Somalia, 22.2% of facial fractures are caused by firearm injuries 5 . As a result of such firearm injuries, removal of foreign bodies is usually a surgical challenge due to either difficult access or close anatomical relationship of the foreign body with vital structures, or both.…”