Maxillofacial trauma in central karnataka, India: an outcome of 95 cases in a regional trauma care centre

Abstract

Materials and Methods A 6-year retrospective analysis of 111 patients treated for maxillofacial fractures in Davangere, Karnataka from January 2004 to December 2009 was performed. Variables like age, gender, occupation, type of fracture and mechanism of injury, concomitant injury, mode of treatment, and complications were recorded and assessed. Results Men between 21 and 30 years were mostly affected (male-to-female ratio = 10:1; age range = 17.60 years; mean 31.7 ± 9.8 [standard deviation]). Most fractures were caused by road traffic accidents (RTAs; 74.7%), followed by interpersonal violence (IPV; 15.8%), falls (4.2%), industrial hazards and animal attacks (2.1% each), and self-inflicted injury (1.1%). Forty-two cases were isolated zygomaticomaxillary complex (ZMC) fractures. The total number of facial fractures documented was 316, of which 222 were purely related to the ZMC; however, 11 were confined only to the midface. Fifty-three cases had concomitant lower jaw fractures, totaling 83. Ophthalmic injuries occurred in 30.52% of cases. Ninety-two cases were treated with open reduction and internal fixation (ORIF), and three cases were managed conservatively. The complication rate observed was 25.26%. Conclusion RTA continues to be the chief etiological factor in maxillofacial injury with males being affected predominantly. IPV and falls next contribute significantly to the incidence of such injuries. Concomitant injuries, however, require prompt recognition and appropriate management. ORIF still remains the mainstay of treatment; however, fixation devices are constantly being improved upon in an attempt to reduce immobilization time thereby facilitating early return to function with minimal morbidity. Nevertheless, future advances in maxillofacial trauma diagnosis and management are likely to reduce associated morbidity.

Keywords: ORIF; mandibular fractures; maxillofacial trauma; mid-face; zygomaticomaxillary fractures.

Figure 1

Etiology versus percentage of cases. RTA, road traffic accident.

Figure 2

Etiology, age, and gender distribution. RTA, road traffic accident.

Figure 3

Etiology, age, and gender distribution. RTA, road traffic accident.

Figure 4

Algorithm that summarizes the comprehensive management of maxillofacial fractures. GCS, Glasgow Coma Scale; CT, computed tomography; MRI, magnetic resonance image; ZMC, zygomaticomaxillary complex; ORIF, open reduction and internal fixation; ENT, ear, nose, and throat.