From the year 1982 to 1992, 760 cases (625 males, 135 females) with maxillo facial injuries were treated. Among them there were 384 cases of 21-30 years old. Traffic accidents were the main causes of casualty. 43.63% of cases were upper maxial fracture, more than lower fracture (34.66%). There were 45 cases of Leforrt simple type, among them 22 cases of sequellae. General systemic trauma combining with maxillo facial injury were in 42 cases, among them combined cerebral skull trauma had got the highest rate of 22 cases.
Diagnosis ; Maxillofacial Injuries ; Epidemiology

Objective: The study aimed to evaluate mandibular fractures in a tertiary military hospital, to determine the age group in which injury occurred most often, to examine the various mechanisms of injury, to determine the anatomical part of the mandible most frequently affected and to determine if there were significant relationships between the various mechanisms of injury and the different fracture sites. Methods: Design: Cross-sectional retrospective study Setting: Tertiary Public Military Hospital Patients: Medical records of 328 active military personnel and their dependents, treated for mandibular fracture at the Department of Otorhinolaryngology – Head and Neck Surgery, Armed Forces of the Philippines Medical Center from January 1999 – December 2009 were retrospectively reviewed for data regarding sex, age, various mechanisms of injury and fractured anatomical part of the mandible. The number of fractures per site according to mechanism of injury was tabulated and prevalence ratios (95% confidence intervals) and p values were computed for the different fracture sites among the various mechanisms of injury. The probability or risk of sustaining fractures in these sites based on mechanism of injury was then computed. Results: The most fractured anatomical part of the mandible was the body (28%), followed by the parasymphysis (24%), angle (17%), symphysis (12%), ramus (8%), condyle (7%), alveolar ridge (3%) and coronoid (1%). There were associated injuries in 54% of those with mandibular fractures. In these patients, zygomaticomaxillary complex fractures occurred in 25%, head and neck abrasions and lacerations in 30%, head injuries in 28%, ocular injuries in 10%, nasal fractures in 8% and cervical spine fractures in 5%. Other injuries present were extremity trauma in 60%, thoracic trauma in 5% and abdominal trauma in 3%. Males dominated with a ratio of 99:1. Males 21 to 30 years of age sustained the most mandible fractures. Most fractures were caused by vehicular accidents (60%), followed by gunshot wounds (31%), falls (4%), violent assault (4%) and sports activities (1%). Alcohol was a contributing factor at the time of injury in 20.6% of fractures. All cases were treated by open reduction and internal fixation with plating or wiring. Conclusion The body was the most commonly fractured anatomic region of the mandible in this series. There appeared to be a statistically significant relationship between violent assault and fractures of the ramus, but not between the other mechanisms of injury and the site of fracture. Its prevalence ratio of 3.32 (95% confidence interval: 1.13; 9.74, p value 0.039) suggests that the prevalence of fractures of the ramus among those exposed to violent assault was 3 times higher than those who were not.
Mandibular Fractures ; Maxillofacial Injuries ; Wounds and Injuries

Disasters ; Earthquakes ; Humans ; Maxillofacial Injuries ; therapy

Humans ; Maxillofacial Injuries ; therapy ; Patient Care Team

Disasters ; Earthquakes ; Humans ; Maxillofacial Injuries ; surgery ; Surgery, Plastic

Forensic Ballistics ; Humans ; Maxillofacial Injuries ; surgery ; Wounds, Gunshot ; surgery

Humans ; Maxillofacial Injuries ; diagnosis ; surgery ; Wounds, Gunshot ; diagnosis ; surgery

Humans ; Maxillofacial Injuries ; surgery ; Minimally Invasive Surgical Procedures

OBJECTIVEThis study aimed to compare the treatment effects of simultaneous surgical treatment and stage operation for patients with craniomaxillofacial fracture combined with other injuries.

METHODSFifty patients with maxillofacial fractures combined with other injuries were chosen and divided into simultaneous (28 patients) and staging (22 patients) operation groups. In simultaneous operation group, maxillofacial fracture reduction, internal fixation, and other parts of the surgery were simultaneously operated by relevant departments jointly. In the staging operation group, maxillofacial fracture reduction and internal fixation were performed after treatment of other injuries. Data on the treatment efficacy and associated injuries of the two groups were statistically analyzed.

RESULTSIn the simultaneous operation group, 26 patients had good occluding relation, the maximum mouth opening was (34.5 +/- 3.7) mm, the symmetry and shape of hard tissues recovered well, and the bone plate of one patient was removed because of internal fixation infection. In the staging operation group, 14 patients had good occluding relation, the maximum mouth opening was (28.5 +/- 3.5) mm, the symmetry and shape of hard tissues poorly recovered, and the bone plates of 5 patients were removed because of internal fixation infection. Statistical significance was determined among occluding relation, maximum mouth opening, postoperative complications, and length of stay of the two groups (P< 0.05). Treatment of the simultaneous operation group was more effective than that of the staging operation group.

CONCLUSIONWhen a patient's condition is relatively stable, simultaneous surgical treatment of multiple specialties should be conducted to treat craniomaxillofacial fracture combined with other injuries.

Since maxillofacial injury is frequently accompanied by other diseases, its evaluation and treatment are open delayed. When the evaluation is delayed, the surgical treatment can be difficult or impossible. A 21-yr-old man presented with right facial swelling and deformity after injury. We planned immediate surgical repair for his right tetrapod fracture, but the operation was delayed for two months due to severe hyperthyroidism. During the operation, we reducted and fixed the deviated bone after refracture of the zygomatic arch with an osteotome to achieve mobility. The facial deformity and difficulty in mouth opening were improved after the operation. Even in the presence of accompanying fractures, early evaluation and proper management can prevent complications and achieve acceptable cosmetic outcomes in maxillofacial trauma patients. In patients with malunion of fracture sites, fixation after refracture using an osteotome can be a good treatment option for obtaining good mobility.
Congenital Abnormalities ; Cosmetics ; Facial Injuries ; Fracture Fixation ; Humans ; Hyperthyroidism ; Maxillofacial Injuries ; Mouth ; Zygoma