Maxillofacial Fractures - A Review of 417 Cases

Abstract

Background: The incidence of facial injury has significantly increased in Taiwan due to a rising number of traffic accidents in recent years. Otolaryn-gologists may provide emergency care for patients who have sustained facial trauma. Knowledge of the anatomy of the facial skeleton and of the potential injuries associated with each of the various types of facial injuries will facilitate effective management. Methods: The medical records of 417 patients with maxillofacial fractures occurring in the 10-year period from 1989 through 1998 were reviewed. Data collected included patient demographics, causes of injury, treatments, and outcomes. The injuries were classified into seven treatment groups: nasal bone, maxillar, zygomatic arch, zygomatic complex, mandibular, nasofrontal-ethmoidal complex, and multiple fractures. Results: The average age of the study population was 37.6 years old (rang-ing from 5 to 86 years old); most of the cases resulted from motorcycle accidents (71%). Of the 417 patients, nasal bone fracture was the most common injury, affecting 171 patients (41.0%). Almost half of the patients, 192 (46%), were treated with closed reduction under local anes-thesia. Repair in most of the open reduction cases was performed under general anesthesia. Conclusions: Motorcycle accidents were the main cause of nasal bone, zygo-matic complex, zygomatic arch, and mandibular fractures. Our hospital is located in a rural area of Tainan where most traffic accidents are low-speed motorcycle crashes. In this series, the body is the most common site of all mandibular fractures because of the role of motorcycle accidents. In contrast, the condylar fracture is the most common fracture in other stud-ies since most of the injuries in those were due to car accidents.