Abstract
BackgroundMaxillofacial fractures are of great medico-legal implications because they are of common occurrence with other injuries, predominantly head injuries that might involve serious esthetic and functional problems, and so clinically described as consequential injuries. The aims were to assess the medico-legal aspects of maxillofacial fractured cases concomitant with closed head injury over a 6-year period (2011–2016) in the Trauma Unit of Assiut University Hospitals, Egypt, and to evaluate the demographic feature and the trend of different patterns of such fractures.Patient and methodsA descriptive hospital-based study included all cases of maxillofacial fractures combined with closed head injury attending the Trauma Unit of Assiut University Hospitals in the period of January 2011 to December 2016.ResultsThe study included 1221 cases, the percent of maxillofacial fractures with a closed head injury was 4%, the age group 18–40 years was having the highest incidence, and mean age was 25.9 ± 15.3 years with male to female ratio of 7:1. Road traffic accidents were the main etiology of injury (69.7%), followed by falls (15.1%) and violent assaults (10.2%) while firearm injuries were the last (5%). Unintentional injuries were the commonest in 83.1% followed by homicidal (16.3%); only 7 cases were due to suicidal attacks. The mandibular fracture was the commonest (49.7%) followed by fracture maxilla (19.2%), fracture zygoma (16.8%), and lastly frontal bone and nasal fracture. The trend of maxillofacial fractures over the 6-year period tended to be increased with the highest number in 2011 (21.5%) and the lowest in 2014 (13.3%).ConclusionMaxillofacial fracture with a closed head injury in Upper Egypt is common in the middle age with male predominance. Road traffic accident is the main etiologic factor, and accidental trauma is the commonest manner. Mandibular fractures are the commonest pattern followed by fracture maxilla. Traumatic head injuries in cases of maxillofacial fractures were mild in about half of the cases. The trend of maxillofacial fractures over the 6-year period of the study (2011–2016) tended to be increased with the highest number in 2011 and the lowest in 2014.
Highlights
Maxillofacial fractures are of special medico-legal implications as they are considered medico-legal cases and a part of poly-trauma conditions
The percent of maxillofacial fractures was 4%
Different patterns of maxillofacial fractures were present as mandibular fracture was the commonest one (49.7%) followed by fracture maxilla (19.2%), fracture zygoma (16.8%), and lastly frontal bone fracture and nasal and naso-ethmoid fracture (9.1% and 5.2%) respectively
Summary
The descriptive hospital-based study includes 1221 cases of maxillofacial fractures with a closed head injury that attended the Trauma Unit of Assiut University Hospitals, Egypt, between January 2011 and December 2016. Violent assaults/fights and firearm injuries occurred most in age ≥ 40 years (15.6% and 7.3%, respectively) (Fig. 2). Regarding the different pattern of MFF, mandibular fracture has the highest incidence of occurrence (49.7%) with a trend followed the maxillofacial fractures trend (Fig. 5)
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