Medicolegal aspects of maxilofacial trauma associated with head injuries and its effect on the patients outcome in Upper Egypt: a retrospective study

Abstract

Introduction: Trauma is a serious health problem. Traumatic brain injury(TBI) is a significant health problem because it results in negative long-term or permanent physical and emotional changes. Trauma to the maxillofacial region needs special attention. Aim of the study: To study the medico-legal aspects of maxillofacial trauma cases associated with head injury over one year. Methodology: The current study is a retrospective study was performed in the Trauma Unit of Assiut University Hospitals, it included two groups, groupI: maxillofacial trauma patients only. GroupII: maxillofacial trauma patients associated with head injuries. The collected data included, socio-demographic data, medico-legal aspects of cases: cause, pattern and outcome of injuries. Types of maxillofacial fractures and types of head injury. Outcome of the cases. Results: Most of cases were in age group (18-40 years) and male-to-female ratios was (4:1) in both groups. Falling from height was the main cause of injury in groupI while in groupII it was motor cycle accident. As regards maxillofacial injuries, for both groups the most common injury was soft tissue injury. About 55.5 % of patients with head injuries had sustained cranial bone fractures. Concussion was the most common intracranial injury observed followed by intracranial hemorrhage. Only (34.5%) of groupI were required surgical treatment, while in groupII it was (60.3%). Concerning the outcome, a significant difference was found between both groups, improvement was the main outcome while death occurred only in 2.3% of groupI and 5.3% of groupII. Conclusion: In this retrospective study, there was a significant association between head injuries and maxillofacial trauma as number of maxillofacial trauma cases associated with head injuries were three times those with maxillofacial trauma only. So, every maxillofacial fracture patient must be carefully evaluated clinically and radiologically to rule out any underlying head injury and to decrease permanent infirmity and mortality rate.