Pattern of occurrence, presentation and management of mid-face fractures among patients attending the Muhimbili National Hospital, Dar Es Salaam, Tanzania

Abstract

Background: Mid-face fractures are a common occurrence among patients who are attended at the Muhimbili National Hospital (MNH). Despite the fact that quite often their management is carried out through a multidisciplinary approach, some patients end up with permanent complications.
 Objective: The main objective of this study was to determine the pattern of occurrence, presentation and management outcome of mid-face fractures among patients attending MNH in Dar es Salaam, Tanzania.
 Material and methods: A descriptive prospective hospital-based study was carried out at MNH for a period of one year, from May 2013 to April 2014. All patients with mid-face fractures were included in the study. They were interviewed using a structured questionnaire followed by a thorough clinical examination. Radiological imaging and basic laboratory investigations were done. Details were recorded in a special clinical form. Thereafter, patients were managed according to the MNH protocol. Data obtained were analysed using the Statistical Package for Social Sciences (SPSS) version 19.
 Results: Three hundred patients were enrolled in this study. The age range was from 6-62 years (mean of 29.64 ± 9.78), with the highest frequency in the 20-29-year age group and the female to male ratio was 1:10.5. Road traffic crash(RTC) was the most common cause of mid-face fractures accounting for 82% of the cases. Of the RTC, motorcycle accidents were predominant (63.9%).
 Five hundred and ninety-four mid-face fractures were recorded of which zygomatic complex fracture was the most (26.8%) prevalent. Definitive treatment was given to 79.7% of the patients. Closed methods were predominantly used. Among the patients who were treated 18% had one or more complications, the most (81.5%) common being aesthetic impairment.
 Conclusion: Road traffic crashes and in particular motorcycle accidents constituted the major cause of mid-face fractures. Young adult males were the main victims. Zygomatic complex fracture was the most frequently occurring mid-face fracture. The majority of fractures were treated by closed methods and the common complication was aesthetic impairment.