Through the ages-Aetiological changes in maxillofacial trauma.

Abstract

The number of patients suffering maxillofacial trauma remains constant although the affected patients become older. The aim of this study was to illuminate the patterns of maxillofacial fractures in a University Medical Centre and to analyse potential changes in patient population and treatment methods during a 5-year period. In a retrospective analysis, the records of 573 patients with maxillofacial fractures treated in a level one trauma centre from January 2010 to December 2014 were analysed with regard to gender, age, date and time of hospitalization as well as discharge, aetiology, type of fracture, surgery details, complications and further injuries. Causes were subdivided into assaults, falls, epileptic seizure, work-related, traffic accident by car or bicycle, sport-associated or others (eg caused by explosions, horse kicks or unknown). The most common causes for fractures were assaults (28.8%; n=165), followed by falls (23.9%; n=137), although falls became the main reason for maxillofacial fractures in 2013 and 2014. The mean age for patients suffering from facial fractures due to falls was significantly higher compared to those injured by other causes. Most commonly, fractures of the zygomatico-maxillary complex with or without orbital floor involvement were seen (31.6%; n=291) followed by fractures of the mandible (20.6%; n=190) and fractures of the nose (15.2%; n=140). Most patients were treated surgically (89.5%; n=513) even though an increase in non-surgical treatment was found over the examination period, especially in older patients. Maxillofacial fractures are mostly seen in younger male patients. Assaults were the main pattern of injury during the whole examination period, although falls became the main cause in older patients over the last 2years.