Maxillary Bone Fractures Research Articles

Camel-Related Facial Injuries: A Seven-Year Retrospective Study.

Facial injuries caused by camels can be associated with adverse long-term effects on patients' quality of life. We aimed to investigate camel-related facial injuries in Al-Ain City, UAE, focusing on their incidence, types, mechanisms, anatomical distribution, and outcomes, to enhance preventive measures. We retrospectively collected data from all patients who were admitted to our hospital with camel-related facial injuries from January 2014 through January 2021. Thirty-six patients were included; all were males, with a mean (range) age of 31 (14-66) years, 29 (80.5%) were camel caregivers. The most common mechanisms of injury were falling while riding a camel and camel kicks. The head was the most commonly injured region in 52.7%. Twenty-three (63.8%) patients had facial bone fractures. The middle third of the face accounted for 71.4% of the bony fractures. The most performed surgical procedures in our patients were soft tissue laceration repair and open reduction with internal fixation of fractures (ORIF). Camel-related facial injuries affect young adult male camel caregivers working on camel farms. Orbital and maxillary bone fractures are the most predominant fractures requiring operative management. Legislation for compulsory helmet usage may reduce the incidence of these injuries and their serious consequences.

Isolated traumatic aniridia with full and partial iris expulsion in pseudophakic eyes

BackgroundTotal aniridia after ocular trauma without disruption of the intraocular lens (IOL) has been reported in patients with a history of small-incisional cataract surgery. We report one case each of total and partial aniridia after accidental falls experienced by two elderly Japanese women.Case presentationsCase 1. A 76-year-old woman with a history of small-incisional cataract surgery more than 10 years previously fell onto concrete and had a contusion that affected the left side of her face. At the initial visit, the best-corrected visual acuity (BCVA) was hand motions and the intraocular pressure (IOP) was 38 mmHg in her left eye (OS). A blood clot was present in the well-formed anterior chamber and expulsed iris tissue was seen beneath the conjunctiva. Exploratory surgery showed no scleral laceration other than the previous sclerocorneal tunnel. After hyphema removal, total aniridia and an intact in-the-bag fixed IOL were seen. By 4 months, the BCVA was 1.2 and the IOP was 13 mmHg OS. Case 2. An 88-year-old woman with a history of small-incisional cataract surgery more than 10 years previously had a fall that resulted in right-sided zygomatic and maxillary bone fractures. The BCVA was light perception and the IOP was 29 mmHg in her right eye (OD). Exploratory surgery showed no scleral laceration and the previous sclerocorneal tunnel was found; iris strand prolapsing from the sclerocorneal tunnel was seen. After hyphema removal, partial iris loss and an intact lens position were seen. By 1 week postoperatively, the BCVA was 0.05 OD and the IOP was 12 mmHg OD.ConclusionsIt has been postulated that previously created small-incision tunnels can function as release valves during blunt trauma by preventing further global rupture and limiting IOL prolapse or retinal injury. Our cases suggested this can happen even long periods after cataract surgery. The case with partial aniridia demonstrated the process of the expulsive aniridia, and its findings do not contradict the postulated mechanisms.

Prevalence, pattern and etiology of maxillofacial injury in chengalpattu india: a retrospective study

Introduction: Maxillofacial injures are affected by population, social and financial conditions. Increased and up-to-date knowledge about maxillofacial trauma may aid in the implementation of preventive strategies to reduce maxillofacial trauma. Aim: The objective of this research was to evaluate the prevalence, pattern, and etiology of maxillofacial trauma in patients treated at Chengalpattu Medical College and Hospital. Materials and methods: This retrospective study was conducted in the Department of Dental Surgery. Information on age and gender, etiology and mechanisms of trauma and facial bone fractures have been collected and analysed retrospectively to determine the prevalence, pattern and etiology of maxillofacial trauma. Results: This study included a total of 854 maxillofacial trauma patients. 90.3 percent of the overall trauma was attributed to maxillofacial fractures. There is a statistically significant association between gender and the etiology of study subjects with maxillofacial trauma. Fractures of the mandible (42.6 %) were significantly more frequent than malar and maxillary bone fractures (35.7%). Conclusions: It can be concluded that maxillofacial injuries occur mainly as a result of road traffic accidents with male predominance and that there is a significant association between gender and mechanisms of trauma in the prevalence of maxillofacial trauma.

Association of frontal and maxillary bone fractures and concomitant craniocerebral injuries in patients presenting with head trauma.

Maxillofacial fractures and craniocerebral injuries are common in patients with head trauma. These are injuries with high mortality and morbidity. Therefore, patients with head trauma should be evaluated early with a multidisciplinary approach. The association between frontal and maxillary bone fractures and concurrent craniocerebral injuries were investigated in patients presenting with head trauma in this study. The data of the patients were analyzed retrospectively. Age and gender distributions were evaluated in frontal and maxillary fractures. Concomitant craniocerebral injuries were investigated. Craniocerebral injuries were grouped as pneumocephalus, extra-axial, intra-axial injuries and brain edema. Craniocerebral injuries in frontal and maxillary fractures were compared statistically. Frontal bone and maxillary bone fractures were detected in 24% and 95% of the patients. Coexistence of pneumocephalus and intra-axial injuries in frontal bone fracture was statistically significant. The association of frontal posterior wall fractures with pneumocephalus and parenchymal contusion was found to be statistically significant. In addition, the association of craniocerebral injuries were evaluated and statistically significant ones were determined. The presence of maxillofacial fractures in patients presenting with head trauma increases mortality and morbidity. Craniocerebral injuries can be life-threatening and delay the treatment of facial fractures. Upper facial bone fractures are significantly more common in craniocerebral injuries.

Frequency of Maxillofacial Trauma and Accompanying Types of Maxillofacial Fractures

Purpose: In this study, it was aimed to examine the characteristics, causes of trauma, and age distribution of maxillofacial fractures in patients admitted to the emergency department as a result of blunt maxillofacial trauma. Patients and Methods: Between 01.01.2015-31.12.2019, 1248 patients who were admitted to the emergency department with maxillofacial trauma were evaluated retrospectively. Patients who underwent CT examination and were diagnosed with fracture were included in our study. Results: The median age of the patients was 32 years, and 71.2 % of them were male. Trauma-related fractures were detected in 239 (19.2%) of 1248 patients with maxillofacial trauma. The affected group of participants comprised of individuals of younger age and male gender. The main mechanisms of trauma were traffic accidents and falls from height. Orbital fractures were the most common, followed by maxillary bone fractures. Severe maxillofacial fractures were often accompanied by traumatic brain injuries. The mortality rate was low (0.4%) in patients with isolated maxillofacial trauma compared to patients with polytrauma (16%) ( p= 0.001). In our study, it has been shown that face AIS (Odds ratio: 2.79) and Glasgow coma score (Odds ratio: 0.98) can predict mortality in trauma patients with multivariable regression analysis. Conclusion: As a result of this study, we determined the relationship between variables associated with common traumatic injury in the maxillofacial region. Age, gender, and injury mechanism are of great clinical importance in the identification and prediction of traumatic maxillofacial fractures.

Virtual dissection table in diagnosis and classification of Le Fort fractures: A retrospective study of feasibility

ObjectivesThe usefulness of Virtual dissection tables (VDTs) as diagnostic tools is still poorly assessed.The purpose of this study was to evaluate their ability to improve the diagnostic accuracy of maxillofacial CT scans of patients presenting with Le Fort fractures. MethodsWe retrospectively enrolled 10 trauma patients who had previously undergone maxillofacial CT scan. Five of these patients had been diagnosed with type I, II or III Le Fort fractures, while the other five had not revealed any evident maxillary bone fractures (control group). Four different reader groups were identified: staff radiologists, senior residents, junior residents, and students. Each group consisted of two readers who carried out a blinded double reading session. Readers evaluated CT scans on the radiological workstation first, and after they reviewed the VDT-generated 3D models (Anatomage Table, Anatomage Europe, Italy). We assessed: 1) Le Fort fracture grade, 2) confidence in diagnosis, 3) anatomic resolution, 4) 3D-model handling. Intra-reader agreement on Le Fort fracture grade was assessed using Cohen's. Qualitative parameters were determined using Likert scale. ResultsIntra-reader agreement for Le Fort fracture grade according to Cohen's was above 90% in all readers. showed almost perfect agreement in 7 out of 8 readers and substantial agreement in 1 out of 8. Qualitative parameters indicated a substantial preference of the VDT over the radiological workstation in all readers. ConclusionsVDT represents a valuable tool for diagnosis and classification of complex maxillofacial injuries, regardless of whether the user is a student, a junior or senior resident, or a staff radiologist.

Dental evaluation specificity in orofacial damage assessment: A serial case study

IntroductionThe evaluation of medico-legal post-traumatic events has been increasing over the last decades. This study analysed the input of dental evaluation in orofacial damage assessment, highlighting the individual's biopsychosocial model, by a serial case study. It is aimed to analyse the physical as well as the psychological repercussions of traumatic events. It also aimed to relate the type of trauma impact with the individual's sequelae. Material and methodAn observational and retrospective study was carried out of Portuguese medico-legal database. A serial case study was distinguished by the direction of the impact: frontal striking, lateral striking and clashing with a bidirectional (frontal-lateral). Results and discussion7 cases fulfilled the inclusion criteria, as a pilot study. They have in common the involvement of the 2 lower thirds of the face, including the temporomandibular joint. The consolidation of the maxillary bone fractures does not always correspond to restituto ad integrum. ConclusionThe impact direction may guide clinical examination in detecting permanent impairment, emphasizing temporomandibular joint disorders, as well as their association with psychosocial repercussions. The medical-dental examination is differentiating and relevant to the accomplishment of the general objective of damage assessment.

A Clinical Study on 299 Cases of Nasal Bone Fractures

AbstractWe clinically investigated 299 cases of fresh nasal bone fractures diagnosed using computed tomography (CT) scan in our hospital between January 2008 and December 2017. The ages of the patients ranged from 2 to 93 years with an average of 29.4 years. There were 207 males and 92 females. The causes of the nasal bone fractures included sports (93 cases), falls (80 cases), blow or injuries (53 cases), violence or fights (40 cases), and traffic accidents (33 cases). Males in their teenage years accounted for the majority of cases, particularly in the sports-related injuries. In these cases, the most common cause was baseball (32 cases), followed by soccer (19 cases), softball (15 cases), basketball (8 cases), and so on. In the cases of traffic accidents, nasal bone fractures were caused by bicycles (18 cases), cars (10 cases), motorcycles (2 cases), and so on. Elderly males and females accounted for high numbers of falls. The external appearance of the nasal bone fractures were divided into three types: the displacement type (171 cases), depressed type (96 cases), and mixed type (32 cases). CT scan revealed nasal septum fractures in 132 cases (44.2%). Complicated facial bone fractures, apart from nasal septum fractures, were found in 35 cases (11.7%, mainly blow-out and maxillary bone fractures). In total, 221 cases (73.9%) underwent closed reductions of the nasal bone fracture. Of these, 206 cases (93.2%) were treated under general anesthesia and in 131 cases (59.3%), open reduction of the nasal septum fractures was mainly performed. In the cases of nasal bone fractures combined with nasal septum fractures, open reduction of the nasal septum fractures was helpful for the recovery of the nasal obstruction and nasal deformity.

Severe open bite due to traumatic condylar fractures treated nonsurgically with implanted miniscrew anchorage

This case report illustrates the use of miniscrews to treat a patient with an open bite caused by mandibular condylar fractures. The patient was 36 years old when she visited our hospital with a chief complaint of difficulty with chewing. She had suffered condylar and maxillary bone fractures in a traffic accident 6 months before her visit. She had an anterior open bite and Angle Class II molar relationships. Her mandibular midline was deviated to the right relative to the maxilla. The cephalometric analysis showed a skeletal Class II relationship. Titanium miniscrews were implanted in the bilateral maxillary buccal areas. The maxillary dentition was retracted and intruded by using elastomeric chains and miniscrews. After this treatment, an Angle Class I molar relationship was achieved, her overjet and overbite became ideal, and a good facial appearance was obtained. The total active orthodontic treatment period was 33 months. Treating an open bite with molar intrusion often leads to counterclockwise rotation of the mandible; however, in this patient, the mandible was moved anteriorly and upward. We believe that this movement was caused by the patient's condylar fractures and the subsequent remodeling. Although there was some relapse, our results suggest that implant anchorage is useful for correcting anterior open bites originating from condylar fractures.

Risk factors associated with facial fractures

The aim of the present study was to identify risk factors for facial fractures in patients treated in the emergency department of a hospital. The medical charts of 1121 patients treated in an emergency ward over a three-year period were analyzed. The independent variables were gender, age, place of residence (urban or rural area) and type of accident. The dependent variables were fractured mandible, zygoma, maxilla, nasal bone and more than one fractured facial bone. Statistical analysis was performed using the chi-square test (a < 0.05), univariate and multivariate Poisson distributions and the logistic regression analysis (p < 0.20). Maxillofacial trauma was recorded in 790 charts (70.5%), with 393 (35.1%) charts reporting facial fractures. Motorcycle accidents were found to be the main risk factor for mandibular fractures (PR = 1.576, CI = 1.402-1.772) and simultaneous fractures of more than one facial bone (OR = 4.625, CI = 1.888-11.329) as well as the only risk factor for maxillary bone fractures (OR = 11.032, CI = 5.294-22.989). Fractures of the zygomatic and nasal bones were mainly associated with accidents involving animals (PR = 1.206, CI = 1.104-1.317) and sports (OR = 8.710, CI = 4.006-18.936), respectively. The determinant for the majority of facial fractures was motorcycle accidents, followed by accidents involving animals and sports.

Mortalidade por acidentes de trânsito e ocorrência de fraturas maxilofaciais

The aim of this study was to evaluate the mortality due to traffic accidents and the occurrence of maxillofacial fractures in the city of Campina Grande, PB, Brazil. In this cross-sectional study, medical reports of adult victims of traffic accidents collected from the Department of Forensic Medicine (Numol) in Campina Grande were reviewed. The sample consisted of 273 medical forensic reports of victims of traffic accidents in 2005. The following variables were analyzed: sex, age, day and time of accident, type of death cause, number of injuries, region of the injury (head and face), maxillofacial fracture, dental avulsion and fractured facial bones. In the studied population, traffic accident victims were young men driving motorcycles who presented multiple injuries. The head and face regions were often involved and maxillary bone fractures were frequent

Maxillary nerve block in management of maxillary bone fractures: Our experience.

Background and Objectives:The objective of this study is to evaluate the intraoral high tuberocity maxillary nerve block technique in zygoma and arch fracture reduction and fixation.Study and Design:This study was carried out at Arvind Multi-Specialty Hospital, Namakkal, Tamil Nadu on seven male patients with zygomatic bone and arch fracture.Materials and Methods:Intraoral high tuberocity maxillary nerve block administered in seven patients for management of isolated zygomatic bone and arch fracture. Lidocaine 2% measuring 4 mL with 1:80000 adrenaline anesthetic solutions was used to anesthetize maxillary nerve through a 3.2 cm length and 24G, needle. The following parameters were evaluated namely onset of anesthesia, nerve block duration, outcome of treatment and Patient's comfort.Results:The blocks were effective and patients were comfortable without pain during initial stage of surgery, but in latter stages two patients had mild to moderate pain. Duration of block varied from 60 to 90 min while onset varied from 3 to 10 min. There were vascular punctures in three patients, however, without hematoma.Conclusions:The maxillary nerve block is a good alternative option in selective cases of zygomatic bone fracture reduction.

弘前大学耳鼻咽喉科における過去８年間の上顎骨々折２６症例の検討

Socio-medical factors in maxillary bone-fractures were investigated statistically in 26 patients. Although incidence of facial irjury increased annually, the increase in the incidence of maxillary bone-fractures for the past 8 years did not parallel that of nasal bone-fractures.Surgery for maxillary bone-fbacture should be performed not only for cosmetic plasty but also to improve dysfunction. Our results suggested that sufficient improvements of the maxillo-mandibular dysfunction could be obtained by surgery performed within 2 weeks after the injury, and surgery for the disturbance of eye-movement should be performed in accordance with the indication of operation for the blow out fracture.