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Results for “Maxillofacial Injuries”

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PubMed2004

Patterns of maxillofacial injuries related to interaction with horses.

PURPOSE: Studies of trauma patients have described patterns of injuries sustained from unfortunate encounters with large animals. However, the patterns of maxillofacial injuries have yet to be reported. The goal of this investigation was to describe and report on maxillofacial injuries that are associated with interaction with horses. PATIENTS AND METHODS: Charts were selected from the trauma registry by E-code at a level 1 trauma center in Portland, OR. A retrospective review was performed on charts collected from the previous 5 years (1998-2002). Data were collected according to patient, pattern of injuries, and mechanism of injury. RESULTS: The 62 patients who were identified consisted of 15 males (24%) and 47 females (76%) and ranged in age from 1 to 83 years (average age, 32 years; most frequent age, 12 years). Most of the accidents occurred in the spring months and involved a horse known to the patient. The most common mechanism was falling from the horse. However, being kicked was correlated with a more serious injury (P =.048). The most frequent injury was abrasion/contusion (24 [39%]), second were lacerations (20 [32%]), and third were fractures (18 [29%]). Fifty (81%) were not wearing helmets. Forty-six (74%) of the patients had other associated injuries. CONCLUSIONS: In patients with facial injuries related to horses, younger females were the most frequently involved. Facial injuries were often associated with other types of injuries. Nearly a third of the facial injuries sustained were fractures. The percentage of riders without a helmet was high. However, in our patient population, wearing a helmet does not seem to add any protection to the face, and almost all of the accidents involved a horse known to the patient. More education aimed at horse owners regarding the use of helmets, proper handling and riding skills, and supervising young riders is encouraged to prevent further injuries.

Accidents↗
PubMed2004

[Preliminary proposal of the severity score system for maxillofacial injuries].

OBJECTIVE: A new injury severity score system was proposed in this study to evaluate maxillofacial injuries. METHODS: Based on AIS-90, all clinical samples were given diagnosis. Their month opening limitation, malocclusion and facial deformity were recorded as indices in scoring system. Severity injury scores for different groups and types were statistically. analyzed. RESULTS: It was demonstrated that there was a significant difference in scores between injuries of soft tissue and bone tissue and between different fracture groups. CONCLUSIONS: The proposed scoring was system useful to predict the cost of medical care and the days of in-patient, reliable, sensitive and specific in evaluation the maxillofacial injury severity.

Adolescent↗
PubMed1996

Maxillofacial injuries in the multiply injured.

A survey of patients with maxillofacial injuries (MFI) was carried out in a triaged cohort of multiply injured patients (n = 802) evacuated from accident scenes by the helicopter emergency medical service (HEMS). Despite intubation at accident scenes, some patients required further airway protection on arrival at hospital. One hundred and ninety-six patients (24.5%) had MFI and 90 (11.2%) were classified as severe with ISS of facial region > 2 or more severe (ISS up to 16, median 4). The latter group were commonly found to be associated with other severe injuries (median ISS of 36) leading to death in 41 patients (5.1% of the total). Out of the 196 multiply injured patients with MFI, 57 (29%) had diagnostic peritoneal lavage for suspected haemorrhage, 27 (14%) subsequently underwent laparotomy. Six (3%) had thoracotomies and 29 (15%) had chest drains inserted. Seventeen (9%) had emergency craniotomies and 14 (7%) required intracranial pressure monitoring. Orthopaedic injuries were most commonly associated with MFI and 91 patients (46%) underwent surgical interventions. The purpose of the present study was primarily to establish a database for MFI patients with multiple injuries. The longer term objective being to gain evidence for early definitive management of these complicated cases rather than the more traditional expectant policies. In our view delayed management of MFI can rarely correct all the consequent facial deformities.

Adolescent↗
PubMed1993

Observations on the use of rectally administered diazepam for sedating children before treatment of maxillofacial injuries: report of nine cases.

The use of diazepam in solution, administered per rectum, as an adjunct to treatment of paediatric maxillofacial injuries, has not been previously reported. Its use in a series of nine cases is described. The authors recommend this route of administration as an alternative form of management in the treatment of maxillofacial injuries in anxious children.

Administration, Rectal↗
PubMed1999

The circumstances and scope for prevention of maxillofacial injuries in cyclists.

A prospective study of cyclists with maxillofacial injuries attending Accident and Emergency departments in South Wales was carried out over a 12 month period. 65% of the 104 accident victims were aged under 14 years, and 81% were male. Only 14% were wearing helmets. Injuries were mapped to 9 facial zones. Nearly half the victims sustained injury to the central facial zone. There was an association between head injury (HI) and the location of impact on the face (p < 0.0001 Chi-square = 41 df = 8), the nature of the accident (p < 0.012 Chi-square = 10.9 df = 3), and type of injury in the impact zone (p < 0.007 Chi-square = 13.4 df = 4). More patients with facial injuries but without facial bone fractures sustained HIs than those with fractures. The facial skeleton may protect the brain by absorbing impact. The high incidence of midface injuries could be reduced by incorporating a facebar in helmet design.

Adolescent↗
PubMed1989

Trends in maxillofacial injuries in war-time (1914-1986).

In view of evidence of increasing ophthalmic injury in modern warfare we examined available data for evidence of any changes in the incidence of head and neck injuries since 1914. Although data concerning maxillofacial injuries were available for only five of 26 conflicts, we could find no evidence of increasing incidence of head and neck injury. Overall mean incidence of head and neck injury was 16%; greater than expected in terms of random wounding and the proportion of whole body surface area (12%). Data from the Falklands Campaign and Northern Ireland indicate that 3-8% of all casualties sustained middle or lower third fractures of the facial skeleton. Specialists who have expertise in maxillofacial surgery therefore remain an indispensable part of casualty care in modern warfare. Terrorist activity appeared to give rise to more head and neck injury than either rural attack or minor or major conventional war.

Blast Injuries↗
PubMed1996

Maxillofacial injuries scale.

This new proposed maxillofacial categorization is based on the scoring of two groups: Group I and Group II. The information obtained in Group I permits evaluation of (1) life-threatening injuries; (2) maxillofacial etiological factors producing life-threatening injuries; and (3) other organ or anatomic areas that may also have been injured. This information permits a fast and correct categorization of the patient before hospitalization and helps achieve transportation to an adequate hospital in an adequate amount of time and adequate treatment. Using the score obtained for Group II categorization, the functional and aesthetic severity of soft tissues (skin, mucosa, scalp), skeletal facial areas, and other important tissues (e.g., facial nerve, ocular globe, palpebral tissues) is determined. The final score resulting in Group II categorization is based on three grades of different severity: Grade I (minor), 1 to 6; Grade II (moderate), 7 to 24; and Grade III (grave), greater than 25. By means of Group II categorization the following can be evaluated: (1) type and severity of functional and aesthetic lesions; (2) adequate timing of treatment; (3) convenient treatment; (4) type and severity of functional and aesthetic sequelae; and (5) probability of successful treatment of sequelae.

Humans↗
PubMed1992

Maxillofacial injuries following steering wheel contact by drivers using seat belts.

Maxillofacial injuries are common sequelae in road traffic accidents. For the restrained driver, impact against the steering wheel is the most prevalent cause of injury. A sample of drivers restrained by seat belts with facial injury caused by the steering wheel was taken from data at the Accident Research Unit, University of Birmingham, UK. Two hundred and forty facial injuries occurred in 135 drivers, and these are described. Superficial contusion, laceration and nasal fractures predominated. There were 504 injuries at other body regions, and these were often caused by other vehicle components. These were, for 57% of drivers, no more serious than the facial injury caused by steering wheel contact. The role of steering wheel design in maxillofacial trauma is discussed and new solutions briefly reviewed.

Abbreviated Injury Scale↗
PubMed2000

Maxillofacial injuries in the pediatric patient.

Approximately 22 million children are injured in the United States annually. Children are uniquely susceptible to craniofacial trauma because of their greater cranial-mass-to-body ratio. The pediatric population sustains 1% to 14.7% of all facial fractures. The majority of these injuries are encountered by boys (53.7% - 80%) who are involved in motor vehicle accidents (up to 80.2%). The incidence of other systemic injury concomitant to facial trauma is significant (10.4% - 88%). The management of the pediatric patient with maxillofacial injury should take into consideration the differences in anatomy and physiology between children and adults, the presence of concomitant injury, the particular stage in growth and development (anatomic, physiologic, and psychologic), and the specific injuries and anatomic sites that the injuries affect. This comprehensive review, based on the last 25 years of the world's English-speaking surgical literature, presents current thoughts on the anatomic and physiologic differences between adults and children, a synopsis of childhood growth and development, and an overview of state-of-the-art management of the pediatric patient who has sustained maxillofacial injury.

Accidents, Traffic↗
PubMed1989

[Emergency care in maxillofacial injuries].

We present the methodology of the emergency care in maxillofacial injuries, mainly the preservation of vital functions and the control of the general condition of the patient. Definitive care will follow the emergency care measures.

Critical Care↗
PubMed1996

Maxillofacial injuries in a group of South Africans under 18 years of age.

OBJECTIVE: To find out the incidence of maxillofacial injuries in South African children aged 18 years or less. DESIGN: Retrospective study of casenotes. SETTING: Six teaching hospitals affiliated to the University of Witwatersrand, Johannesburg, serving a population of about 5 million people. SUBJECTS: All 326 children treated for facial injuries in the maxillofacial and oral departments of the six hospitals between 1 January 1989 and 30 June 1992. MAIN OUTCOME MEASURES: Classification of the types of injury, associated injuries, cause of the injury, and methods of diagnosis. RESULTS: Of the total of 4192 patients of all ages treated for facial injuries, 326 (8%) were within the age range of the study. The female:male ratio was 1:2.3. Most of the injuries (227, 70%) occurred in the 13-18 age group, and assaults, fights and gunshot wounds accounted for 155 injuries (48%). Of the 326 children, 173 (53%) had single injuries and 153 (47%) had multiple injuries. Mandibular fractures were the most common (64%) followed by maxillomandibular fractures (25%). Violence was the most common cause of injury, as in the USA and Zimbabwe, but unlike the rest of the world in which it is motor vehicle accidents. Soft tissue injuries were the most common associated injuries, and conventional plain radiography was the usual investigation. CONCLUSION: The incidence of 8% compares favourably with those in other countries, but far too many injuries are the result of violence.

Accidents, Traffic↗
PubMed1986

[Sports and maxillofacial injuries: etiological and clinical aspects apropos of 46 cases. Preventive measures].

Maxillofacial injuries due to sporting activities represent approximately 10% of all cases of injury admitted to the University Hospital Center, Lyon, France, and more than half of these occur in football or rugby players. The causes of these accidents (blows against another player, the ground, the field equipment or the game accessories) are discussed. Lesions are generally simple in young, fit adults and results of surgical treatment satisfactory, apart from the rare cases of facial disruption. Preventive measures include examination for aptitude for sporting activities, adequate referring of games and the wearing of helmets, masks and inter-maxillary protective bars.

Adult↗
PubMed1978

Maxillofacial injury.

This chapter has emphasized the relative infrequency of severe skeletal maxillofacial injuries in children. When they do occur, it is extremely important that they be approached by a team of physicians, each of whom is competent to manage the injury and complications related to his specialty. Particular attention must be given to the issues of general facial bone growth as well as future dental development. All operative procedures must be designed to avoid further injury to unerupted teeth, and the traditional methods of immobilization must be modified in order to avoid the avulsion of deciduous teeth.

Child↗
PubMed1997

Management of maxillofacial injuries in the Iran-Iraq War.

PURPOSE: This study discusses types of maxillofacial injury, their treatment, and complications encountered in the Iran-Iraq war. PATIENTS AND METHODS: During 1981 to 1986, 210 casualties were treated with 250 operations in Mostafa-Khomeini hospital in Tehran. Their records were analyzed retrospectively. The operations were mostly reconstructive and consisted of methods adopted because of available instruments of that time. RESULTS: Mandibular defects were the most prominent kind of injury (43.2%), and approximately two thirds of them needed tracheostomy. Ophthalmic injuries represented 20% of midfacial injuries. Osteomyelitis was a common complication of primary phases of treatment. CONCLUSION: The inability to evacuate and promptly treat patients with gunshot wounds can result in complications, especially infections, that make the later phases of treatment difficult.

Adolescent↗
PubMed2006

Motorcycle-related maxillofacial injuries among Nigerian intracity road users.

PURPOSE: We sought to determine the etiology and pattern of motorcycle-related maxillofacial injuries among intracity road users in Nigeria. PATIENTS AND METHODS: We conducted a prospective review of all patients presenting at the maxillofacial surgery units of the Obafemi Awolowo University Teaching Hospital Ile-Ife and Usmanu Dan Fodiyo University Teaching Hospital Sokoto with motorcycle-related injuries. RESULTS: One hundred seven patients were included in the study. A significant male preponderance was observed (P = .002). Overall, the peak age incidence was 20 to 29 years, whereas female patients had a peak age incidence of 10 to 19 years. Victims were mostly riders (50.5%) but none of them was a female. While 8.4% of accidents occurred on motorcycles with more than one pillion passenger, none of the victims reported using a crash helmet. Mechanism of accident was mostly head-on collision (39.2%). The injuries sustained were predominantly soft tissue injuries or in combination with bone injury. Bone and dental injuries were attributed mostly to falls. Facial bone injuries occurred mostly in the mandible (64 of 104). A symmetric distribution of injuries was observed in the upper, middle, and lower thirds of the face, but the middle third had the highest injury sites while the upper third had the least. CONCLUSIONS: Motorcycle-related maxillofacial injuries among Nigerians affect males predominantly. The injuries sustained have a symmetric distribution and were mostly soft tissue injuries in isolation or in combination with bony injuries. The middle third of the face is most vulnerable. Mandatory use of safety helmets and education of cyclists on the appropriate number of pillion passengers are imperative to minimize the morbidity and mortality associated with motorcycle accidents.

Accidents, Traffic↗
PubMed2006

[Epidemiology of maxillofacial injuries in athletes].

The general enthusiasm connected with sports activities causes that we often forget about threat connected with careless sports activities. The aim of this paper was the evaluation of causes and frequencies of maxillofacial injuries in hospitalized athletes in the Department of Maxillofacial Surgery in Katowice. Period between 1992-2002 was analyzed. Material consisted of 59 patients in whom injury required hospitalization. In studied material the frequency and causes of maxillofacial injuries in athletes in eleven-year period was examined. Male and female patients were divided in two groups: I--team sports and II--individual sports. In analyzed material injuries of upper part of facial skull were not affirmed. Injuries of upper facial massif overweighed its bottom massif injuries.

Accidents↗