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Mechanisms, pattern and treatment costs of maxillofacial injuries.

Facial contact with the steering wheel was the most common source of maxillofacial injuries sustained by vehicle occupants. Maxillofacial injuries to non-restrained occupants, especially children, most commonly resulted from contact with the vehicle's seats. In contrast to previous studies, contact with the windscreen by non-restrained occupants produced only a small number of minor facial injuries. Serious fractures of the facial skeleton were rare and no maxillofacial injury was fatal. A relationship between impact speed and the severity of facial injury sustained was demonstrable. Total compliance with seat belt legislation could be expected to save the National Health Service in excess of 5 pounds million/year from the reduction in maxillofacial injuries alone.

Accidents, Traffic

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

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

Dental aspects of maxillofacial injuries.

The chief progress of maxillofacial surgery in recent years has been the preservation and the retention of functional tissue. The recent advances in microvascular and reimplantation surgery are examples. Similarly the preservation of the masticatory apparatus is best served by the retention of all viable components. Additional benefits derived from this approach include the facilitation with alignment of the bony fragments, proper occlusion of the teeth and maintenance of the vertical relationship between the upper and lower jaws; in addition to the restoration of appearance and the functions of mastication and speech. Although injuries of the teeth and their supporting stuctures at first glance may seem to be simple problems, frequently they turn out to be complicated. The most common injury is partial avulsion of the alveolar bone with loss of attached teeth, which may produce a severe defect in the jaw bone. During healing there is additional resorbtion of alveolar bone, which is quite a normal physiologic phenomenon. Therefore, the eventual defect is likely to be more severe yet. For this reason more concern should be shown for these lesser injuries.

Dentition

Automobile accident studies of maxillofacial injuries.

The use of the available lap and shoulder belts would between 10,000 and 15,000 fatalities annually, and would significantly reduce the number of injuries, particularly those of the face. By mandatory seat belt usage laws a significant reduction in deaths, disfiguring injuries, and hospital bed-days would be realized.

Accidents, Traffic

[Evaluation of maxillofacial injuries in a Quebec hospital].

This article describes a study done on patients with maxillofacial traumas at the Hôpital Christ-Roi in Quebec City. The patients were selected from those treated during the first three years after the Oral and Maxillofacial Surgery Department was set up. The hospital has 200 beds. In this study, the different epidemiological data and traumatic type are examined. Patient treatment is also discussed. The data analysis is supported by existing literature on the subject.

Adolescent