scholarly journals Favorable and unfavorable maxillofacial comminuted fractures

Author(s):  
Sara Ahmed Hifny ◽  
Abdullah Mohammed Almuzaini ◽  
Shaika Meshal Alharbi ◽  
Abdullah Abdulaziz AlJelayel ◽  
Ohud Awwadh Kehaili ◽  
...  

Many maxillofacial injuries were reported with the most common ones being nasal bone injuries. In another context, injuries occurring to the mandible followed by the malar bone and axilla are the most common injuries that require surgical interventions. However, favorable outcomes regarding the management of these injuries are associated with many factors. Such factors include the severity of the fracture and the presence of associated morbidities and other fractures, which might lead to unwanted complications and complex management plans. In this study, we aim to discuss the most reported maxillofacial fractures, elaborating when favorable and unfavorable events can be detected. Moreover, this literature review discusses some challenges that might be present in some cases, requiring the integration of certain management skills and techniques. Providing adequate examination is essential to conduct better management. Caring for the associated fractures with the main event is also important, and should be considered to intervene against the development of any adverse events.  

2017 ◽  
Vol 12 (4) ◽  
pp. 131-136
Author(s):  
V Natraj Prasad ◽  
Ashish Khanal

Background & Objectives: The maxillofacial region, a complex anatomical structure, can be evaluated by conventional (plain) films, Tomography, Multidetector Computed Tomography, Three-Dimensional Computed Tomography, Orthopantomogram and Magnetic Resonance Imaging. The study was conducted with objective of describing various forms of maxillofacial injuries, imaging features of different types of maxillofacial fractures and the advantage of using Three- Dimensional Computed Tomography reconstructed image. Materials & Methods: A hospital based cross-sectional study was conducted among 50 patients during April 2014 to September 2016 using Toshiba Aquilion Prime 160 slice Multi Detector Computed Tomography scanner.Results: The maxillofacial fractures were significantly higher in male population (88%) than female population (12 %). Road traffic accidents were the most common cause of injury others being physical assault and fall from height. It was most common in 31-40 years (26%) and 21-30 (24%) years age group. Maxillary sinus was the commonest fracture (36%) followed by nasal bone and zygomatic bone (30%), mandible and orbital bones (28%). Soft tissue swelling was the commonest associated finding. Three dimensional images (3 D) compared to the axial scans missed some fractures. However, the extension of the complex fracture lines and degree of displacement were more accurately assessed. Complex fractures found were Le fort (6%) and naso-orbito-ethmoid (4%) fractures.Conclusion: The proper evaluation of complex anatomy of the facial bones requires Multidetector Computed Tomography which offers excellent spatial resolution enabling multiplanar reformations and three dimensional reconstructions for enhanced diagnostic accuracy and surgical planning.


2021 ◽  
Author(s):  
Lusine V. Aleksanyan ◽  
Anna Yu Poghosyan ◽  
Martin S. Misakyan ◽  
Armen M. Minasyan ◽  
Aren Yu Bablumyan ◽  
...  

Abstract Background: The aim of this study was to perform a retrospective analysis of the prevalence, etiologies, and types of maxillofacial injuries (MFI) and sites of maxillofacial fractures (MFF) and their management in Yerevan, Armenia.Methods: A retrospective cross-sectional study was conducted. Data including age, sex, date of referral, mode of injury, etiology, radiology records and treatment methods were extracted. Study outcomes were measured using percentages, means, standard deviations and tests of proportions. P <.05 was considered significant.Results: A total of 204 patients had a mean age of 36.26 ±1.08 years (156 males and 48 females), and a total of 259 MFIs were recorded between 2017 and 2020. Interpersonal violence (IV) was found to be the most common etiology of MFFs in this study (42.1%), followed by road traffic accidents (RTAs) (27.9%) and falls (18.6%). The nasal bone was the most common injury site (47.5%), followed by the mandible (31.4%) and zygomatic complex (11.7%). The most common fracture site was the mandibular angle (37.9%), followed by the symphysis/parasymphysis (28.1%) and body (12.6%). The majority of MFFs were treated by open reduction and internal fixation.Conclusion: Interpersonal violence, followed by RTAs and falls, was the most common cause of MFIs. The nasal bone was the most common injury site, followed by the mandible and zygomatic complex. Social education with the objective of reducing aggression and interpersonal conflict should be improved, and appropriate RTA prevention strategies should be strengthened and implemented.


2021 ◽  
Vol 10 (35) ◽  
pp. 3070-3073
Author(s):  
Vybhavi M. K. ◽  
Prashanth V. ◽  
Srinivas V.

Zygomaticomaxillary complex (ZMC) fractures are relatively common. Zygomatic complex fractures with functional or aesthetic impairments often require surgical intervention. Treatment of ZMC fractures consists of reduction and fixation of the dislocated bone fragments to their original location. The zygomaticomaxillary complex functions as a major buttress for the face and because of its prominent convex shape, is frequently involved in facial trauma.1 ZMC fractures are also called tripod, tetrapod, quadripod, malar or trimalar fractures. They account for approximately 15 % - 23.5 % of maxillofacial fractures.2,3 The aetiology of zygomatic complex fractures primarily includes road traffic accidents (RTA), violent assaults, falls and sports injuries. They are the second most common facial fracture after nasal bone fractures.3-6 ZMC fractures are more common in men than women, and most commonly occur in the third decade of life.7-10 The main clinical features of zygomatic complex fractures include diplopia, enophthalmos, subconjunctival ecchymosis, extraocular muscle entrapment, cosmetic deformity, malocclusion and neurosensory disturbances of the infra-orbital nerve.10 The gold standard radiological investigation for evaluation of ZMC fractures is computed tomography (CT) scan. Surgical intervention is effective in cases of displaced and comminuted fractures involving functional and aesthetic defects, whereas a nonsurgical approach is often used for non-displaced fractures.11 Various surgical approaches and treatment strategies have been proposed to obtain a successful treatment outcome. Based on review of literature, it has been observed that the open reduction with internal fixation using mini plates and screws is the most commonly preferred treatment for displaced and comminuted fractures.10-12 Here, we report a clinical case of right zygomaticomaxillary complex fracture and its management.


2021 ◽  
Author(s):  
Lusine Aleksanyan ◽  
Anna Poghosyan ◽  
Martin Misakyan ◽  
Armen Minasyan ◽  
Aren Bablumyan ◽  
...  

Objective: The aim of this study was to perform a retrospective analysis of the prevalence, etiologies, and types of maxillofacial injuries (MFI) and sites of maxillofacial fractures (MFF) and their management in the Department of ENT and Maxillofacial Surgery of "Heratsi" No. 1 University Hospital in Yerevan, Armenia. Material and methods: A retrospective cross-sectional study was conducted. Data including age, sex, date of referral, mode of injury, etiology, radiology records and treatment methods were extracted. Study outcomes were measured using percentages, means, standard deviations and tests of proportions. P <.05 was considered significant. Results: A total of 204 patients had a mean age of 36.26 years (156 males and 48 females), and a total of 259 MFIs were recorded between 2017 and 2020. Interpersonal violence (IV) was found to be the most common etiology of MFFs in this study (42.1%), followed by road traffic accidents (RTAs) (27.9%) and falls (18.6%). The nasal bone was the most common injury site (47.5%), followed by the mandible (31.4%) and zygomatic complex (11.7%). The most common fracture site was the mandibular angle (37.9%), followed by the symphysis/parasymphysis (28.1%) and body (12.6%). The majority of MFFs were treated by open reduction and internal fixation. Conclusion: Interpersonal violence, followed by RTAs and falls, was the most common cause of MFIs. The nasal bone was the most common injury site, followed by the mandible and zygomatic complex. Social education with the objective of reducing aggression and interpersonal conflict should be improved, and appropriate RTA prevention strategies should be strengthened and implemented.


2021 ◽  
Vol 26 (9) ◽  
pp. 452-457
Author(s):  
Paula Boyer

Chronic obstructive pulmonary disease (COPD) is being increasingly diagnosed in the UKs on the rise, and is expected to continue to rise due to an ageing population with multiple co-morbidities and exposure to risk factors, such as cigarette smoke, noxious gases and air pollutants. The prevalence of this disease is high is areas of socioeconomic deprivation and among high industrial areas. The use of self-management plans in COPD is recommended by the National Institute for Health and Care Excellence (NICE), to enable to patients with this disease to be competent and confident in taking part in managing their own health condition and recognising signs and symptoms of an exacerbation. The aim of this article is to discuss self-management of COPD and the clinical guidance surrounding exacerbation of disease. A follow-up literature review will focus on the effectiveness of self-management plans in COPD.


2021 ◽  
pp. 30-48
Author(s):  
Andrei Anatolevich Mudrov ◽  
Aleksandr Yur’evich Titov ◽  
Mariyam Magomedovna Omarova ◽  
Sergei Alekseevich Frolov ◽  
Ivan Vasilevich Kostarev ◽  
...  

Despite the large number of available surgical interventions aimed at the treatment of rectovaginal fistulas, the results of their use remain extremely disappointing, associated with the high recurrence rate of the disease reaching 80 %, as well as the lack of a single tactic to minimize the risk of anal incontinence and the need for colostomy. Objective: to conduct a systematic literature review in order to summarize information related to the rectovaginal fistulas surgery. The systematic review includes the results of an analysis of 97 clinical trials selected from 756 publications found in databases. Inclusion criteria: a full-text article, the presence of at least 5 patients in the study, as well as data on the outcome of surgery. Clinical trials with different surgical treatments were identified and classified into the following categories: elimination of the rectovaginal septal defect with a displaced flap (rectal and vaginal); Martius surgery; gracilis muscle transposition; transperineal procedure; abdominal procedure including endoscopic and laparoscopic methods; use of biological or biocompatible materials. Treatment outcomes vary significantly from 0 % to > 80 %. None of the studies were randomized. Due to the low quality of the identified studies, comparison of results and meta-analysis conduction were not possible. Conclusion: as a result of the systematic review, data for the analysis and development of any strategic and tactical algorithms for the treatment of RVF were not obtained. The most important questions still remain open: what and when surgical method to choose, is it necessary to form a disconnecting stoma?


2015 ◽  
Vol 22 (2) ◽  
pp. 66-75
Author(s):  
M. V Mikhailovskiy ◽  
V. V Novikov ◽  
I. G Udalov

Widely used in clinical practice surgical interventions directed to the correction of severe kyphotic spine deformities, i.e. Ponte osteotomy, Smith-Peterson osteotomy, pedicle subtraction osteotomy and vertebral column resection are presented. Surgical techniques, surgery planning based on spinal and pelvic sagittal contour parameters, treatment results are described.


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