scholarly journals Epidemiological analysis of facial fractures

2021 ◽  
Vol 7 (7) ◽  
pp. 1176
Author(s):  
Deepalakshmi Tanthry ◽  
Aisha Nehla ◽  
Mahesh Santhraya ◽  
Devan Poothatta Pannen
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Road Traffic ◽  
Bone Fractures ◽  
Significant Proportion ◽  
Nasal Bone ◽  
Facial Trauma ◽  
Trauma Patients ◽  
Facial Fractures

<p class="abstract">Facial trauma occurs in significant proportion of trauma patients requiring prompt diagnosis of fractures and soft tissue injuries with possible emergency intervention. The epidemiology of facial fractures varies with regards to Injury type, severity, and cause depending upon the population studied. The aim of the study was to understand the cause, severity and temporal distribution of facial trauma and aims in focusing on clinical and research priorities for effective treatment and prevention. It was done in the department of otorhinolaryngology at a tertiary health care centre. 100 patients between the age group of 20-60 years of both the sexes were included in the study. Patients were evaluated thoroughly with prime focus on the radiological intervention I.e., Computed tomography and X-ray. Open or closed reduction was carried out depending on the type and site of fracture. Facial fractures were found more commonly in third decade of life. Most of them had a period of hospital stay of an average of 9 days. Open reduction and internal fixation was done in cases of zygoma fractures and closed reduction was done in nasal fractures. Road traffic accidents were reported as commonest cause for facial fractures followed by assault and fall respectively. Males were the common victims. Nasal bones were the foremost fractures followed by zygomatic fractures. Closed reduction was done in nasal bone fractures. Open reduction and internal fixation was done in all cases of zygoma fractures.</p>

scholarly journals Comparison of infraorbital nerve recovery after open and closed reduction of zygomaticomaxillary complex fractures

2018 ◽  
Vol 4 (3) ◽  
pp. 613
Author(s):  
Yaser Ishaq ◽  
Maria Noor ◽  
Malik Adeel Anwar
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Bone Fractures ◽  
Nasal Bone ◽  
Infraorbital Nerve ◽  
Inclusion Criteria ◽  
The Road ◽  
Nerve Recovery ◽  
Zygomaticomaxillary Complex

<p class="abstract"><strong>Background:</strong> Zygomaticomaxillary complex (ZMC) fracture is quite commonly seen fracture in the road side accidents (RTA). It is the second most common fracture after nasal bone fractures. Infraorbital nerve is almost always involved with ZMC fractures which can be treated with open reduction and internal fixation or closed reduction.</p><p class="abstract"><strong>Methods:</strong> The aim of this study was to compare the recovery of infraorbital nerve paresthesia following open reduction and internal fixation verses closed reduction in the management of ZMC fractures.  </p><p class="abstract"><strong>Results:</strong> Two groups with n=50 patients each, qualifying our inclusion criteria were selected, examined, reduced by open and closed reduction respectively and followed up.</p><p class="abstract"><strong>Conclusions:</strong> The functional infraorbital nerve recovery was found among 74% patients those who underwent open reduction and internal fixation. While the patients treated with closed reduction the functional nerve recovery was seen in 52%.</p>

scholarly journals External Fixation of Unstable, “Flail” Nasal Fractures

2012 ◽  
Vol 5 (2) ◽  
pp. 99-105 ◽  
Author(s):  
George E. Anastassov ◽  
Ali Payami ◽  
Zain Manji
Keyword(s):  
External Fixation ◽  
Closed Reduction ◽  
Nasal Septum ◽  
Bone Fractures ◽  
Nasal Bone ◽  
Facial Fractures ◽  
Kirschner Wires ◽  
Nasal Bones ◽  
External Stabilization ◽  
Nasal Fractures

Nasal bone fractures are the most common among facial fractures. Usually these are adequately treated with closed reduction and internal and/or external stabilization with splints. However, there are clinical situations where the nasal bones are severely displaced, the nasal septum fractured and displaced, or there are external drape lacerations which preclude the use of nasal splints. If the nasal bones are reducible but unstable we consider them “flail” and in this case transmucosal, endonasal Kirschner wires are used for dorsal support until sufficient healing occurs. The technique is simple, quick, and predictable and causes minimal discomfort to the patients.

scholarly journals Effectiveness of Closed Reduction in the treatment of nasal bone fractures

2021 ◽  
Vol 23 (1) ◽  
pp. 37-40
Author(s):  
Brihaspati Sigdel ◽  
K Sah
Keyword(s):  
Bone Fracture ◽  
Closed Reduction ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Bone Fractures ◽  
Nasal Bone ◽  
College Teaching ◽  
Road Traffic Accidents ◽  
Functional Abnormality ◽  
Nasal Injury

This study was conducted to investigate the effectiveness of closed reduction of nasal bone fracture according to severity. It was a retrospective study carried on 60 patients with mean age of 30.2 years (range 10-67 years) who have undergone a closed reduction of a nasal bone fracture at Gandaki Medical College Teaching Hospital from January 2017 to December 2019. The patient with nasal bone fracture who underwent surgical intervention with closed reduction under General anaesthesia were included in this study. Fracture severity was evaluated according to Hwang et al.’s classification method. All patients underwent closed reduction with external nasal splinting under General anesthesia. The patients were followed-up for at least three months to assess the complications, such as fracture recurrence and functional abnormality in the Department. The most common cause of nasal bone fracture was road traffic accidents 25 (41.6%) followed by physical assaults 18 (30%), fall injuries 12 (20%), other incidences 3 (5%), and industrial accidents 2 (3%). Forty-three (72%) cases underwent closed reduction within 24 hours of those who arrived within 4-6 hour of nasal injury in the hospital and the remaining 17 (28%) cases were reduced after 5 days of trauma. Concurrent fracture found in 8 (13%) cases and it included maxillary, zygomatic, orbital, frontal bone fracture. Nasal bone fracture mostly occurs in road traffic accidents. Closed reduction with good alignment is the preferred method. Septorhinoplasty and extracorporeal septoplasty should be applied in difficult and comminuted nasoseptal fracture.

scholarly journals Nasal Bone Fractures: Differences Amongst Sub-Specialty Consultants

2020 ◽  
Vol 129 (11) ◽  
pp. 1120-1128
Author(s):  
Jason E. Cohn ◽  
Sammy Othman ◽  
Michael Toscano ◽  
Tom Shokri ◽  
Jason D. Bloom ◽  
...  
Keyword(s):  
Plastic Surgery ◽  
Bone Fractures ◽  
Nasal Bone ◽  
Retrospective Chart Review ◽  
Operative Management ◽  
Outpatient Setting ◽  
Categorical Variables ◽  
Facial Trauma ◽  
Trauma Patients ◽  
Continuous Variables

Background: Nasal fractures constitute the largest proportion of facial trauma each year, however, there is no consensus management. In this study, we investingated the role of the consultant and the functional and aesthetic outcomes of procedures performed to address nasal bone fractures. Methods: A retrospective chart review of patients who sustained nasal bone fractures was conducted from 8/1/14 through 1/23/18. Categorical variables were analyzed using chi-squared testing and Fisher’s exact test, where appropriate, while continuous variables were compared using Mann–Whitney U testing. Results: During the study period, 136 patients met inclusion criteria for full analysis. The mean age of this cohort was 47.6 ± 20.2 years with the majority identifying as African–American (53.7%) and male (67.2%). Otolaryngologists were significantly more likely to assess pre-operative nasal obstruction (100%) compared to plastic surgeons (24.1%) ( P < .001). Otolaryngology elected operative management (53.3%) at a significantly higher rate than plastic surgery (24.1%) ( P = .005). Additionally, otolaryngology was significantly more likely to manage patients in an outpatient setting (91.2%), whereas plastic surgery more commonly performed inpatient management (57.1%) ( P = .006). Plastic surgery averaged a significantly shorter amount of time from presentation to operative management (7.3 ± 10.7 days) compared to otolaryngology (20 ± 27.7) ( P = .019). Consulting service was not associated with a need for revision surgery. Conclusions: Consultants across subspecialties differ in the management of nasal bone trauma. A more standardized approach is warranted by all individuals involved in the care of maxillofacial trauma patients.

scholarly journals Challenge and management outcome of panfacial fractures in Sohag University hospital, Egypt

2017 ◽  
Vol 5 (1) ◽  
pp. 126 ◽  
Author(s):  
Tarek Elsayed Ftohy Abdelrahman ◽  
Ahmed Abdelmaaboud ◽  
Ahmed Hamody
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Road Traffic ◽  
Mouth Opening ◽  
University Hospital ◽  
Mandibular Fractures ◽  
Trauma Patients ◽  
Adult Males ◽  
Maxillofacial Fractures ◽  
Panfacial Fractures

Background: panfacial fractures resembles a therapeutic challenge to maxillofacial surgeons This study was carried out to determine the etiology, injury characteristics and management outcome of pan facial fractures at Sohag university hospital.Methods: A retrospective hospital based study of panfacial fractures patients was carried out at Sohag university hospital from January 2010 to December 2016. Data was collected and analyzed using SPPS.Results: 200 Panfacial Trauma Patients were analysed. Males to females by a ratio of 24:1. Their ages ranged from 13 to 63 years with a mean of 30±12 years Most injuries were due to road traffic accidents (78%), and by falling from height in 12%. Mandibular fractures were the most common type of injuries. Open reduction and internal fixation by using plates and screws was the commonest surgical technique, used in 97.8% of cases. The most common complications were limited mouth opening, malocclusion. The mean duration of hospital stay was 11.13±2.23 days.Conclusions: Road traffic accident (RTC) was the most common cause of panfacial injuries in our locality and the young adult males were the most commonly affected victims. The majority of maxillofacial fractures were treated by open reduction and internal fixation.

scholarly journals NASAL BONE FRACTUR

2009 ◽  
Vol 16 (02) ◽  
pp. 258-262
Author(s):  
EJAZ RAHIM ◽  
SUHAIL ASLAM ◽  
MUHAMMAD ALI
Keyword(s):  
Effective Treatment ◽  
Closed Reduction ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Bone Fractures ◽  
Age Groups ◽  
Nasal Bone ◽  
Functional Results ◽  
Female Ratio ◽  
Nasal Fractures

b j e c t i v e : To analyze modes of presentation, types of the nasal fractures and their management. Setting and Period:From 01 Apr 2006 to 31 Mar 2007 at Frontier Corps Hospital, Quetta. Patients and methods: This descriptive study consists of 50 patientsof both sexes and all age groups, managed for nasal bone fractures, presented in emergency as well as in outpatient department. Selectionof cases was non probability, convenient type. All patients were admitted in the hospital for evaluation and further management. Every caseof nasal fracture was properly evaluated, assessed and was managed accordingly. Diagnosis was based on proper history, thorough clinicalexamination and radiological confirmation. Results: From this study it was concluded that adults (80%) were affected more than children.Highest incidence was seen in the age group 18-30 years (46%). The male to female ratio was 3:1. The main aetiological factors in adultswere Sports injuries (30%), personal falls (24%), road traffic accidents (22%) and interpersonal assaults (20%) and in children personal falls(24%). Most of the patients (90%) presented within 2 weeks of the nasal trauma. Epistaxis (92%), nasal deformity (76%), pain andtenderness (72%) and nasal obstruction (70%) were main clinical features. Closed reduction under general anaesthesia (80%) was the mostcommon and effective treatment awarded and complications were minimal. Three cases who presented after 1 year of trauma were treatedby Septorhinoplasty (1), Septoplasty(1 )and SMR(1). 14%(7) patients were treated conservatively. Conclusion: Nasal bone fractures shouldnot be considered minor injuries until they have been thoroughly assessed. Closed reduction under GA is most effective treatment for thepatients presenting within 2 weeks of injury. Prognosis of un-complicated nasal fractures, in general, is good and they heal within 2-3 weekswith good cosmetic and functional results.

Injury Patterns in Pediatric Facial Fractures Unique to an Urban Environment

2021 ◽  
Author(s):  
Anthony P. Sclafani ◽  
Matthew Scott Sclafani ◽  
Sallie Long ◽  
Tasher Losenegger ◽  
Daniel Spielman ◽  
...  
Keyword(s):  
Urban Environment ◽  
Older Patients ◽  
High Energy ◽  
Urban Setting ◽  
Cranial Bone ◽  
Csf Leak ◽  
Facial Trauma ◽  
Trauma Patients ◽  
Associated Injuries ◽  
Facial Fractures

AbstractThis study aimed to define better the clinical presentation, fracture patterns, and features predictive of associated injuries and need for surgery in pediatric facial trauma patients in an urban setting. Charts of patients 18 years or younger with International Classification of Disease 9th and 10th revision (ICD-9/ICD-10) codes specific for facial fractures (excluding isolated nasal fractures) at NY-Presbyterian/Weill Cornell Medical Center between 2008 and 2017 were retrospectively reviewed. Of 204 patients, most were referred to the emergency department by a physician's office or self-presented. Children (age 0–6 years) were most likely to have been injured by falls, while more patients 7 to 12 years and 13 to 18 years were injured during sporting activities (p < 0.0001). Roughly half (50.5%) of the patients had a single fracture, and the likelihood of surgery increased with greater numbers of fractures. Older patients with either orbital or mandibular fractures were more likely to undergo surgery than younger ones (p = 0.0048 and p = 0.0053, respectively). Cranial bone fractures, CSF leaks, and intracranial injuries were more common in younger patients (p < 0.0001) than older patients and were more likely after high energy injuries; however, 16.2% of patients sustaining low energy injuries also sustained cranial bone, CSF leak, or intracranial injury. In an urban environment, significant pediatric facial fractures and associated injuries may occur after nonclassic low kinetic energy traumatic events. The age of the patient impacts both the injuries sustained and the treatment rendered. It is essential to maintain a high index of suspicion for associated injuries in all pediatric facial trauma patients.

Complications of the Transmasseteric Anteroparotid Approach for Subcondylar Fractures: A Retrospective Study

2021 ◽  
pp. 194338752110169
Author(s):  
Jared Gilliland ◽  
Fabio Ritto ◽  
Paul Tiwana
Keyword(s):  
Retrospective Study ◽  
Facial Nerve ◽  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Mouth Opening ◽  
Facial Nerve Paralysis ◽  
Nerve Paralysis ◽  
University Of Oklahoma ◽  
The University

Study Design: A retrospective analysis of patients with subcondylar fractures treated via a transmasseteric anteroparotid approach by the Oral and Maxillofacial Department at the University of Oklahoma. Objective: The goal of this study was to evaluate complications, morbidity, and safety with the transmasseteric anteroparotid approach for treatment of subcondylar fractures, and compare it to other findings previously reported in the literature. Methods: A retrospective study was conducted that consisted of 23 surgically treated patients in the past 2 years for subcondylar fractures. Only patients with pre-operative malocclusion and who underwent open reduction with internal fixation with the transmasseteric anteroparotid (TMAP) approach were included. Exclusion criteria included 1) patients treated with closed reduction 2) patients who failed the minimum of 1, 3, and 6-week post-operative visits. The examined parameters were the degree of mouth opening, occlusal relationship, facial nerve function, incidence of salivary fistula and results of imaging studies. Results: 20 of the surgically treated patients met the inclusion criteria. Two patients were excluded due to poor post-operative follow up and 1 was a revision of an attempted closed reduction by an outside surgeon that presented with pre-existing complications. There were no cases of temporary or permanent facial nerve paralysis reported. There were 3 salivary fistulas and 2 sialoceles, which were managed conservatively and resolved within 2 weeks, and 2 cases of inadequate post-surgical maximal incisal opening (<40 mm) were observed. Conclusion: The transmasseteric anteroparotid approach is a safe approach for open reduction and internal fixation of low condylar neck and subcondylar fractures, and it has minimal complications.

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