scholarly journals A retrospective study of causes, management, and complications of pediatric facial fractures

2018 ◽  
Vol 12 (02) ◽  
pp. 247-252 ◽  
Author(s):  
Muhammad Ehsan Ul Haq ◽  
Abdul Samad Khan

ABSTRACT Objectives: The objective of this study was to report causes, management options, and complications of facial fractures among children. Materials and Methods: The groups were defined on the basis of age, gender, cause of injuries, location, and type of injuries. The treatment modalities ranged from no intervention, closed reduction alone or with open reduction internal fixation (ORIF). Statistical Analysis: Descriptive statistics were generated by using SPSS software for the entire range of the variables under study. Results: Records of 240 pediatric patients were obtained and a total of 322 fractures were found among a study sample. Among these, one-thirds were due to road traffic accidents (RTAs) (37.26%) and fall injuries (36.64%), making them the leading causes of facial fractures. Mandibular fractures were the most common and they accounted for 46% (n = 148) of all fractures. The highest number of RTA (n = 27) was found in adolescents and fall injuries were more prevalent in preschool children (n = 34). Forty-two percent of the fractures (n = 101) were treated with close treatment using arch bars and splints, followed by ORIF (n = 68). The rest, 29.6% (n = 71), received conservative treatments. Postoperative complications were observed in 18.33% (n = 44) of cases, of which jaw deviation, growth disturbance, and trismus were more frequently encountered. Conclusion: Pediatric facial fractures if not managed properly can cause severe issues; therefore, injury prevention strategies should be strictly followed to reduce pediatric injuries in low socioeconomic countries.

2015 ◽  
Vol 8 (1) ◽  
pp. 59-63 ◽  
Author(s):  
Salwan Bede

The purpose of this study was to evaluate the epidemiological characteristics of the mandibular fractures relating to gender, age, the etiology of injury, and the rendered treatment modalities and complications. The data of the patients who sustained mandibular fractures were retrieved and were analyzed retrospectively, and based on these data a descriptive analysis was conducted. A total of 112 patients were included in this study; the most common cause was road traffic accidents (RTAs) followed by assaults and missile injuries. The most frequently involved age group was 11 to 20 years, treatment modalities included conservative, closed reduction and indirect fixation, and open reduction and internal fixation (ORIF) in 11.6, 79.5, and 8.9% of the cases, respectively. Most of the major complications were injury related. This study showed RTAs to be the most frequent cause followed by assaults, it also showed that a high percentage of assault victims were females mainly of low socioeconomic status. Another distinguishing feature in this study was the high incidence of missile injuries in the form of bullets and blasts. Closed reduction still has an important role in the treatment of fractures of mandible especially when the necessary equipments for ORIF are not readily available. A higher complication rate was observed in patients diagnosed with multiple and comminuted fractures as well as those caused by violence in the form of missile and assault injuries.


2021 ◽  
Vol 8 (9) ◽  
pp. 1423
Author(s):  
Desak P. K. Wedayanti ◽  
Gusti N. K. Dinatha ◽  
Putu Gosen Partama ◽  
Made Kurniawan Ardi Saputra

Mandibular fractures are among the most common injuries to the facial skeleton. Mandibular parasymphysis fractures lead to the loss of occlusion with step deformity formation. Treatment of mandibular fractures aims to restore occlusion and function and facilitate direct bone healing by adequate reduction and immobilization on the fractured site. We report a mandibular parasymphysis fracture of 17 years old male patient due to the road traffic accidents. Patient reported severe jaw pain during movement and abundant intraoral bleeding was observed. A clinically computed tomography scan of the face with axial, coronal, and 3-D reconstruction was performed, which showed parasymphysis fracture. The following treatment done was the application Arch bar and open reduction internal fixation (ORIF) mini plate under general anesthesia. After access, mandibulomaxillary fixation was performed to ensure satisfactory occlusion after adequate fragment reduction. The fractures were properly fixed with 6 hole and 3 hole, screw 8mm for the left mandibular, and for the right mandibular used 5 hole and 3 hole, screw 8 mm. Mandibular fractures are the most common fractures of facial region and treatment options depend upon the type of fracture of mandible according to the anatomic variations. 


2018 ◽  
Vol 08 (02) ◽  
pp. 97-102
Author(s):  
Muhammad Asif Shahzad ◽  
Momin Ayub Marath ◽  
Daud Mirza

Objective: The objective of current study was to evaluate the etiology, patterns of presentation, frequency and different treatment modalities for mandibular fractures in patients treated at Lahore Medical and Dental College/Ghurki Trust Teaching Hospital (LMDC/GTTH). Methodology: This descriptive – cross sectional study was conducted at Lahore Medical and Dental College, Lahore/Ghurki Trust Teaching Hospital (LMDC/GTTH) from March 2015 to September 2017. The current study included one hundred and twelve (112) patients who were indentified having mandibular fractures. Data were collected regarding patient’s age, gender, etiology, site of fracture, patterns and treatment modalities and analyzed using SPSS version 20. Results: The patients’ ages were between 3 to 55 years (24.87±10.867, mean/SD). The majority of fractures occurred amongst 21-30 years of age group having female to male ratio of 1:5.6. Road traffic accident (RTA) was the most frequent etiological factor for mandibular fractures in 89 (79.47%) of patients, followed by assaults 11(09.82%) and fall 07 (06.25%). A total of 189 fractures were recorded in 112 patients giving a mean of 1.7 fractures per patient. Out of 189 fractures, the parasymphysis was the most prominent site of mandibular fractures(43.39%), followed by condyle (22.75%) and angle (15.87%). The treatment modality of open reduction and internal fixation (ORIF/ORIF with IMF) was performed in 88(78.57%) of patients while closed reduction and indirect fixation (IMF with eyelet wiring/arch bar elastics & splint fixation) was done in 24 (21.43%) of patients. Conclusion: As evidenced by the present study, road traffic accidents are the most common cause of mandibular fractures in young adults, mostly due to violation of traffic rules. These findings highlight the need to reinforce legislation for prevention of such injuries both in children and adults


CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S69-S69
Author(s):  
V. Tsang ◽  
K. Bao ◽  
J. Taylor

Introduction: Whole-body computed tomography scans (WBCT) are a mainstay in the work-up of polytrauma or multiple trauma patients in the emergency department. While incredibly useful for identifying traumatic injuries, WBCTs also reveal incidental findings in patients, some of which require further diagnostic testing and subsequent treatment. Although the presence of incidental findings in WBCTs have been well documented, there has been no systematic review conducted to organize and interpret findings, determine IF prevalence, and document strategies for best management. Methods: A systematic review was conducted using MEDLINE, PUBMED, and EMBASE. Specific journals and reference lists were hand-mined, and Google Scholar was used to find any additional papers. Data synthesis was performed to gather information on patient demographics, prevalence and type of incidental findings (IFs), and follow-up management was collected. All documents were independently assessed by the two reviewers for inclusion and any disagreements were resolved by consensus. Results: 1231 study results were identified, 59 abstracts, and 12 included in final review. A mean of 53.9% of patients had at least one IF identified, 31.5% had major findings, and 68.5% had minor findings. A mean of 2.7 IFs per patient was reported for articles that included number of total IFs. The mean age of patients included in the studies were 44 years old with IFs more common in older patients and men with more IFs than women. IFs were most commonly found in the abdominal/pelvic region followed by kidneys. Frequency of follow-up documentation was poor. The most common reported mechanisms of injury for patients included in the study were MVA and road traffic accidents (60.0%) followed by falls from >3m (23.2%). Conclusion: Although there is good documentation on the mechanism of injury, patient demographics, and type of IF, follow-up for IFs following acute trauma admission lacks documentation and follow-up and is an identified issue in patient management. There is great need for systematic protocols to address management of IFs in polytrauma patients.


2021 ◽  
Vol 15 (8) ◽  
pp. 1920-1922
Author(s):  
Nabeela Riaz ◽  
Samreen Younas ◽  
Ijaz Ur Rehman ◽  
Ahmad Abdul Haseeb ◽  
Saba Hanif ◽  
...  

Aim: to explore the mandibular bone fractures in elderly patients with reference to etiology of trauma. Methodology: This was a descriptive study conducted in the department of Oral and Maxillofacial Surgery KEMU/ Mayo Hospital Lahore. Elderly patients (age 60-100years) with mandibular bone fractures. Results: Aetiology of trauma leading to mandibular fractures was as follows; there were 79(65.83%) cases of RTA, 32(26.66%) falls, 4(3.33%) assaults and there were only 3(2.5%) cases of industrial injury. Conclusion: To conclude, this study depicts that road traffic accidents were the predominant cause of injury in the studied age group. Elderly patients need more care and attention, especially after traumatic incidents and lead to financial burden in hospitals Keywords: Maxillofacial trauma, Elderly population, Mandibular injuries, Elderly fractures


2018 ◽  
Vol 6 (1) ◽  
pp. 51
Author(s):  
T. Chenthil Sivamuthu

Background: Faciomaxillary injuries are increasing in incidence in Tirunelveli district due to the increasing number of vehicles on the street which are inadequate and due to assault. The common denominator in both these situations is alcohol abuse. This study aims to assess the incidence, causative factors and management options of Faciomaxillary trauma.Methods: Around 50 case of faciomaxillary injuries admitted in the Department of Plastic surgery, TVMCH were taken up for study. The cases were studied for age, sex, personal habits, mode of injury, associated injuries, involved bones and type of fracture, clinical features, treatment modalities, and complications.Results: Road Traffic Accident (RTA) was the most common cause. Males aged 20-30 were the most commonly involved. Alcohol abuse and Intoxication was the most common antecedent event. Associated head, limbs and chest injuries were common. Mandible was the commonest bone to be fractured followed by zygoma, maxilla and nasal bones. ORIF and IMF was the common surgery performed.Conclusions: Alcohol abuse is the leading cause of faciomaxillary injuries. Educating the public about the traffic rules and the ill effects of drunken driving will go a long way to prevent these injuries.


2017 ◽  
Vol 99 (8) ◽  
pp. 637-640 ◽  
Author(s):  
P Singh ◽  
M Khatib ◽  
A Elfaki ◽  
N Hachach-Haram ◽  
E Singh ◽  
...  

Introduction Pretibial lacerations are common injuries, often presenting in the elderly and infirm. Unclear management pathways often result in inappropriate care. We identify patient demographics, morbidity risk factors, injury severity and management options. Materials and methods This retrospective study involved analysing databases and hardcopy notes for patients admitted with pretibial lacerations to Addenbrooke’s Hospital, January to December 2012. Microsoft Excel and Fishers exact test were used to analyse the data with a P-value of less than 0.05 representative of statistical significance. Information on patient demographics, site of lesion, preoperative symptoms, management, operative details and clinical outcomes were collected. Results A total of 36 patients were identified; the mean age was 79 years (± 16 years, 1 standard deviation) with a three to two female to male preponderance; 57% of injuries were caused by mechanical fall, 33% traumatic blunt impact and 7% road traffic accidents. American Society of Anesthesiologists physical status classification was 43% level III, 40% II, 9% I and 9% IV. Dunkin classification of severity was 33% grade III, 30% grade I, 24% grade IV and 12% grade II. Median inpatient duration was 11 days for surgically managed compared with 15 days for conservatively managed patients. Discussion Pretibial lacerations tend to affect the elderly. Management is compounded by polypharmacy and comorbidities. If inadequately managed, such injuries can adopt characteristics of chronic wounds, with lengthy inpatient stays. Surgical intervention may be appropriate where injuries are severe and the patient stable enough for theatre. Conclusions We believe that surgical management with autologous tissue repair, with minimal delay between presentation and theatre, is warranted for extensive injuries wherever possible, with conservative management used for predominantly less extensive pretibial lacerations.


2010 ◽  
Vol 2010 ◽  
pp. 1-23 ◽  
Author(s):  
Lucie Laflamme ◽  
Marie Hasselberg ◽  
Stephanie Burrows

Injuries are one of the major causes of both death and social inequalities in health in children. This paper reviews and reflects on two decades of empirical studies (1990 to 2009) published in the peer-reviewed medical and public health literature on socioeconomic disparities as regards the five main causes of childhood unintentional injuries (i.e., traffic, drowning, poisoning, burns, falls). Studies have been conducted at both area and individual levels, the bulk of which deal with road traffic, burn, and fall injuries. As a whole and for each injury cause separately, their results support the notion that low socioeconomic status is greatly detrimental to child safety but not in all instances and settings. In light of variations between causes and, within causes, between settings and countries, it is emphasized that the prevention of inequities in child safety requires not only that proximal risk factors of injuries be tackled but also remote and fundamental ones inherent to poverty.


2016 ◽  
Vol 23 (04) ◽  
pp. 378-382
Author(s):  
Tajammal Abbas Shah

To see the percentage, the different groups affected and pattern of injury by roadtraffic accidents among patients attending a unit of surgery in a teaching hospital. Objectives: Tosee the percentage of trauma among patients admitted in one surgical unit of a tertiary hospitalin one year and to compare this with the patients admitted in all surgical units of same tertiaryunit. To evaluate the pattern of trauma, male to female ratio, affected age groups, mechanismof injury, the organs affected, and the mortality rate in one surgical unit of a tertiary hospital of3rd most populated city of Pakistan during one year. Study Design: Prospective study. Setting:Surgical Unit II at Allied Hospital Faisalabad. Period: January 2009 to February 2010. Materialsand Methods: Patients admitted during this period for road traffic accidents in surgical unit IIof Allied Hospital Faisalabad were 94 (4.8 %) out of total 1956 patients presented and admittedin surgical unit II during this year. Total number of patients admitted in all surgical units of thishospital were 7388 while 21,400, patients received and admitted by all other specialties throughemergency units of Allied Hospital Faisalabad. Patients with road traffic accidents admitted insurgical unit II through emergency unit of this hospital were part of this study. Among these94 patients 78 patients (82.97%) were adults and 18 children (19.14%). Patients with all otheremergencies modalities and minor injuries treated and discharged from emergency wereexcluded from this study. Results: Out of 1956 patients admitted in Surgical Unit II from total 7388of all surgical admissions and 21400 all emergencies ward patients, 94 patients (4.8%, 1.27%,and 0.439% respectively) were injured by road traffic accidents. Out of these 94 patients, 78patients (82.97%) were adults and 18 children (19.14%) patients. 58 patients (61.70%) were malesand 36 patients (38.29%) were females. 43 patients (45.74%) were pedestrians, 10 patients were(10.63%) on bicycles, 26 patients were (27.65%) on motorcycle while 15 patients (15.95%) werein other vehicles. 52 patients (55.31%) developed head injuries, 10 patients (10.93%) blunt traumaabdomen, 5 patients (5.31%) blunt trauma chest and 26 patients (27.65%) skeletal injuries ( 10patients forearm bones fracture, 6 patients with fracture mid-shaft of tibia, another 5 patients withfracture lower 1/3rd of femur and 5 patients with hand bones fracture ). All patients were treated bycombined specialty trauma surgeons. 3 patients (3.19%) died out of which 2 patients (2.12%) withsevere head trauma and one pedestrian (1.06%) with blunt trauma abdomen and lower chest. Allother patients survived and recovered with some morbidity. Conclusion: Road traffic trauma isone of major dilemma of our society. 94 road traffic accidents causalities were admitted duringone year in one surgical unit of a tertiary care center and 3 patients died. It is an alarming signto properly protect people, educate general population, employ dedicated road safety staff andfollow rules and regulation of traffic authorities.


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