Associated Injuries Related to Patients With Facial Fractures

Purpose To find out the incidence, type, and severity of injuries in other parts of the body in patients diagnosed with facial fractures. The study also analyzed any correlation between these injuries and facial fractures. Material & Methods A retrospective study of 991 patients with facial fractures during the period of 2006-2016. Results 111 patients reported associated injuries (11.1%). The most common type of injury was limb injury (33.33%), followed by head injury (22.5%), clavicle fracture (14.7%), rib fracture (10.9%), cervical spine injury (5.4%), and other injuries constituted (13.2%). Multiple associated injuries were observed in 14% of patients. Conclusion The findings show that facial fracture management is a multidisciplinary approach. Prompt diagnosis and proper management are important to reduce the mortality rate and improve the prognosis of the patient.

ASA Physical Status Classification and Complications Following Facial Fracture Repair

Background: To investigate the association between American Society of Anesthesiologists (ASA) physical status classification and rates of postoperative complications in patients undergoing facial fracture repair. Methods: Patients were divided into 2 cohorts based on the ASA classification system: Class I/II and Class III/IV. Chi-square and Fisher’s exact tests were used for univariate analyses. Multivariate logistic regressions were used to assess the independent associations of covariates on postoperative complication rates. Results: A total of 3575 patients who underwent facial fracture repair with known ASA classification were identified. Class III/IV patients had higher rates of deep surgical site infection ( P = .012) as well as bleeding, readmission, reoperation, surgical, medical, and overall postoperative complications ( P < .001). Multivariate regression analysis found that Class III/IV was significantly associated with increased length of stay ( P < .001) and risk of overall complications ( P = .032). Specifically, ASA Class III/IV was associated with increased rates of deep surgical site infection ( P = .049), postoperative bleeding ( P = .036), and failure to wean off ventilator ( P = .027). Conclusions: Higher ASA class is associated with increased length of hospital stay and odds of deep surgical site infection, bleeding, and failure to wean off of ventilator following facial fracture repair. Surgeons should be aware of the increased risk for postoperative complications when performing facial fracture repair in patients with high ASA classification.

South Australian facial trauma: a population analysis of social economic deprivation and facial fractures

Background: Trauma remains a leading cause of morbidity and mortality in Australia. The objective of this South Australian study was to analyse epidemiological trends in facial fractures and assess the relationship between socioeconomic disadvantage and clinical outcomes. Part one of this paper includes methods and results; part two includes discussion and conclusion. The two papers should be read together. Method: A retrospective analysis of the relationship was conducted between socioeconomic disadvantage and facial fractures. All paediatric and adult patients with facial fractures who attended the Royal Adelaide Hospital and the Women’s and Children’s Hospital Adelaide between January 2012 and January 2017 either as in- or outpatients. The medical records, progress notes, imaging and operative notes from plastics, craniofacial and oral maxillofacial surgery teams were retrospectively collated into a registry and reviewed. Ethics approval was granted from the RAH Human Research and Ethics Committee [HREC/17/RAH/402]. Results: A total of 2559 patients, 1976 males (77.2%) and 583 females (22.8%), sustained a facial fracture. The most disadvantaged group had the highest proportion of facial fractures (36.9%), with the highest incidence in the 25–34 age group (22.4%). Assaults were the most common injury with decreasing odds as socioeconomic advantage increased (p<0.05). Orbitozygomatic fractures were the most common type of facial fracture (27.7%). Indigenous patients were more likely (OR=2.8) to have surgery compared to non–indigenous patients (p<0.05). There were no significant differences in length of stay between socioeconomic groups (F(4,964.387)=2.091, p = 0.080). Conclusion: Socioeconomic status strongly influences the mechanisms on injury, types of fracture and likelihood of surgery with the most disadvantaged having higher rates compared to the least disadvantaged.

South Australian facial trauma: a population analysis of social economic deprivation and facial fractures

Background: Trauma remains a leading cause of morbidity and mortality in Australia. The objective of this South Australian study was to analyse epidemiological trends in facial fractures and assess the relationship between socioeconomic disadvantage and clinical outcomes. Part one of this paper includes methods and results; part two includes discussion and conclusion. The two papers should be read together. Method: A retrospective analysis of the relationship was conducted between socioeconomic disadvantage and facial fractures. All paediatric and adult patients with facial fractures who attended the Royal Adelaide Hospital and the Women’s and Children’s Hospital Adelaide between January 2012 and January 2017 either as in- or outpatients. The medical records, progress notes, imaging and operative notes from plastics, craniofacial and oral maxillofacial surgery teams were retrospectively collated into a registry and reviewed. Ethics approval was granted from the RAH Human Research and Ethics Committee [HREC/17/RAH/402]. Results: A total of 2559 patients, 1976 males (77.2%) and 583 females (22.8%), sustained a facial fracture. The most disadvantaged group had the highest proportion of facial fractures (36.9%), with the highest incidence in the 25–34 age group (22.4%). Assaults were the most common injury with decreasing odds as socioeconomic advantage increased (p<0.05). Orbitozygomatic fractures were the most common type of facial fracture (27.7%). Indigenous patients were more likely (OR=2.8) to have surgery compared to non–indigenous patients (p<0.05). There were no significant differences in length of stay between socioeconomic groups (F(4,964.387)=2.091, p = 0.080). Conclusion: Socioeconomic status strongly influences the mechanisms on injury, types of fracture and likelihood of surgery with the most disadvantaged having higher rates compared to the least disadvantaged.

Tatalaksana Trauma Wajah dengan Panfasial Fraktur

AbstrakFraktur pada wajah dapat menyebabkan defisit fungsional dan estetika jika tidak ditangani dengan baik. Tatalaksana akut yang tepat dari fraktur wajah harus didasarkan pada evaluasi cepat dan menyeluruh. Keberhasilan rekontruksi wajah merupakan keadaan darurat yang perlu dievaluasi dalam waktu 24 jam dari trauma. Berbagai jenis reduksi dan fiksasi tergantung pada fungsi, lokasi, jenis fraktur, dan usia pasien. Kasus ini diajukan untuk memperlihatkan keberhasilan tatalaksana trauma akut maksilofasial. Dilaporkan seorang laki-laki 37 tahun dengan panfasial fraktur yang dilakukan reduksi dan fiksasi 3 hari setelah trauma dengan pemasangan plat dan sekrup, serta fiksasi mukoginggival kombinasi antara arch bardan quickfix. Reduksi, reposisi dan fiksasi dilakukan setelah edema mukosa hebat disertai kombinasi antara arch bar dan quickfix pada mukoginggival merupakan salah satu alternatif untuk mengurangi risiko perdarahan dan memudahkan reposisi.Kata kunci: fraktur wajah, panfasial fraktur,edema mukosa.Management of Maxillofacial Traumawith Panfacial FractureAbstractFacial fractures can cause functional and aesthetic deficits if not treated properly. Appropriate acute management of facial fractures should be based on a rapid and thorough evaluation. Successful facial reconstruction is an emergency that needs to be evaluated within 24 hours of trauma. Different types of reduction and fixation depend on the function, location, type of fracture, and the age of the patient. This case is presented to demonstrate the success of acute maxillofacial trauma management. Reported a 37-year-old man with a facial fracture who underwent reduction and fixation 3 days after trauma with plate and screw installation, and combination mucogingival fixation between arch bar and quickfix. Reduction, reposition and fixation performed after severe mucosal edema accompanied by a combination of arch bar and quickfix on the mucogingival is an alternative to reduce the risk of bleeding and facilitate repositioning.Keywords: facial fracture, panfacial fracture, mucosal edema.