Maxillofacial fractures in the province of Latina, Lazio, Italy: Review of 400 injuries and 83 cases

doi:10.1016/j.jcms.2013.07.030

Journal of Cranio-Maxillofacial Surgery

Volume 42, Issue 5, July 2014, Pages 583-587

https://doi.org/10.1016/j.jcms.2013.07.030 Get rights and content

Abstract

A retrospective study was performed to assess maxillofacial fractures in patients treated at the public “S.M. Goretti Hospital” hospital from 2011 to 31/8/2012. Data were prospectively recorded including age and sex, cause and mechanisms of injury, soft tissue injuries, dentoalveolar trauma, facial bone fractures and type of treatment.

The pre-surgical and post-surgical hospitalization days were also analysed.

Causes were grouped into five categories: road traffic collision, sports accidents, occupational accidents, assaults and domestic accidents. The analyses involved descriptive statistics. Records from 83 patient sustaining 95 maxillofacial fractures were evaluated.

The zygoma was the most fractured anatomical site in both males and females, accounting for 32% of injuries, followed by isolated fracture of the orbital floor (blow-out and blow-in) with 11%.

The age group between 18 and 39 years showed the highest rate of incidence of maxillofacial fractures.

Men were more involved than women in all cases with a male:female ratio of 5,4:1.

Accidents were the most frequent cause of maxillofacial fractures in the age group between 18 and 39 years and interpersonal violence was the most frequent cause of maxillofacial fractures in the age group between 40 and 59 years.

Facial fractures occurred primarily among men under 30 years of age, and the most common sites of fractures in the face were the mandible and the zygomatic complex. Road traffic collisions were the main aetiologic factor associated with maxillofacial trauma.

Introduction

A substantial proportion of traumatology consists of maxillofacial fractures (Salentijn et al., 2013).

The management of cranio-maxillofacial trauma includes treatment of facial bone fractures, dentoalveolar trauma, and soft tissue injuries, as well as associated injuries, mainly of the head and neck (Hausamen, 2001). The patterns of maxillofacial trauma in Italy are poorly studied. Only 16 reports are presented in related literature and only 3 of them provided a general maxillofacial fractures trend (Chantel and Fazzari, 1986, Russo et al., 1997, Re and Porzio, 1967). Understanding maxillofacial trauma helps to evaluate the behaviour patterns of people in different countries and to establish effective prevention and treatment strategies (Maliska et al., 2009).

Understanding the cause, severity, and temporal distribution of maxillofacial trauma can assist in establishing clinical and research priorities for effective treatment and prevention of these injuries (Gassner et al., 2003).

The epidemiology of facial fractures varies in type, severity, and cause depending on the population studied (Girotto et al., 2001, Haug et al., 1990). Maxillofacial fractures affect a significant portion of trauma patients (Maliska et al., 2009). They can occur isolated or in combination with other serious injuries, including cranial, spinal, upper and lower body injuries (Oikarinen, 1995).

This is the first epidemiological study of facial fractures in Province of Latina which has 559.678 inhabitants (ISTAT, 2011). It covers an area of 2250.52 km² in the longitudinal direction between the provinces of Rome and Caserta. It is an important holiday destination, and during the summer months there is an exponential increase of the population in the area.

The purpose of this retrospective study is to analyse the maxillofacial fractures treated during an 18-month period (2011–2012) at the “S.M. Goretti Hospital” of Latina, with a special attention of the association between age and diversity, incidence, fractures pattern and clinical management.

Additionally, the results of this study were compared to several epidemiological studies about cranio-maxillofacial traumatology described in literature.

Section snippets

Materials and methods

From February 2011 to August 2012, 400 patients presented with maxillofacial trauma; 95 of these were treated at the S.M. Goretti Hospital of Latina.

Data were collected directly from the medical records of the hospital, including name, sex, medical history, patient's symptoms, clinical signs and the radiological findings, date of admission, date of surgery, date of discharge, cause and type of fracture.

Only 83 (87%) of 95 interventions performed in this period were included in the study. The

Results

Cranio-maxillofacial trauma affects a significant proportion of trauma patients, as confirmed by data collected to date only at the “S.M. Goretti Hospital”, where over 400 consultations for trauma patients regarding maxillofacial injury took place during the period of this study.

95 cases have been considered. Among these 83 (87%) who had undergone surgery for traumatic maxillofacial surgery were selected. The remaining 12 cases (13%) were excluded from the sample because complete data were not

Discussion

Trauma is the leading cause of death in the first 40 years of life. In addition, traumatic injury has been identified as the leading cause of lost productivity, causing more loss of working years than heart disease and cancer combined (Gassner et al., 2003).

The incidence of facial injuries occurring in conjunction with major trauma has been shown in several surveys to range from 34% of 87,174 trauma patients in a North American Database on Trauma (Washington; (Sastry et al., 1995)) to 15% of

Conclusions

The study shows that maxillofacial trauma in Province of Latina is mainly caused by traffic accidents involving the active population This is also related to the movement of large numbers of people who go on vacation in our Province, with serious human and economic repercussions for the patient, his household and the State.

The severity and complexity of facial trauma not only requires interdisciplinary co-operation in the care of these patients but also asks for continued education of the lay

Funding

No grants were used.

Conflicts of interest

None.

Acknowledgements

None.

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