Clinical aspects and treatment of midface fractures through inter-personal violence: a 10 year cross-sectional cohort retrospective study

Authors

  • Paul Andrei Țenț Faculty of Medicine and Pharmacy, University of Oradea, Romania; Department of Oral and Maxillo-Facial Surgery
  • Daniela Popa Faculty of Dental Medicine, “Iuliu Haţieganu” University of Medicine and Pharmacy, Department of Prosthetic Dentistry, 32 Clinicilor Street, Cluj-Napoca, 400006, Romania
  • Raluca Juncar Faculty of Medicine and Pharmacy, University of Oradea; Department of Prosthetics;
  • Antonia Țenț Research Center for Functional Genomics, Biomedicine and Translational Medicine, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania.
  • Abel Emanuel Moca Faculty of Medicine and Pharmacy, University of Oradea, Department of Dentistry
  • Mihai Juncar Faculty of Medicine and Pharmacy, University of Oradea, Romania;Department of Oral and Maxillo-Facial Surgery

Keywords:

midface fracture, inter-humanl violence, aggression, zygomatic fractures

Abstract

The incidence of midface fractures due to inter-human aggression (IPV) has increased dramatically in industrialized countries recently. In this context, the World Health Organization considers the treatment and counseling of IPV victims an international priority.  The aim of this study was to determine the characteristics of midface fractures by IPV in order to create the premises for a correct and rapid diagnosis by the clinician, as well as to evaluate the effectiveness of treatment methods applied depending on the number and type of postoperative complications. Materials and methods: Patients hospitalized and treated in a tertiary hospital for oral and maxillofacial surgery for a period of 10 years were available for this study. After the statistical analysis of the variables followed, a value of p <0.005 was considered statistically significant. Results: The most common was zygomatic complex fracture n = 87 (51.80 %), followed by fracture of nasal bones n = 30 (17.90%), orbit n = 36 (21.40 %) . Most patients had fractures with displacement n = 124 (73.80%) and closed n = 150 (89.3%). The opening of the fracture was most common in the case of zygomatic complex fractures (p = 0.045). The most common soft tissue lesion was present in 134 patients (57.26%), followed by excoriation n = 58 (24.79%) and laceration n = 42 (17.95%). Most patients were treated with closed treatment methods n = 145 (86.32%), followed by combined treatment methods open reduction with internal fixation (ORIF) + maxilla-mandibulo fixation (MMF) n = 12 (7.14% ) and n = 11 (6.55%) strictly ORIF. Conclusions: Inter-human aggression most frequently causes complex-zygomatic fractures, complete, with displacement and without opening the fracture outbreak accompanied by hematomas of the soft parts. The severity of the soft tissue associated injuries is directly proportional to the underlying fracture pattern.

References

Boffano P, Roccia F, Zavattero E, et al. Assault-related maxillofacial injuries: the results from the European Maxillofacial Trauma (EURMAT) multicenter and prospective collaboration. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;119(4):385-391

Ferreira MC, Batista AM, Ferreira Fde O, Ramos-Jorge ML, Marques LS. Pattern of oral-maxillofacial trauma stemming from interpersonal physical violence and determinant factors. Dent Traumatol. 2014 Feb;30(1):15-21.

Hoppe IC, Kordahi AM, Lee ES, Granick MS. Pediatric Facial Fractures: Interpersonal Violence as a Mechanism of Injury. J Craniofac Surg. 2015 Jul;26(5):1446-9.

Lee KH, Qiu M. Characteristics of Alcohol-Related Facial Fractures. J Oral Maxillofac Surg. 2017;75(4):786.e1-786.e7.

Yamamoto K, Matsusue Y, Horita S, Murakami K, Sugiura T, Kirita T. Maxillofacial Fractures Associated With Interpersonal Violence. J Craniofac Surg. 2019 Jun;30(4):e312-e315.

Werlinger F, Villalón M, Duarte V, et al. Trends of maxillofacial trauma: An update from the prospective register of a multicenter study in emergency services of Chile. Med Oral Patol Oral Cir Bucal. 2019;24(5):e588-e594.

Roccia F, Savoini M, Ramieri G, et al. An analysis of 711 victims of interpersonal violence to the face, Turin, Italy. J Craniomaxillofac Surg 2016;44:1025–1028.

Arangio P, Vellone V, Torre U, Calafati V, Capriotti M, Cascone P. Maxillofacial fractures in the province of Latina, Lazio, Italy: review of 400 injuries and 83 cases. J Craniomaxillofac Surg. 2014;42(5):583-587

Fomete B, Adebayo ET, Agbara R, Osunde DO, Abah ER. Pattern of Ocular Involvement in Midface Injuries Seen at a Tertiary Care Hospital in Northern Nigeria. Niger J Surg. 2021;27(1):33-37.

Cohn JE, Iezzi Z, Licata JJ, Othman S, Zwillenberg S. An Update on Maxillary Fractures: A Heterogenous Group. J Craniofac Surg. 2020;31(7):1920-1924.

Dikhit PS, Mohapatra M, Jena AK, Srivastava A. Emerging Trends of Zygomaticomaxillary Complex Fractures and Their Etiological Analysis in a Tertiary Health Centre from Eastern India: A Retrospective Study. J Maxillofac Oral Surg. 2021;20(1):70-75

Abhinav RP, Selvarasu K, Maheswari GU, Taltia AA. The Patterns and Etiology of Maxillofacial Trauma in South India. Ann Maxillofac Surg. 2019;9(1):114-117.

Juncar M, Tent PA, Juncar RI, Harangus A, Mircea R. An epidemiological analysis of maxillofacial fractures: a 10-year cross-sectional cohort retrospective study of 1007 patients. BMC Oral Health. 2021;21(1):128. Published 2021 Mar 17.

Wainwright DJ, Moffitt JK, Bartz-Kurycki M, et al. The Trends of Pediatric Facial Fractures Due to Violence in a Level One Trauma Population. J Craniofac Surg. 2019;30(7):1970-1973.

Xiao-Dong L, Qiu-Xu W, Wei-Xian L. Epidemiological pattern of maxillofacial fractures in northern China: A retrospective study of 829 cases. Medicine (Baltimore). 2020;99(9):e19299.

Garcez RHM, Thomaz EBAF, Marques RC, Azevedo JAP, Lopes FF. Caracterização de lesões bucomaxilofaciais decorrentes de agressão física: diferenças entre gênero [Characterization of oral maxillofacial lesions resulting from physical aggression: differences between genders]. Cien Saude Colet. 2019;24(3):1143-1152.

Long S, Spielman DB, Losenegger T, et al. Patterns of Facial Fractures in a Major Metropolitan Level 1 Trauma Center: A 10-year Experience. Laryngoscope. 2021;131(7):E2176-E2180.

Werlinger F, Villalón M, Duarte V, et al. Trends of maxillofacial trauma: An update from the prospective register of a multicenter study in emergency services of Chile. Med Oral Patol Oral Cir Bucal. 2019;24(5):e588-e594.

Hong K, Jeong J, Susson YN, Abramowicz S. Patterns of Pediatric Facial Fractures. Craniomaxillofac Trauma Reconstr. 2021;14(4):325-329.

Jin KS, Lee H, Sohn JB, et al. Fracture patterns and causes in the craniofacial region: an 8-year review of 2076 patients. Maxillofac Plast Reconstr Surg. 2018;40(1):29

Kyrgidis A, Koloutsos G, Kommata A, Lazarides N, Antoniades K. Incidence, aetiology, treatment outcome and complications of maxillofacial fractures. A retrospective study from Northern Greece. J Craniomaxillofac Surg. 2013 Oct;41(7):637-43.

Runci M, De Ponte FS, Falzea R, et al. Facial and Orbital Fractures: A Fifteen Years Retrospective Evaluation of North East Sicily Treated Patients. Open Dent J. 2017;11:546–556.

Yamamoto K, Matsusue Y, Horita S, Murakami K, Sugiura T, Kirita T. Clinical analysis of midfacial fractures. Mater Sociomed. 2014 Feb;26(1):21-5.

Bernardino ÍM, Barbosa KGN, Nóbrega LM, Cavalcante GMS, Ferreira EFE, d'Ávila S. Interpersonal violence, circumstances of aggressions and patterns of maxillofacial injuries in the metropolitan area of Campina Grande, State of Paraíba, Brazil (2008-2011). Violência interpessoal, circunstâncias das agressões e padrões dos traumas maxilofaciais na região metropolitana de Campina Grande, Paraíba, Brasil (2008-2011). Cien Saude Colet. 2017;22(9):3033-3044.

Jaber MA, AlQahtani F, Bishawi K, Kuriadom ST. Patterns of Maxillofacial Injuries in the Middle East and North Africa: A Systematic Review. Int Dent J. 2021;71(4):292-299.

Schneider D, Kämmerer PW, Schön G, Dinu C, Radloff S, Bschorer R. Etiology and injury patterns of maxillofacial fractures from the years 2010 to 2013 in Mecklenburg-Western Pomerania, Germany: A retrospective study of 409 patients. J Craniomaxillofac Surg. 2015;43(10):1948-1951.

Manana W, Odhiambo WA, Chindia ML, Koech K. The Pattern of Orbital Fractures Managed at Two Referral Centers in Nairobi, Kenya. J Craniofac Surg. 2017;28(4):e338-e342.

Pati D, Mishra N, Kar I, Meher B, Samal D, Rath KC. Nasoorbitoethmoid fractures in a tertiary care hospital of eastern India: A prospective study. Natl J Maxillofac Surg. 2021;12(1):42-49. doi:10.4103/njms.NJMS_151_20

Forouzanfar T, Salentijn E, Peng G, Van Den Bergh B. A 10-year analysis of the "Amsterdam" protocol in the treatment of zygomatic complex fractures. J craniomaxillofac Surg. 2013; 41: 616-22.

Reiter Mj, Schwope Rb, Theler Jm. Postoperative CT of the Midfacial Skeleton After Trauma: Review of Normal Appearances and Common Complications. AJR Am J Roentgenol. 2017; 209: 238-248.

Fraioli Re, Branstetter Bf 4th, Deleyiannis Fw. Facial fractures: beyond Le Fort. Otolaryngol Clin North Am 2008; 41: 51-76

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Published

2022-02-18

How to Cite

Paul Andrei Țenț, Popa, D., Raluca Juncar, Antonia Țenț, Abel Emanuel Moca, & Mihai Juncar. (2022). Clinical aspects and treatment of midface fractures through inter-personal violence: a 10 year cross-sectional cohort retrospective study. American Scientific Research Journal for Engineering, Technology, and Sciences, 86(1), 17–26. Retrieved from https://asrjetsjournal.org/index.php/American_Scientific_Journal/article/view/7490

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