Occurrence and Types of Associated Injuries in Patients with Maxillofacial Fractures

Introduction Severity and complexity of combined maxillofacial traumas require not only multidisciplinary approach, but prevention of this trauma is also of extreme importance, as this may reduce direct and indirect social economic losses. Understanding the trauma reasons, severity and age structure may support clinical priorities determination, increase treatment effectiveness, and also may achieve certain trauma prevention. Initial estimation and trauma treatment in MFT patients must be performed per ATLS algorithm. Purpose The aim is to identify the aetiology, occurence, clinical characteristics of maxillofacial combined traumas types, and severity of associated injuries outside the facial region in patients diagnosed with facial fractures. Material and methods A total of 352 traumatic patients were retrospectively and prospectively examined for the period of 6 years (05.2005 - 12.2011), treated at Department of Oral and Maxillofacial surgery at the St. Anna University Hospital, Sofia, on grounds of the accurately kept hospital documents in conformity with accepted standards and with ethical requirements for performing such studies. Results Associated injuries were observed in 129 patients (36 %). The most common associated injury was head trauma (71.3 %), followed by orthopaedic (9, 3 %), ophthalmologic (7, 8 %), spinal cord injuries (1, 6 %), and abdominal (0.8 %), otorhynolaryngology (0, 8 %) injuries. Multiple associated injuries were observed in 3, 1 % and polytrauma in 5, 4 %. In combined maxillofacial trauma (MFT), the most common maxillofacial fracture is lower jaw fracture (46.5 %), followed by zygomatic bone trauma (34.9 %) and nasal bones trauma (21.7 %). The occurrence of associated injury correlated significantly with trauma mechanism and fracture type; high-speed accidents and severe facial fractures were significant predictors of associated injury. Alcohol plays a key role in maxillofacial trauma appearance, whereas the alcohol relation is significant with interpersonal injuries (42 %), with falling (20 %) and with motor vehicle accidents (5.7 %). Conclusion Applying of multidisciplinary approach (anaesthesiologists, neurosurgeons, abdominal surgeons, traumatologists, maxillofacial surgeons) in traumatic patients, provides optimum results and the best possible outcome in their treatment.