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Background/aim: Domestic violence has been identified as a cause of maxillofacial fractures especially among women. The present study investigated the maxillofacial fractures in Tehran, Iran, with special focus on injuries related to domestic violence., Material and Methods: Records of patients with maxillofacial fractures who were referred to Shariati hospital, Tehran, from June 2004 to June 2006 were considered to extract required data. The extracted data included the patients' gender, age, cause of fracture, and type of fracture. For patients with domestic violence recorded as their fracture cause, complementary data were also recorded. Chi-square test served for statistical analysis., Results: Totally, the records of 257 patients (188 men, 69 women) were considered. Of the 257 records studied, 188 records (73%) belonged to men. The most common fracture cause was vehicle accidents (55.3%) among both men (52.1%) and women (63.8%). The domestic violence stood for 3.5% of cases (all women). It was the fracture cause among 13% of women. One-third of women with domestic violence as fracture cause had previous history of fracture. The spouses of one-third of domestic violence victims were drug addicted., Conclusion: Prevalence of domestic violence as a cause for maxillofacial fracture is relatively high among women. Because these fractures can be life-threatening, appropriate strategies at both community and family levels should be implemented to prevent and reduce these types of fractures., (© 2011 John Wiley & Sons A/S.)

Purpose: Pattern and aetiology of maxillofacial injuries varies from one country to another and even within the same country depending on prevailing socio-economic, cultural and environmental factors. Various studies have been carried out in various countries to study the epidemiology and demographics of the maxillofacial injuries but the studies from India are few., Material and Methods: Retrospective study was undertaken at Christian Medical College Ludhiana (India) from January 2006 to December 2009. Treatment records of the patients was checked and age, gender, aetiology of injury, associated injuries, maxillofacial fractures and treatment offered were recorded., Results: A total of 1075 fractures were recorded in 718 patients, ranging from 11 months to 85 years of age. Male:female ratio was 6.6:1. Maxillofacial injuries were most common in third decade of life. A total of 517 patients suffered injuries because of road traffic accident, 115 because of accidental fall and 67 because of interpersonal violence. A total of 184 patients had 221 associated injuries of which 56.1% head injuries, 29.0% orthopaedic injuries and 14.9% other injuries were present. Of 596 middle third fractures, 29.8% were managed conservatively; for 21.7% and 48.7% of fractures, closed reduction and open reduction were performed respectively. Of 479 mandibular fractures, 1.8% was managed conservatively; for 16.7% and 81.5% fractures, closed reduction and open reduction were performed respectively., Conclusion: Better socio-economic status of people, increased vehicular movements and non-implementation of road safety norms have increased road traffic accidents. Proper education of the people who are most commonly involved in the RTA can be one of the possible ways to reduce the maxillofacial injuries., (© 2011 John Wiley & Sons A/S.)

Background/aim: One of the highest rates of car accidents and related morbidities and mortalities in the world is reported from Iran. Facial structures are usually injured in such accidents. This study is conducted to find the patterns and etiologies of mid-facial fractures in Iran., Material and Methods: During three consecutive years, patients with mid-facial fractures who were referred to a major oral and maxillofacial surgery center were studied for fracture etiologies and fracture locations., Results: Two-hundred and forty-three patients with mid-facial fractures were studied. Male-to-female ratio was 4.5-1. The average age of the patients was 31.7 years, but the 20-29 age group bears the highest rate of mid-facial fractures. Forty-four percent of fractures were related to automobile accidents, and 21% were attributed to motorcycle accidents. Other etiologies are 13.2% for collisions, 10.3% for falls, 6.2% for physical abuse, 2.9% for bicycle events, 1.6% for occupational events, and 0.8% for sport events. Most fractures occurred in zygoma followed by Le Fort and nasal bone fractures. More than half of all patients (80% of automobile and motorcycle accidents) were not either fastening the seat belt or wearing protective helmets., Conclusions: The main etiology of mid-facial fractures is automobile and motorcycle accidents. Protective measures were not observed in the majority of patients., (© 2011 John Wiley & Sons A/S.)

Background/aim: The aim of this retrospective study was to evaluate the epidemiology, treatment, and complications of zygomatico-orbital complex (ZOC) and/or zygomatic arch (ZA) fractures either associated with other facial fractures or not over a 71-month period., Material and Methods: This survey was performed in three hospitals of Ribeirao Preto in Sao Paulo, Brazil, from August 2002 to July 2008. The records of 1575 patients with facial trauma were reviewed. There were 140 cases of ZOC and ZA fractures either associated with other facial fractures or not. Data regarding gender, age, race, addictions, day of trauma, etiology, signs and symptoms, oral hygiene condition, day of initial evaluation, hospital admission, day of surgery, surgery approach, pattern of fractures, treatment performed, post-operative antibiotic therapy, day of hospital discharge, and post-operative complications were collected. The data were subjected to descriptive statistical analyses., Results: The most frequent fractures affected Caucasian men and occurred during the fourth decade of life. The most frequent etiology was traffic accident, and symptoms and signs included pain and edema. Type I fractures were the main injury observed, and the treatment of choice was always rigid internal fixation. Post-operative antibiotic therapy was solely employed when there was an indication. Complications were observed in 13.1% of the cases., Conclusions: The treatment protocol yielded suitable post-operative results and also showed success rates comparable to published data around the world., (© 2011 John Wiley & Sons A/S.)

Objective: To analyze retrospectively 419 patients after the Wenchuan earthquake and 46 after Yushu earthquake with maxillofacial fractures so as to provide reference on patients' treatment after an earthquake., Method: We investigated 419 patients after Wenchuan earthquake and 46 after Yushu earthquake with maxillofacial fractures who were admitted to the West China Hospital of Stomatology and other 46 hospitals in 10 provinces., Result: A total of 58 patients had maxillofacial fractures (13.8%) including 33 (56.9%) men and 25 (43.1%) women after the Wenchuan earthquake and 6 (13%) had maxillofacial fractures after Yushu earthquake. Most patients were injured by pressing or burying. The nasal-orbital-ethmoidal region was the most frequent site of the maxillofacial fracture (58.6% in the Wenchuan earthquake and 66.7% in the Yushu earthquake). The most prevalent pattern of maxillofacial fracture was multiple and/or comminuted fractures (87.9% in the Wenchuan earthquake and 100% in the Yushu earthquake). There were 48 (82.8%) patients with associated injuries, and the most common site was extremity injuries (58.6%) after Wenchuan earthquake. Few patients received adequate prehospital treatment, with bandages predominantly. Most patients (65.5% in the Wenchuan earthquake and 100% in the Yushu earthquake) underwent open reduction and rigid internal fixation. We failed to find any patients with generalized infection. However, all patients in our study presented the symptoms of post-traumatic stress disorder., Conclusion: We analyze the characteristics of maxillofacial fractures after the two earthquakes, so as to improve our medical emergency system when such disasters happen again., (© 2010 John Wiley & Sons A/S.)

Aim: The purpose of this study was to review the etiology, incidence and treatment of selected oral and maxillofacial fractures in children in Belo Horizonte, Brazil, during a period of 3 years., Materials and Methods: The data collected for this study included age, gender, etiology, date of trauma, associated maxillofacial trauma, anatomic site of fracture and treatment. The analysis involved descriptive statistics and chi-squared test, Bonferroni test, Kolmogorov-Smirnov, Kruskal-Wallis and Mann-Whiney tests and analysis of variance., Results and Conclusions: This study examined 566 facial fractures in 464 children of 18 years of age or less. The majority of fractures were observed in children within the age group of 13-18 years of age. Bicycle accidents were the major cause of trauma, followed by falls. The mandible was found to be the most common fractured bone in the facial skeleton, followed by the nose. A conservative approach was applied in most cases.

A very popular sport worldwide, soccer generates a great number of maxillofacial injuries, mainly fractures, resulting in esthetic or functional problems. The aim of this retrospective study was to contribute to the knowledge of soccer-related maxillofacial injuries, and call attention to the risk factors that favor these injuries. A total of 108 patients, who attended hospital because of maxillofacial injuries during soccer within a period of 8 years, were included in this study. The relationship of the patients with soccer, the type, the site, the severity, the mechanism of the injuries and the applied treatment were analyzed. The injured were all males, and were principally amateurs. Around 89.8% of the patients suffered maxillofacial fractures while 10.2% presented only soft tissue injuries; 13.9% had multiple fractures; 50% of the maxillofacial fractures concerned the zygomatic complex and 38.2% the mandible where the majority occurred at the angle. The prevailing mechanism was the direct impact of players. Head to head impact outnumbered. Elbow to head impact caused contusions of the temporomandibular joint. Kick to head impact was the main cause of multiple fractures. The treatment of fractures was mainly surgical (68.2%). These findings support the fact that maxillofacial injuries sustained during soccer tend to be severe, demanding surgical treatment. The mandibular angle is in danger due to the usual existence of impacted and semi-impacted third molars. There should be a preventive intervention on the above contributors, and mainly coaches and sports physicians should be properly informed about the specificity of the maxillofacial injuries.

A retrospective analysis of 128 zygomatic complex fractures was undertaken. There were 109 males (85.2%) and 19 females (14.8%), aged 3-74 years (mean +/- SD, 33 +/- 12.6 years). Patients in the third decade of life (38.3%) recorded the highest incidence. Road traffic accidents (74.2%) mainly from automobile (61.7%) and motorcycle (9.4%) involvement were the predominant etiology. While 38.8% of them presented within the first 24 h, males were relatively earlier than their female counterparts, although this was not statistically significant (P > 0.05). Class 3 fractures were the commonest (50%), followed by classes 2 (zygomatic arch) and 4, respectively. Most class 6 fractures (6.3%) resulted from gunshot injuries. There were 116 unilateral (left 63, right 53) and 12 bilateral fractures with the right side of the face recording more zygomatic arch fractures. In addition, statistical significance was observed between etiology, class and type of fracture (P < 0.05). One hundred and twenty-four (136 fractures) patients were available for treatment as four declined. Twelve cases did not require treatment while others were managed by either closed or open reduction under general anesthesia. Gillies' temporal approach was the commonest (57.1%) surgical technique employed. However the unstable nature of the fractures necessitated open reduction and transosseous wiring in 33 cases. The high prevalence of zygomatic complex fractures arising from vehicular accidents reflects the poor status of the road network in rural and suburban Nigerian communities. Hence government should improve on existing infrastructures, decongest the highways and enforce traffic laws amongst road users. In addition, the need to encourage massive investments in safer alternative transport systems is emphasized.