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An update on the trends in maxillofacial traumatology provides additional information on the actual and changing needs. This retrospective study aimed to review all patient records of patients treated for isolated midface fractures in the Department of Cranial- and Maxillofacial Surgery at the Dortmund General Hospital between 2007 and 2017. The patient radiographs and patient files were reviewed. The safety and efficacy of the applied methods were controlled by assessing complications based on the Clavien-Dindo classification system. The statistical analysis included descriptive methods including regression analysis and χ 2 -test. In eleven years, 3474 isolated midface fracture sites have been identified in 2868 patients. The yearly trend is slightly increasing, in elderly clearly worsening, in children and youth decreasing. The male-to-female ratio was 2.16:1 for the whole study population, in the age group 18-25 y.o. 6.95:1 while in elderly above 80 y.o. 1:2.51, the age group specific incidence reflects this result, too. The most common fractures were nasal bone fractures (1405), zygomatic fractures (832) and orbital floor fractures (700). The average hospital stay was 2.7 days, the most fractures were operated within 24 h. The complication rate was 2.02% (Clavien-Dindo class II-V). The incidence of midfacial fractures is increasing in the total population and especially in elderly, but decreasing in children. Development of injury prevention measures is needed in this population. The diagnostic and therapeutic procedures are appropriate, as there is a low complication rate and short inpatient stay observed., (© 2021. The Author(s).)

Concomitant maxillofacial and cervical spine injuries occur in 0.8-12% of the cases. We examined the relation of injury localization and the probability of cervical spine fracture. A retrospective study was conducted on patients that have been treated at Dortmund General Hospital for injuries both to the maxillofacial region and to the cervical spine between January 1st, 2007 and December 31th, 2017. Descriptive statistical methods were used to describe the correlation of cervical spine injuries with gender, age as well as maxillofacial injury localization. 7708 patients were hospitalized with maxillofacial injury, among them 173 were identified with cervical spine injury. The average ages for both genders lie remarkably above the average of all maxillofacial trauma patients (36.2 y.o. in male and 50.9 y.o. in female). In the group of men, most injuries were found between the ages of 50 and 65. Whereas most injuries among women occurred after the age of 80. The relative ratio of cervical spine injuries (CSI) varies between 1.1 and 5.26% of the maxillofacial injuries (MFI), being highest in the soft tissue injury group, patients with forehead fractures (3.12%) and patients with panfacial fractures (2.52%). Further, nasal, Le Fort I and II, zygomatic complex and mandibular condyle fractures are often associated with CSI. Fractures next to the Frankfurt horizontal plane represent 87.7% of all MFI with concomitant CSI. Patients in critical age groups with a high-energy injury are more likely to suffer both, MFI and CSI injuries. Our findings help to avoid missing the diagnosis of cervical spine injury in maxillofacial trauma patients.

Background: Complications mean a recurring problem in everyday clinical practice. Complication rates between 6 and 13% are described for the treatment of bony injuries to the head and neck area. This paper aims to provide a detailed analysis of the complications after osteosynthesis in facial skull fractures., Material and Method: In this retrospective study, we reviewed all patient records of injured treated in the Department of Cranial and Maxillofacial Surgery at the Dortmund General Hospital between 2015 and 2017., Results: Of the 22,031 head and neck injuries, 685 were treated with osteosynthesis. A clinically significant complication was reported in 32 patients (4.76%). The number of total complications was 63. In total, 66.7% of all complications have been identified in the paramedian mandible (44%), median mandible, mandibular angle, and in the collar area (each 12.7%). Eleven implants (in 5 patients) showed a cancellous bone impaction. Broken implants have been recognized in two cases. In 8 cases, there was a pseudarthrosis in the fracture area; in one case, there was a broken implant and pseudarthrosis in combination., Conclusion: Osteosynthesis is a safe method of treating facial skull fractures, which is why we consider it the gold standard of therapy. The complication rate is well below 5%. The 3-dimensional adaptation (bending) and shortening of the osteosynthesis implants do not lead to an increase in complications.