A 10-year retrospective study on mandibular fractures in Northern Taiwan

Background/purpose

The mandible is an independent and protruding bone structure in the lower third portion of the human facial skeleton. Because of its prominent and unprotected position, the mandible is a primary site of facial trauma. Previous studies have not comprehensively discussed the association between the mandibular fractures and concomitant fractures of facial bones, the trunk, or limbs. This study analyzed the epidemiology of mandibular fractures and their correlation with concomitant fractures.

Materials and methods

The present study enrolled 118 patients with a total of 202 mandibular fracture sites during at any time from January 1, 2012, to December 31, 2021, in northern Taiwan.

Results

According to the study results, the patients between 21 and 30 years of age had the highest occurrence of trauma, and road traffic accidents (RTAs) constituted the primary cause of mandibular fractures. Fall-related injuries were significant in patients >30 years of age. By the analysis of Pearson's contingency coefficient, the number of mandibular fractures was not significantly associated with concomitant fractures of the extremities or the trunk. However, accompanying maxillary fractures can be regarded as an indication of concomitant extremity or trunk fractures in patients with mandibular fractures.

Conclusion

Three-site mandibular fractures are not necessarily accompanied by extremity and trunk fractures; however, clinicians should implement multidisciplinary examination and management in patients with mandibular fractures accompanied by maxillary fractures. Maxillary fractures can be regarded as an indication of concomitant fractures of other facial bones, the extremities, or the trunk.

Delayed contralateral traumatic carotid cavernous fistula after craniomaxillofacial fractures

A carotid-cavernous sinus fistula is a rare condition in which an abnormal communication exists between the internal or external carotid artery and the cavernous sinus. It typically occurs within a few weeks after craniomaxillofacial trauma. In most cases, the carotid-cavernous sinus fistula occurs on the same side as the craniomaxillofacial fracture. We report a case of delayed carotidcavernous sinus fistula that developed symptoms 7 months after the craniomaxillofacial fracture. The fistula developed on the side opposite to that of the craniomaxillofacial fracture. Based on our experience with this case, we recommend a long follow-up period of 7–8 months after the occurrence of a craniomaxillofacial fracture. We also recommend that the follow-up should include consideration of the side contralateral to the injury.

Convex bone deformity after closed reduction of nasal bone fracture

BACKGROUND

Nasal fracture is the most common type of facial fracture treated by plastic surgeons. Here, we clarify the postoperative deformities that frequently remain after closed reduction of fresh nasal bone fracture by three-dimensional computed tomography (3D-CT).

METHODS

Hundred consecutive cases of fresh nasal bone fracture in patients treated between May 2010 and January 2016 were examined. After closed reduction, the overall appearance of the arch formed by the nasal bone and maxillary process was evaluated as 'Excellent', 'Good' or 'Fair'. Patients were also asked about their overall satisfaction with the operation, and the responses were classified as 'Satisfied', 'Neutral' or 'Dissatisfied'.

RESULTS

Eighty-six patients underwent 3D-CT examination both at the time of the initial consultation and 3 months after the operation. The results were 'Excellent' in 69 patients and 'Good' in 17 patients, with none of the patients having only 'Fair' results. Convex bone deformities on one side were seen in all six bilateral type fractures evaluated as 'Good'. All patients classified as 'Excellent' reported being 'Satisfied' with the results, but some patients classified as 'Good' gave a 'Neutral' evaluation regarding their satisfaction.

CONCLUSIONS

The residual deformities seen in bilateral type fractures were most notable, and they were all convex bone deformities on one side. Plastic surgeons should use ultrasonography or other reliable new methods in addition to visual inspection during the operation to successfully treat the region of the convex fracture.

A Retrospective Analysis of 303 Cases of Facial Bone Fracture: Socioeconomic Status and Injury Characteristics

Background

The incidence and etiology of facial bone fracture differ widely according to time and geographic setting. Because of this, prevention and management of facial bone fracture requires ongoing research. This study examines the relationship between socioeconomic status and the incidence of facial bone fractures in patients who had been admitted for facial bone fractures.

Methods

A retrospective study was performed for all patients admitted for facial bone fracture at the National Medical Center (Seoul, Korea) from 2010 to 2014. We sought correlations amongst age, gender, fracture type, injury mechanism, alcohol consumption, and type of medical insurance.

Results

Out of the 303 patients meeting inclusion criteria, 214 (70.6%) patients were enrolled in National Health Insurance (NHI), 46 (15.2%) patients had Medical Aid, and 43 (14.2%) patients were homeless. The main causes of facial bone fractures were accidental trauma (51.4%), physical altercation (23.1%), and traffic accident (14.2%). On Pearson's chi-square test, alcohol consumption was correlated significantly with accidental trauma (p<0.05). And, the ratio of alcohol consumption leading to facial bone fractures differed significantly in the homeless group compared to the NHI group and the Medical Aid group (p<0.05).

Conclusion

We found a significant inverse correlation between economic status and the incidence of facial bone fractures caused by alcohol consumption. Our findings indicate that more elaborate guidelines and prevention programs are needed for socioeconomically marginalized populations.