RESUMEN
AIM: This study evaluated records of patients with maxillofacial trauma due to interpersonal violence (IPV) being treated in the emergency room of a level I trauma center hospital in São Paulo, Brazil. MATERIAL AND METHODS: Data of patients with maxillofacial trauma due to IPV recorded between January 2019 and December 2019 were retrospectively examined. Personal data, days on which they experienced IPV, and the type of maxillofacial trauma sustained were extracted and statistically analyzed (p < .050). RESULTS: During the analysis, 1034 patients with maxillofacial trauma were identified; of these patients, 292 (28.2%) who experienced trauma due to IPV were included in this study. There was a mean age of 32.6 years and the most common type of trauma was soft tissue injuries (38.7%). Mandible and nose fractures were more prevalent in males and females, respectively. Our data, when compared with other studies on maxillofacial trauma due to IPV, showed a lower prevalence and male-to-female ratio, and a higher presence of dentoalveolar trauma. Additionally, our data when compared with studies on maxillofacial trauma due to other causes showed lower mean age and male-to-female ratios, and a higher occurrence of nose fractures differing from the predominance of mandibular fractures. CONCLUSION: Oral and maxillofacial surgeons must be able to suspect and identify cases due to IPV among their patients with trauma. With our results, although each case has its individuality, we can suggest that cases of maxillofacial trauma in young, female, and nasal fracture patients may be suspicious for IPV.
Asunto(s)
Fracturas Mandibulares , Traumatismos Maxilofaciales , Fracturas Craneales , Humanos , Masculino , Femenino , Adulto , Estudios Retrospectivos , Violencia , Brasil/epidemiología , Traumatismos Maxilofaciales/epidemiología , Traumatismos Maxilofaciales/etiología , Fracturas Craneales/epidemiología , Fracturas Craneales/etiología , Fracturas Mandibulares/etiología , Fracturas Mandibulares/complicaciones , Servicio de Urgencia en Hospital , Accidentes de TránsitoRESUMEN
Introduction: The consumption of alcoholic beverages reduces the body's ability to deal with dangerous situations and exposes people to trauma. Objective: To determine the association between the consumption of alcoholic beverages and the characteristics of maxillofacial fractures treated at a Cuban university hospital in the context of COVID-19. Material and Methods: An observational, analytical, and cross-sectional study was carried out in the Maxillofacial Surgery unit at the "Carlos Manuel de Céspedes" General University Hospital during the year 2020. Prevalence ratios, 95% confidence intervals and p-values were obtained using generalized linear models. Results: In 58.23% of the cases, fractures were related to the consumption of alcoholic beverages. The fundamental etiology was interpersonal violence (47.75%), regardless of the consumption of alcoholic beverages. There was a prevalence of patients with nasal fractures (n=98; 55.06%), among which, 35.71% had consumed alcoholic beverages at the time of the trauma. Being male (p=0.005), the lack of university studies (p=0.007), the need for surgical treatment (p<0.001), the fractures of the zygomaticomaxillary complex (p=0.023), and the traumas that occurred during the weekends (p<0.001) or during the month of June (p=0.029) were factors associated with a higher frequency of fractures related to the consumption of alcoholic beverages. There was a lower frequency of fractures associated with alcohol consumption during the months of January (p=0.006) and March (p=0.001). Conclusion: Six out of ten cases were under the influence of alcoholic beverages. There was a greater number of young and male patients, mainly due to interpersonal violence.
Introducción: La ingestión de bebidas alcohólicas disminuye la capacidad del organismo para enfrentar situaciones de peligro y lo predispone a sufrir traumatismos diversos. Objetivo: Determinar la asociación entre el consumo de bebidas alcohólicas y las características de las fracturas maxilofaciales atendidas en un hospital universitario cubano en el contexto de la COVID-19. Material y Métodos: Estudio observacional, analítico y transversal realizado en el servicio de Cirugía Maxilofacial del Hospital General Universitario "Carlos Manuel de Céspedes" durante el 2020. Se obtuvieron razones de prevalencia, intervalos de confianza a 95% y valores p mediante modelos lineales generalizados. Resultados: En el 58.23% de los casos las fracturas se relacionaron con la ingestión de bebidas alcohólicas. La etiología fundamental fue la violencia interpersonal (47.75%), independientemente del consumo o no de bebidas alcohólicas. Predominaron los pacientes con fracturas nasales (n=98; 55.06%), en los que el 35.71% había consumido bebidas alcohólicas en el momento del trauma. El sexo masculino (p=0.005), la carencia de estudios universitarios (p=0.007), la necesidad de tratamiento quirúrgico (p<0.001), las fracturas del complejo cigomático-maxilar (p=0.023), los traumas sucedidos durante los fines de semanas (p<0.001) o durante el mes de junio (p=0.029) fueron factores asociados a una mayor frecuencia de fracturas relacionadas con el consumo de bebidas alcohólicas. Hubo menor frecuencia de fracturas asociadas a este consumo durante los meses de enero (p=0.006) y marzo (p= 0.001). Conclusión: Seis de cada diez casos estuvieron bajo los efectos de la ingestión de bebidas alcohólicas. Existió una mayor afectación de pacientes jóvenes, masculinos, a causa principalmente de la violencia interpersonal.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Fracturas Craneales/etiología , Accidentes por Caídas/estadística & datos numéricos , Consumo de Bebidas Alcohólicas/fisiopatología , COVID-19 , Traumatismos Maxilofaciales/etiología , Estudios Transversales , Cuba/epidemiología , Bebidas Alcohólicas , Alcoholismo/complicaciones , PandemiasRESUMEN
Introduction Low-velocity penetrating brain injury is not prevalent. In some conditions such as childhood, and with the penetration of a pellet in weak spots of skull, low-velocity penetrating brain injury is expected; however, high-velocity projectiles have also been reported as the cause of severe brain injuries. One of the complications of penetrating brain injury is infection, in which different types ofmicroorganisms play a role. The Streptococcus genus is the leading cause of abscess formation in nontraumatic patients. Multiple brain abscesses are not common. Case Presentation A 10-year-old boy with penetrating brain injury caused by an air gun pellet, who developed signs and symptoms of high intracranial pressure 18 days after the trauma. After the imaging scans and the detection of multiple brain abscesses and severe brain edema, prompt surgical intervention was performed for all three lesions in a single operation. The culture of a pus specimen was positive for Streptococcus species, and, with adequate antibiotic therapy, the patient was discharged from the hospital in good condition. Conclusion Brain injurywith air gun shot is not prevalent. The penetration of a low-velocity air gun pellet in weak points of the skull (such as the orbit, the squamous portion of the temporal bone, and the cranial suture), specially in children, can cause significant brain injuries.
Asunto(s)
Humanos , Masculino , Niño , Infecciones Estreptocócicas/tratamiento farmacológico , Heridas por Arma de Fuego/cirugía , Absceso Encefálico/cirugía , Lesiones Traumáticas del Encéfalo/cirugía , Lesiones Traumáticas del Encéfalo/etiología , Fracturas Craneales/cirugía , Fracturas Craneales/etiología , Fracturas Craneales/diagnóstico por imagen , Streptococcus/patogenicidad , Absceso Encefálico/etiología , Absceso Encefálico/diagnóstico por imagenRESUMEN
Understanding the cause, severity, and elapsed time for the restoration of the functions of maxillofacial injuries can contribute to the establishment of clinical priorities aiming at effective treatment and further prevention of facial trauma. The objective of this study was to understand the factors associated with the restoration of mastication, ocular, and nasal functions in the face of trauma victims, estimating their recovery time after surgical treatment. We analyzed 114 medical records of patients treated at the Hospital Montenegro, who attended follow-up consultations for up to 180 days. For analysis of the recovery time, we performed survival analysis, followed by COX analysis. We observed that half of the patients recovered their functions within 20 days. The average time for recovery from trauma in the zygomatic-orbital-malar-nasal complex was 11 days, and in the maxillary-mandibular complex, 21 days (HR: 1.5 [0.99 2.3], p = 0.055). Although functional reestablishment has reached high rates after the surgical approach, it is necessary to analyze the failing cases, as well as the economic impacts and the prevention strategies associated with facial trauma, to improve the service to the population.
Asunto(s)
Huesos Faciales/lesiones , Fijación Interna de Fracturas , Fracturas Mandibulares/cirugía , Fracturas Maxilares/cirugía , Hueso Nasal/cirugía , Fracturas Orbitales/cirugía , Fracturas Craneales/cirugía , Fracturas Cigomáticas/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Niño , Huesos Faciales/cirugía , Femenino , Humanos , Masculino , Fracturas Mandibulares/epidemiología , Fracturas Mandibulares/etiología , Fracturas Maxilares/epidemiología , Fracturas Maxilares/etiología , Persona de Mediana Edad , Hueso Nasal/lesiones , Fracturas Orbitales/epidemiología , Fracturas Orbitales/etiología , Recuperación de la Función , Estudios Retrospectivos , Fracturas Craneales/epidemiología , Fracturas Craneales/etiología , Análisis de Supervivencia , Adulto Joven , Fracturas Cigomáticas/epidemiología , Fracturas Cigomáticas/etiologíaRESUMEN
ABSTRACT Understanding the cause, severity, and elapsed time for the restoration of the functions of maxillofacial injuries can contribute to the establishment of clinical priorities aiming at effective treatment and further prevention of facial trauma. The objective of this study was to understand the factors associated with the restoration of mastication, ocular, and nasal functions in the face of trauma victims, estimating their recovery time after surgical treatment. We analyzed 114 medical records of patients treated at the Hospital Montenegro, who attended follow-up consultations for up to 180 days. For analysis of the recovery time, we performed survival analysis, followed by COX analysis. We observed that half of the patients recovered their functions within 20 days. The average time for recovery from trauma in the zygomatic-orbital-malar-nasal complex was 11 days, and in the maxillary-mandibular complex, 21 days (HR: 1.5 [0.99 2.3], p = 0.055). Although functional reestablishment has reached high rates after the surgical approach, it is necessary to analyze the failing cases, as well as the economic impacts and the prevention strategies associated with facial trauma, to improve the service to the population.
RESUMO O entendimento da causa, da gravidade e do tempo decorrido para o restabelecimento das funções de lesões maxilofaciais pode contribuir para o estabelecimento de prioridades clínicas objetivando o efetivo tratamento e prevenção dos traumatismos de face. Assim, o objetivo deste estudo foi compreender quais os fatores associados ao restabelecimento das funções mastigatórias, oculares e nasais em vítimas de trauma de face, estimando o tempo para recuperação das funções, após o tratamento cirúrgico. Foram analisados 114 prontuários de pacientes atendidos no Hospital de Montenegro que compareceram às consultas de acompanhamento por até 180 dias. Para a análise do tempo para a recuperação, foi realizada a análise de sobrevida, seguida da análise de COX. Observou-se que metade dos pacientes recuperaram as funções em até 20 dias, sendo que o tempo médio para recuperação dos traumas no complexo zigomático-orbitário-malar-nasal foi de 11 dias e do complexo maxilo - mandibular de 21 dias (HR: 1,5 (0,99 - 2,3) p=0,055). Embora o restabelecimento das funções tenha atingido taxas elevadas após abordagem cirúrgicas, faz-se necessária a análise dos casos de insucessos bem como os impactos econômicos e as estratégias de prevenção associados aos traumas de face a fim de qualificar o serviço prestado à população.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Adulto Joven , Fracturas Orbitales/cirugía , Fracturas Craneales/cirugía , Fracturas Cigomáticas/cirugía , Huesos Faciales/lesiones , Fijación Interna de Fracturas , Fracturas Mandibulares/cirugía , Fracturas Maxilares/cirugía , Hueso Nasal/cirugía , Fracturas Orbitales/etiología , Fracturas Orbitales/epidemiología , Fracturas Craneales/etiología , Fracturas Craneales/epidemiología , Fracturas Cigomáticas/etiología , Fracturas Cigomáticas/epidemiología , Brasil/epidemiología , Análisis de Supervivencia , Estudios Retrospectivos , Recuperación de la Función , Huesos Faciales/cirugía , Fracturas Mandibulares/etiología , Fracturas Mandibulares/epidemiología , Fracturas Maxilares/etiología , Fracturas Maxilares/epidemiología , Persona de Mediana Edad , Hueso Nasal/lesionesRESUMEN
PURPOSE: The present study aims to describe three cases of patients inflicted by rubber bullets with severe facial fractures. METHODS: In addition, a review of English-language literature involving facial fractures by rubber bullets from 1975 to 2016 was performed. RESULTS: This current study demonstrated that the use of the LLRBW is unsafety even when applied by police enforcements exclusively. CONCLUSIONS: Management of facial fractures caused by LLRBW is done in a usual manner with closed or open reduction associated with bone mini-plates or reconstruction plates when indicated. Special initial wound care should be done to avoid secondary infection and additional procedures.
Asunto(s)
Huesos Faciales/lesiones , Plásticos , Goma , Fracturas Craneales/etiología , Heridas por Arma de Fuego/etiología , Adolescente , Placas Óseas , Brasil , Mejilla/lesiones , Huesos Faciales/diagnóstico por imagen , Huesos Faciales/cirugía , Femenino , Fijación Interna de Fracturas , Fracturas Conminutas/diagnóstico por imagen , Fracturas Conminutas/etiología , Fracturas Conminutas/cirugía , Humanos , Imagenología Tridimensional , Masculino , Fracturas Mandibulares/diagnóstico por imagen , Fracturas Mandibulares/etiología , Fracturas Mandibulares/cirugía , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/lesiones , Seno Maxilar/cirugía , Nariz/diagnóstico por imagen , Nariz/lesiones , Nariz/cirugía , Fracturas Orbitales/diagnóstico por imagen , Fracturas Orbitales/etiología , Fracturas Orbitales/cirugía , Fracturas Craneales/diagnóstico por imagen , Fracturas Craneales/cirugía , Infección de la Herida Quirúrgica/prevención & control , Tomografía Computarizada por Rayos X , Heridas por Arma de Fuego/diagnóstico por imagen , Heridas por Arma de Fuego/cirugíaRESUMEN
Orofacial injuries are common in sports activities and may vary in complexity and the tissues involved. Most sports-related trauma occurs when a player hits another player, an object or the ground. This report presents a case of an injury caused by a punchlike blow to the face during a handball college team practice session. The patient suffered a traumatic blow to the left side of the nose and mouth and promptly attended a dentist. After a clinical examination and a CBCT scan, the following injuries were diagnosed: upper lip laceration, upper left lateral incisor subluxation and anterior nasal spine fracture. More severe teeth injuries were likely prevented because the patient was wearing a mouthguard.
Asunto(s)
Traumatismos en Atletas/etiología , Protectores Bucales , Boca/lesiones , Nariz/lesiones , Fracturas Craneales/etiología , Traumatismos de los Dientes/prevención & control , Tomografía Computarizada de Haz Cónico , Humanos , Masculino , Adulto JovenRESUMEN
PURPOSE: Facial fractures are an important health problem worldwide that can cause temporary or permanent disability and an economic burden. Identifying the risk factors associated with facial fractures is a valuable tool to create preventive public health strategies. This study evaluated the epidemiologic profile of facial fractures in northern Brazil. PATIENTS AND METHODS: Medical records of 1,969 patients who sustained facial fractures were analyzed for characteristics of the population, types of facial fractures, and treatment performed. RESULTS: The zygomatic complex was the most prevalent fracture site (28.8%). Road traffic accident (RTA) was the most common etiology (52%), followed by interpersonal violence (IPV; 34%). Among IPV cases, gunshot wounds were responsible for 14% of cases and 3% resulted from stab wounds. The third decade of life was the most prevalent age group, with a remarkable change in prevalence and etiology pattern at 15 years of age. Open reduction and internal fixation was the most used treatment, especially when the mandible was involved and at least 2 facial bones were fractured. There were 37 deaths (1.9%), with a higher risk observed for stab wounds (3.1-fold higher) and when at least 3 bones were fractured (4.1-fold higher). CONCLUSIONS: This epidemiologic survey identified RTA and IPV as important risk factors for facial fractures and a high prevalence of fractures caused by gunshot wounds. A unique preponderance of facial fractures caused by stab wounds was found, which was responsible for the highest risk of mortality.
Asunto(s)
Huesos Faciales/lesiones , Fracturas Craneales/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Niño , Preescolar , Femenino , Fijación de Fractura , Humanos , Lactante , Modelos Logísticos , Masculino , Persona de Mediana Edad , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Fracturas Craneales/diagnóstico , Fracturas Craneales/etiología , Adulto JovenRESUMEN
The objective of this study was to identify the epidemiological profile of facial fractures and to associate with clinical-epidemiological variables. An epidemiological survey was conducted in which data retrieved from the records of patients with facial fractures were analyzed. Pearson χ(2) test, Student t-test, one-way analysis of variance, Bonferroni post-hoc test, and logistic regression were used for statistical analysis, adopting a level of significance of 5%. The sample consisted of 718 patients ranging in age from 21 to 30 years (56.4%), including 480 (66.9%) men. Traffic accidents were the main etiological agent (62.7%) and the nasal bones were the most affected (41.8%). An association was observed between age and etiology (P < 0.001), fractured bone (P < 0.001), type of treatment (P < 0.001), hospital length of stay (P < 0.001), and complications (P = 0.001). Patients with traffic accident [odds ratio (OR)â= 3.08, P < 0.001] and fall (OR = 2.50, P = 0.049) as etiology had more risk of complications. The type of fractured bone was associated with etiology (P < 0.001), type of treatment (P < 0.001), hospital length of stay (P < 0.001), and complications (maxilla--OR = 1.90, P = 0.004). In conclusion, facial fractures predominantly affect men aged 21 to 30 years. Traffic accidents are the main etiology and the nasal bone is the site most affected. It was observed that the older the patient, the greater the susceptibility to falls, surgical treatment, hospital stay, and complications. Patients with maxillary or mandibular fractures remain hospitalized for longer periods of time. Fractures by traffic accident and fall had more risk of complications. The risk of complications was also higher in patients with maxilla fracture.
Asunto(s)
Huesos Faciales/lesiones , Fracturas Craneales/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Brasil , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Hueso Nasal/lesiones , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Fracturas Craneales/etiología , Adulto JovenRESUMEN
OBJECTIVE: Children who live, work, and play on farms with barn design that includes hay-holes are at risk for a particular type of fall. This study retrospectively reviews all children admitted to a pediatric trauma center with injuries due to fall through a hay-hole over a 19-year period. This study is the first to specifically describe hay-hole fall injuries. METHODS: A retrospective review from a 19-year period at a rural pediatric trauma center identified 66 patients who sustained injuries from a hay-hole fall. Charts were reviewed for patient demographics, injuries, interventions, and hospital course. RESULTS: Sixty-six patients sustained injuries from hay-hole falls. Median patient age was 4 years, and median Injury Severity Score was 14. Forty-one percent of patients were admitted to the intensive care unit, and 26% of patients were intubated. Injuries included skull fracture (73%), facial fracture (27%), intracranial hemorrhage (53%), and noncraniofacial injuries (12%). Eighteen percent required a therapeutic intervention. There was 1 fatality (2%). CONCLUSIONS: Hay-hole fall appears to be a distinct injury mechanism, and patients present with different injury patterns than other types of falls. In this study, a high proportion of patients were young, and craniofacial injuries accounted for the majority of injuries. Only a small proportion of patients sustained noncraniofacial injuries. Injury prevention strategies should be targeted to this unique agrarian injury.
Asunto(s)
Accidentes por Caídas , Agricultura , Heridas y Lesiones/etiología , Heridas y Lesiones/terapia , Preescolar , Huesos Faciales/lesiones , Femenino , Hospitalización/estadística & datos numéricos , Hospitales Rurales , Humanos , Puntaje de Gravedad del Traumatismo , Hemorragias Intracraneales/etiología , Hemorragias Intracraneales/terapia , Intubación Intratraqueal/estadística & datos numéricos , Masculino , Estudios Retrospectivos , Factores de Riesgo , Fracturas Craneales/etiología , Fracturas Craneales/terapia , Centros TraumatológicosRESUMEN
Skull base fractures comprise a relatively common finding among trauma patients. Before the widespread use of computed tomography (CT), these lesions used to be misdiagnosed. Currently, with improved imaging technology, diagnosis of skull base fractures is no longer cumbersome. On the other hand, cranial fractures involving the foramen spinosum are rarely described in the literature. In this present article, we report on a patient affected by head trauma, who suffered from a vault fracture towards the foramen spinosum and acute epidural hematoma (EH) due to middle meningeal artery injury. We further discuss the clinical consequences of foramen spinosum fracture.
Asunto(s)
Traumatismos Craneocerebrales/cirugía , Hematoma Epidural Craneal/cirugía , Arterias Meníngeas/lesiones , Fracturas Craneales/cirugía , Adulto , Traumatismos Craneocerebrales/complicaciones , Traumatismos Craneocerebrales/diagnóstico por imagen , Diagnóstico Diferencial , Resultado Fatal , Hematoma Epidural Craneal/diagnóstico por imagen , Hematoma Epidural Craneal/etiología , Humanos , Masculino , Arterias Meníngeas/diagnóstico por imagen , Radiografía , Base del Cráneo/diagnóstico por imagen , Base del Cráneo/cirugía , Fracturas Craneales/diagnóstico por imagen , Fracturas Craneales/etiologíaRESUMEN
INTRODUCTION: This retrospective study aimed to assess the occurrence of dental avulsions in patients with facial trauma over a 9-year period. MATERIALS AND METHODS: Data was collected from records of patients attended to at the Division of Oral and Maxillofacial Surgery at Piracicaba Dental School-State University of Campinas, Piracicaba (SP), Brazil. RESULTS: Two hundred three patients with 387 avulsed teeth were evaluated, the central incisors being the most common teeth involved (42 % of permanent and 61 % of primary teeth). Thirty-four percent of the cases occurred on weekends, mainly on Saturdays (20 %) and the distribution in relation to the time of year was similar with slight peaks in January. The most prevalent associated dentoalveolar injury was lateral luxation (26 %) and 19 % of the patients presented with an associated facial fracture. The most common sign presented was laceration (23 %), and the main symptoms found were pain (58 %). Associated general trauma was present in 139 patients (68 %), and the most prevalent was the upper limb (41 %). DISCUSSION: Special emphasis should be given not only to diagnosis and treatment of dental avulsion but for prevention, too. An understanding of the etiology, severity, and distribution of associated traumatic injuries can help for future studies and for an effective prevention of these injuries.
Asunto(s)
Traumatismos Faciales/diagnóstico , Traumatismos Faciales/epidemiología , Traumatismo Múltiple/diagnóstico , Traumatismo Múltiple/epidemiología , Avulsión de Diente/diagnóstico , Avulsión de Diente/epidemiología , Adolescente , Adulto , Anciano , Brasil , Niño , Estudios Transversales , Huesos Faciales/lesiones , Traumatismos Faciales/etiología , Traumatismos Faciales/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Traumatismo Múltiple/etiología , Traumatismo Múltiple/cirugía , Factores de Riesgo , Fracturas Craneales/diagnóstico , Fracturas Craneales/epidemiología , Fracturas Craneales/etiología , Fracturas Craneales/cirugía , Avulsión de Diente/etiología , Avulsión de Diente/cirugía , Traumatismos de los Dientes/diagnóstico , Traumatismos de los Dientes/epidemiología , Traumatismos de los Dientes/etiología , Traumatismos de los Dientes/cirugía , Adulto JovenRESUMEN
This study aimed to evaluate the occurrence of injuries to the head and face in adolescent and teenager victims of non-natural deaths. A retrospective study was undertaken by the analysis of medical forensic reports obtained from medical forensic examinations performed at the Department of Forensic Medicine of the city of Campina Grande, PB, Brazil, between January 2003 and December 2007. From a total of 607 reports issued during this time span, the study sample consisted of 423 reports (69.6%) referring to adolescents and teenagers of both genders, aged 12 to 18 years, who were confirmed to have died from external causes. The causes of death were encoded according to the Chapter XX of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The majority of victims were 17 year old males (25.8%). Firearms (33.3%) and transport accidents (32.2%) were the most common causes of death, with boys showing a 3.7 times greater likelihood of getting killed by firearms than girls. There was statistically significant relationship between the occurrence of transport accidents and gender. The majority of victims (71.6%) presented with multiple injuries throughout the body. There was statistically significant relationship between the occurrence of transport accidents and the presence of multiple injuries. A high percentage of the victims presented with injuries to the head and face. There was statistically significant relationship between the occurrence of transport accidents and the presence of injury to the head. Fatal gunshot wounds and transport accidents were the main causes of death of male adolescents and teenagers. The victims presented with multiple injuries, especially to the head and face, and the mandible was the most frequently injured facial bone. .
Asunto(s)
Accidentes de Tránsito/mortalidad , Traumatismos Craneocerebrales/mortalidad , Traumatismos Maxilofaciales/epidemiología , Traumatismo Múltiple/etiología , Heridas por Arma de Fuego/mortalidad , Adolescente , Brasil/epidemiología , Causas de Muerte , Distribución de Chi-Cuadrado , Niño , Traumatismos Craneocerebrales/etiología , Traumatismos Faciales/epidemiología , Traumatismos Faciales/etiología , Femenino , Humanos , Clasificación Internacional de Enfermedades , Masculino , Traumatismos Maxilofaciales/etiología , Traumatismo Múltiple/epidemiología , Oportunidad Relativa , Estudios Retrospectivos , Factores Sexuales , Fracturas Craneales/etiología , Fracturas Craneales/mortalidad , Fracturas de los Dientes/epidemiología , Fracturas de los Dientes/etiología , Heridas por Arma de Fuego/complicacionesRESUMEN
Defects on the craniofacial complex may result in aesthetic defects, functional damage, and psychologic consequences. Previously, surgeons showed no interest in reconstructing the operated area, but in the treatment of the problem, leaving bone contour is a secondary issue. Nowadays, area reconstruction with post-reestablishment of contour and local shape has become one of the surgeon's priorities. The use of alloplastic implants with specific digital design has been stated to be an effective technique on the treatment of craniofacial defects, reducing the need for manipulation in the intraoperative period and decreasing surgery time. Polyether ether ketone (PEEK) is a potential candidate because it is a linear polyaromatic semicrystalline polymer that combines strength, stiffness, durability, and resistance. Polyether ether ketone biocompatibility has been supported in literature, and subsequent medical applications of the material have been observed. The aim of this study was to describe a case of frontal bone defect reconstruction in which the PEEK was used as polymer material in a specific implant for the Synthes (PEEK-PSI) patient.
Asunto(s)
Hueso Frontal/lesiones , Hueso Frontal/cirugía , Procedimientos de Cirugía Plástica/métodos , Prótesis e Implantes , Fracturas Craneales/cirugía , Benzofenonas , Estética , Hueso Frontal/diagnóstico por imagen , Humanos , Cetonas , Masculino , Persona de Mediana Edad , Polietilenglicoles , Polímeros , Fracturas Craneales/etiología , Tomografía Computarizada por Rayos X , ViolenciaAsunto(s)
Traumatismo del Nervio Abducente/etiología , Parálisis Facial/etiología , Mandíbula/cirugía , Maxilar/cirugía , Enfermedades del Nervio Oculomotor/etiología , Traumatismos del Nervio Óptico/etiología , Osteotomía Le Fort/efectos adversos , Adulto , Femenino , Humanos , Base del Cráneo/lesiones , Fracturas Craneales/etiología , Trastornos de la Visión/etiologíaRESUMEN
BACKGROUND: An increasing incidence of maxillofacial trauma in the elderly has been noted, as a consequence of increased longevity, resulting in a higher percentage of elderly people in the population. METHODS: A retrospective study was undertaken to assess facial fractures in elderly presenting during the period 2000 to 2002 in Belo Horizonte, Brazil. The data collected included age, gender, etiology, date of trauma, maxillofacial trauma, anatomic site of fracture, and treatment. The statistical analysis involved evaluation of measures of central tendency and variability and calculation of proportions. RESULTS: It encountered 165 facial fractures in 122 elderly aged 60 years or older. The majority of fractures were sustained by elderly in the age group 60 years to 69 years. Falls was the major cause of trauma followed by car accidents. The mandible was found to be the most common fractured bone in the facial skeleton, followed by the zygomatic complex. A conservative approach was accomplished in the most of cases. CONCLUSION: Gender was associated with the presence or absence of fractures and with the etiology. There was no association between age and fractures. No association was found between etiology and age for women and men. The proportion of fractures of the zygomatic arch, mandible body, and parasymphysis treated surgically were statistically higher than the same proportion among the cases of other fractures. The fractures of the nose were more often treated conservatively than other fractures.
Asunto(s)
Huesos Faciales/lesiones , Fracturas Craneales/epidemiología , Anciano , Brasil/epidemiología , Distribución de Chi-Cuadrado , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Fracturas Craneales/etiología , Fracturas Craneales/terapia , Estadísticas no ParamétricasRESUMEN
Introducción: Las lesiones faciales traumáticas más frecuentes son las fracturas nasales debido a la prominencia de la pirámide nasal. Existe cierto consenso en que cuanto antes se intente su reducción más posibilidades existen de obtener un resultado exitoso. Objetivo: Describir epidemiológicamente y evaluar los resultados funcionales y estéticos de las fracturas. Material y método: Se revisaron las fichas clínicas de los pacientes para describir los datos epidemiológicos, se realizó la encuesta SNOT-22 para evaluar los resultados funcionales y una encuesta cualitativa para la percepción estética de las reducciones. Resultados: De un total de 42 pacientes, predominó el sexo masculino 6:1, la edad promedio fue de 34,4 años. El 83,3 por ciento de la reducciones se realizó en policlínico con anestesia local y el procedimiento se realizó en promedio 8,6 días posfractura. Sobre el resultado funcional destaca la obstrucción nasal posreducción en 43,6 por ciento con un puntaje SNOT-22 promedio de 46,9 puntos y el 47,62 por ciento> consideró su resultado estético como peor. Discusión: Consideramos el resultado estético funcional como no satisfactorio, por lo que no sería inadecuado realizar cirugía de rinoseptoplastía inmediata o diferida para mejorar el resultado.
Introduction: Nasal fractures are the most common facial injuries because ol the prominence of the nose. There is some consensus that the sooner you try their reduction more likely is a successful outcome. Aim: Epidemiologically describe and evaluate functional and aesthetic results of nasal fractures. Material and method: We reviewed the medical records of patients to describe the epidemiológical data, perform the SNOT-22 survey to evaluate the functional results and a qualitative survey for aesthetic perception of the reductions. Results: Of a total of 42 patients, males predominated 6:1, average age was 34.4 years. 83.3 percent of the reductions took place in clinic with local anesthesia and the procedure was performed on average 8.6 days post-fracture. With regard to functional outcome highlights only nasal obstruction after reduction of 43.6 percent with a SNOT-22 scoring average of 46.9 points and 47.62 percent of patients considered a worse cosmetic outcome. Discussion: We believe that the functional and aesthetic result is not satisfactory, so we would recommend a septorhinoplasty immediate or detened for better results.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Fracturas Craneales/cirugía , Hueso Nasal/cirugía , Hueso Nasal/lesiones , Procedimientos Quirúrgicos Otorrinolaringológicos/estadística & datos numéricos , Calidad de Vida , Estudios Transversales , Estética , Fracturas Craneales/etiología , Fracturas Craneales/fisiopatología , Encuestas y Cuestionarios , Recuperación de la Función , Resultado del Tratamiento , Rinoplastia , Satisfacción del PacienteRESUMEN
A rare case of fracture of the coronoid and the pterygoid process caused by firearms is described. A 28-year-old male was hit by a bullet in the face, resulting in restricted mouth opening, difficulty in chewing and pain when opening the mouth. Clinical examination revealed a perforating wound in the right parotid region and a similar wound on the left side of the same region. A CT scan showed comminuted fracture of the left coronoid process and bilateral comminuted fracture of the pterygoid processes. Treatment was conservative, speech therapy was conducted and it was successful. Details of the clinical signs, radiology (3D-CT scan), treatment and follow-up are presented.
Asunto(s)
Fracturas Conminutas/etiología , Fracturas Mandibulares/etiología , Fracturas Craneales/etiología , Hueso Esfenoides/lesiones , Heridas por Arma de Fuego/complicaciones , Adulto , Terapia por Ejercicio , Dolor Facial/etiología , Armas de Fuego , Estudios de Seguimiento , Humanos , Masculino , Masticación/fisiología , Manipulaciones Musculoesqueléticas , Glándula Parótida/lesiones , Logopedia , Trismo/etiologíaRESUMEN
INTRODUCTION: Trauma caused by traffic accidents is among the main etiologies involved in the occurrence of facial fractures throughout the world. However, the trauma mechanisms involved are different according to the location where the study was performed, due to different conditions of development, legislation, and culture. A retrospective study was done between February 2001 and July 2006, with the purpose of determining the epidemiology and the mechanisms involved in the occurrence of facial fractures among car occupants in the metropolitan area of São Paulo. METHODS: Data were collected from 297 patients admitted with facial fractures to the emergency room of the Hospital das Clínicas, São Paulo University Medical School. Within this period, 151 individuals had been involved in traffic accidents, among which 56 (37.08%) were inside passenger cars. These were grouped based on the seating position that they were occupying at the time of the accident and the wearing of seat belts. Data concerning the number and location of fracture lines were obtained from the different groups, and a fracture/patient index (F/P I) was calculated to compare and make reference to the impact energy among these groups, for subsequent analysis and discussion. RESULTS: 323 fracture lines occurred among 56 patients who were car occupants. By applying the F/P I, we obtained higher values in the group of rear-seat passengers who were not wearing seat belts (7.23 fractures per patient), followed by the group of drivers not wearing seat belts (6.33 fractures per patient), the group of front-seat passengers not wearing seat belts (5.58 fractures per patient), the group of drivers wearing seat belts (5.54 fractures per patient) and, finally, the group of front-seat passengers wearing seat belts (4.00 fractures per patient). None of the rear-seat passengers was wearing seat belts. CONCLUSION: The data collected indicate that the driver position shows a high incidence of facial fractures, not being effectively protected by the seat belt, although the wearing of seat belts seems to have a protective role against the occurrence of facial fractures in front-seat passengers. It was not possible to evaluate the wearing of seat belts among rear-seat passengers, even though the high incidence of fractures in this group showed its high susceptibility to the occurrence of facial fractures, which highlights the need of taking protective measures against this situation.