Classification of Mid-facial fractures on Computed Tomography following head injury in a Nigerian population
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Abstract
Background: Head injury is a global epidemic, which results in fractures of the cranio-facial region. Computed Tomography (CT) is the gold standard in evaluating the head injured patient. The aim of this study was to assess the causes of head injury resulting in mid-facial fractures and to characterize and classify the observed fracture patterns and associated findings on CT.
Patients and Methods: Between 2006 and 2008, three hundred (300) consecutive patients with acute head injury were evaluated with a helical General Electric (GE CI/e) CT scan machine Data reviewed included cause of injury, age and gender distribution, types of facial fractures sustained, associated intracranial and soft tissue injuries. The Mid-facial fractures were grouped according to the proposed classification Sub groups were assigned depending on the associated CT findings including soft tissue swelling, cranial fractures and intracranial abnormalities.
Results: The range of patient age was between 30 to 39 years (mean 32.78years ± 18.515D) with a male: female ratio of 8:3. Abnormal CT scans were seen in 244 (81.4%) of the 300 patients studied. Of the 244 abnormal cases, 79 (32.4%) patients had mid-facial fractures. Most of the fractures involved the sino-nasal complex (47.3%) while the remainder was almost equally distributed in the zygomatico-maxillary complex (24.4%) and orbital complex (28.3%).
Conclusion: Road traffic accidents (RTA) continue to be a major cause of head injury and mid-facial fractures followed by falls and assault. We have described the CT findings in mid-facial fractures following head injury in the Nigerian population and suggest a classification system for categorizing these fractures and associated findings.
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1. lida 5, Kogo M, Sugiura T, Mima Tand Matsuya T. Retrospective analysis of 1502 patients with facial fractures. Int Oral Maxillofac Surg. 2001: 30: 286-290.
2. Abiose BO. The incidence and management of middle third facial fractures at the University Teaching Hospital, Ibadan. East Afr Med J. 1991 mar: 68 (3): 164-173
3. Fasola AO, Obiechina AE and Arotiba JI. Zygomatic Complex fractures at the University College Hospital, Ibadarı, Nigeria. East Afr Med J. 2002 mar, 79 (3): 137-139.
4. Martin BC, Trabue JC and Leech TR. An analysis of the aetiology, treatment and complications of fractures of the malar compound and zygomatic arch. Am J Sarg 1956: 92:920-924.
5. Ogunseyinde AQ, Ohajimi MO and Ogundare SM. Radiological evaluation of head trauma by computer tomography in Ibadan, Nigeria. West Af Mel. 1999 Jan-Mar, 18(1):33-38.
6. Obajimi MO, Jumah KB, Brakohiapa WO and Iddirisu M Head Injury in Ghanaians, Evaluation by computed tomography. Ghuma Med 2001; 35 (2): 69-74
7. Agunloye AM, Adeyinka AO, Obajimi MO, Malomo A and Shokunbi MT. Computerized Tomography of Intracranial Subdural haematoma in Ibadan. Af | Med Med Sci 2003:32-215-238
8. Obsajimi MO, Jumah KB, Brakohiapa WO and Iddirisu M Computed tomography features of head injury in Ghanaian children. Nix. Surg Resestrch 2002, 4(3-4):84-88.
9. Akang EE, Kuti MA, Osunkoya AO, Komalade EO, Malomo AQ, Shokambi MT and Amutta SB. Pattern of fatal head injuries in badan a 10 year review. Med Set Lau. 2002 Apr 42 (2): 160-166
10. Ogunlewe MO, James C, Ladeinde Al. and Adeyemo WI... Pattern of paediatric maxillofacial fractures in Lagos, Nigeria. Int/Pardiat Dent 2006 Sep; 16(5): 358-362
11. Obiekwe O, Owotade Fand Osalyuwa O. Aetiology and pattern of zygomatic complex fractures, a retrospective study. Nati Med Assoc. 2005 Jul; Jul: 97(7):992-996
12. Hussain K, Wijetunge Dil, Grubnic Sand Jackson II. A comprehensive analysis of craniofacial tramna. / Trauma 1994 Jan: 36 (1)34-47
13. van As All, van Loghem Al, Biermans IFI, Douglas TS, Wieseithaler N and Naidoo S. Causes and distribution of facial fractures in a group of South African Children and the value of Computed tomography in their assesament Int) Oral Maxillofac Surg 2006: 15 (110):903-906
14. Odebode TO and Abubakar AM. Childhood head injury, causes, outcoeno and outcome predictors. A Nigerian perspective. Pradiatr Surg Int. 2004 May: 20(5),348-352
15. Fasola AO and Denloye OO. Bankole OO Oro-facial soft tissue injuries in Nigerian children: a five-year review. Afr | Med Mad Sci. 2004 Jun, 33(2):93-97,
16. Abantanga FA and Mock CN. Childhood injuries in an urban area of Chana a hospital-based study of 677 cases. Pediatr Surg (nt. 1998 Sep 13(7):515-518
17. lida S and Matsuya T. Paediatric maxillofacial fractures their aetiological characters and fracture patterns. J Craniomaxillofac Surg 2002:30 237-2
18. Malara P, Malaza Band Drugacz J Characteristics of maxillofacial injuries resailting from road traffic accidents a Syear review of the case records from department of maxillofacial surgery in Katowice, Poland. Head & face Med 2006, 2.27.
19. Hang RH. Adams JM, Conforti P) and Likavee MI. Cranial fractures associated
with facial fractures a review of mechanisan, type and severtity of injury. /Oral Maxillofac Surg 1994:52 729 733.
20. Novelline RA, Rheu JT, Rao PM and Stuk 1. Helical CT in emergency radiology. Radialogy Alogy 1999: 213-321-339.
21. Adeyemo WR, Ladeinde Al, Ogunlowe MO and James O. Trends and. characteristics of oral and maxillofacial Injuries in Nigeria a review of literature. Head & Face Medizine 2005; 17.det: 10.1186/1746-160-1-7
22. Fasola AO, Nyako EA, Obiechina AF and Arotiba IT. Trends in the characteristics of maccillofacial fractures in Nigeria. Onal Mextilofar Surg 2003 Oct 61(10): 1140-1143
23. Reuben AD, Watt Smith SR, Dilson D and Golding St. A comparative study of evalnation of radiographs, CT and reformatted CT in facial trauma, what is the role of 30? Br J Radiology 2005, 78:195 201.
24. Rowe LD, Miller E and Brandt Zawadzki M. Computed Tomography in maxillofacial trauma. Laryngoscope 1981; 91:745-757.
25. Hu H. He HD, Foley WD and Fox SH Foar multidetector sow helical CT Image quality and vihame coverage speed. Radiology 2000, 215/55-62.
26. Gentry LR, Manor WF, Turski PA and Strother CM. High resolution CT analysis of facial struts in trauma 2.Osseous and soft tissue complications Am (Radiology 1983; 140533-541
27. Baitrago Teller. CH, Schilli W, Bohnert M. Alt K and Kimmig M. A comprehensive classification of craniofacial frachanes: post mortem and clinical studies with two and three dunensional computed tomography. Injury 2002, 33 (8)651-668
28. Donat TL, Endress Cand Mathog RH Facial fracture classification according to skeletal support mechanisms. Arch Otolaryngol Head Neck Surg. 1998, 124 1306-1314
29. Avery LL, Susarla SM, Novelline RA, Multidetector and three-dimensional CT evaluation of the patient with maxillofacial way. Radid Clin Narth Am 2011, 49 183-201
30 m MC, kunde MT, Maluma AA and Agunlaye AM, Computed Tamagraphy (CCT) in civilian gunshot head injuries in Badan. West Afr Misliacine 21804 Jan-Mar:23:58-61
31. Santak WH, Venturin B, Azzvala II, Nangeim M. Applications of cone-beam computed tomography in fractures the maxillofacial comples. Dent Traumatol 2000, 23306-366
32. Le Fart R. Ettale expérimentale aut Hactures de la machore super Bey Chir 1901, 21 479-500
33. Manson PN, Hoopes J and Su CT. Structural pillars of the facial sk an approach to the management of le Fort fractures Plan Surg
19
34. Las RH, Camble WIL, Robertson and Manson PN. The MCFONTZL Лабилалии куem for soft tissu injuries to the late Surg 10100: 1150-1157
35. Jako IT. Clamilication anul of orbitmaygonatic and orkutoethenol Fractures the place of bone grafting an
Cow and David D. Compute based coding of tractures in the Cramofacial region Bras Surg 19 42:17-26
37. Adebayo ET, Ajike Chand Alekey C Analysis of the pattern of masiladacial Hatores in Kaduna, Nigeria. Ol Maxilky 2000 Dec 41 (0)396-400
38. Clase HO, Tahir A and Arutiba JT. Changing picture of facial fractures in northern Nigeria.dir wel Maxilly Sag 2012 Apr40(2)140-143
39. Ellie El-Attar and Moos KT An analysis of 2,067 cases of zygomati ordital Itacture Oral Maxby Sury 2985,43 417-428
40. Turvey TA. Midiace fracture A etrospective analysis of 303 casis Onl Sarg. 1977, 35-687-891
41. Brook U and Wood N. Artiology and Incidence as facial fractiones in adults Cral Manilla Surg 1983, 12:295-295
42. Bu Ml. Smith DJ Jr and Robsan M Mandilsilar fractures in urban trauma centa. Trauma 1986 26626-829
43. Emshall R. Shaning H, Rothler Gand Waldhet E. Trend in the incidence an cause of sport related mandibular hactures. A retrospective analysis/Chal
44. M. fiulliven WG, fimith C Phillips LGand Rolsen MC An analysie of 1423 tures in 788 patiems as an urban trauma cadre Traume 19 24-388-381
45. SRackhammer Hand Olson Hartal fractures revne 1122 with special solvence is incidence and astiology Clin Chil
46. Kastin H Lidqvist Cand Laine P. Have the ca maxillofacial fractures changed over the last 18 yours in Finland An epidemiological saly of 720 fractures Dont Trum 2010, 21:14-19.
47. van Beek Gif and Marks CA. C the pattern of fractutes of the maxillofacial akeleson for Oral
48. Gasser R. Tuli T., Hachi O, Monisa R and Vimer H. Craniomasillofacial trauma in children. A review of 3,340 cases with 60 injuries in 10 yчать/Chal Murillac Surg. 2004, 62 300-400
49. Hang H, Prather and Indossano AT An epidemiologic survey of facial fractures and concomitant injuries.Ol
50. Guven O. Fractures of the maxillofacial wgiven in children. Crammar Surg 1992-20244-247
51. Kahin Diagnosis and treatment fractures of the facial hones in children 1943-1993. Cal MagSurg 1903 722-725
52. Tarika N, Uhade N, Sani K, Tashiro I, Tumitsuka K. Kimijima Y and Amagasa T. Masillofacial bactures in children/Cme Surg 1993, 21-289-293
53. Calwe Civilian gunshot wounds in a Nigerian general Hospital. Oreni Mal 1992,4:24-27
54. Ona O Management of Gunshot wounds in a Nigerian general Hospital Anh Emerg Mel 1987,4 73-76
55. Vimasa Wand Ogirima MC, Extremity gunshot injuries in civilian practive. The national orthopaedic Hospital Igboli experience. What A Med 2018) 19 (4) 312-316
56. Udosen AM, Finuma All Ligare GA and Basry OO. Gunshot injuries in Calabar, Nigeria: an indication of societal violence and police brutality. Aft Heille So 2016 Sep, 6(3):170-172
57. Akala-Galiano A, Arribas-Carsa. Martin-Perez MA, Romance A, Montalvo-Morena II and Juncos M. Pediatric facial fractures children are not jusi senill ahults. Radiographics, 2008 2812) 441-461
58. Kim JJ, Huch K. Masillofacial (mullaw) fractures. Neuroimaging Clin N Am 20110:20 581-596.
59. Hong H5, Cha G., Paik SH, Park 51, Fark 15. Kim DH, Lee HK. High-resolution sonography los nasal fractures in children Am | Roentgenel 2007, 188:86-92
60. Gruss 15 and MacKinnon SE. Camples manillary fractursse the role of buttress fixation and immediate home gralling Plast Row Surg 1986, 78.9-26.
61. Leipzinger L5 and Manson PN. Nasoethmoid orbital fractures, current concept and management principles Clin Plaw Surg 192, 19(1):167-193,
62. Fuji Nand Yamashiro M. Classification of Malar comples fractures using Computed Tomography Marillac Surg 1983;41:562-567 Orel
63. Hopper RA, Salemy 5 and 5 RW, Diagnosis of Madface Fractures with CL What the surgean needs to know.
Radiographics 2006, 26763-791
64. Crant JH 3rd, Patrindy IK, We AH, Kienswy PC and Gnos 15 Trapdoor Fracture of the orbit in a paediatric population. Plar ReSurg 2012, 109 (2)482-489,490-495
65. Linnau KF, Hallam DK, Lamoschitz FM and Mann FA Orbital apex injury trauma at the jurnction between the face and the cranium. Eur J Radio 2003, 48 (1) 5-16
66. Weisenbach IM Jr. Diagnostic value of zygomatic complex fructres Dral Surg 1970: 25:204
67. Comes PP, Pasari LA and Albegeria Barbosa [R. A5 your retrospective study of zygomata arch fractures in Sao Paolo state, Brazil. Oral Maxillofac Surg 2006 64(3) 63-67
68. Strong B, Pahlavan N and Saito D. Frontal sinus fractures. A 28 year retrospective review. Cholargal Hail & Neck Sary 2006, 135 (5): 774-779
69. Kwon J, Barrina E Jung TY. Most 51. Measurements af arbital volume change using computed tomography in isolated orbital lilowous fractures. Anch Facial Plast Surg. 2009,11(6) 395-8.
70 Catapano 1. Fialkov JA, Binhummus PA McMillan C, Armonyshyn DM. A system for severity scoring of facial Fractureic developmere and validation. J Cramalac Surg 2010), 25(4): 1098-1103.
71. Ong TK annul Dudley M. Craniofacial trauma presenting in adult acciders and emergency department with an emphases on soft these injuries. Injury 1999, 30-357-363
72. Country profiles for population and reproductive health: policy development and indicators 2000 pp 70 UNFPA publication 2003