Aetiology and incidence of maxillofacial trauma in Amsterdam: A retrospective analysis of 579 patients

https://doi.org/10.1016/j.jcms.2011.08.006Get rights and content

Abstract

Introduction

The incidence of maxillofacial fractures varies widely between different countries. The large variability in reported incidence and aetiology is due to a variety of contributing factors, including environmental, cultural and socioeconomic factors. This retrospective report presents a study investigating the aetiology and incidence of patients with maxillofacial fractures in Amsterdam over a period of 10 years.

Results

The study population consisted of 408 males and 171 females with a mean age of 35.9 (SD: ±16.3) years. The age group 20–29 years accounted for the largest subgroup in both sexes. The most common cause of the fractures was traffic related, followed by violence. There were mainly mandibular and zygomatic bone fractures in both males and females, accounting for approximately 80% of all fractures. The main fracture site of the mandible was the combination of mandibular body with mandibular condyle (66 patients; 26.8%), followed by the combination of bilateral condylar fracture and fracture of the symphysis (43 patients; 17.5%). In fractures of the upper 2/3 of the face, zygomatic bone fractures were most common. In patients with alcohol consumption the injury was mostly the result of violence.

In conclusion, this report provides important data for the design of plans for injury prevention, as compared with previous studies. Violence related injuries are increasing whereas fractures caused by traffic accidents are decreasing.

Introduction

Facial fractures are the result of various types of trauma to the face, and may occur in isolation or combined with other injuries (Erdmann et al., 2008). Diagnosis and treatment of facial fractures remains a challenging problem that frequently requires a multidisciplinary approach (Erdmann et al., 2008, Katzen et al., 2003).

The incidence of maxillofacial fractures varies widely between different countries (Al Ahmed et al., 2004). The main causes worldwide are traffic accidents, assaults, falls and sport injuries (Ellis et al., 1985, Gassner et al., 2003, Lee et al., 2010, Motamedi, 2003). Studies performed in countries like Singapore, New Zealand, Denmark, Japan and the Middle East region have shown that motor vehicle crashes are the most common cause of maxillofacial fractures in those countries, whereas in less economically advanced countries like parts of sub-Saharan Africa and South Africa maxillofacial injuries are more often the result of interpersonal violence in the form of fights, assaults and gunshots (Aksoy et al., 2002, Lee et al., 2010). The large variability in reported incidence and aetiology is due to a variety of contributing factors, including environmental, cultural and socioeconomic factors (Al Ahmed et al., 2004, Bakardjiev and Pechalova, 2007, Lee et al., 2010, van Beek and Merkx, 1999). Some studies describe a decrease in road traffic accidents, and an increase in interpersonal violence due to alcohol abuse and growing aggression in the society (de Matos et al., 2010, Lee, 2009a, van Beek and Merkx, 1999).

To our knowledge there is a lack in reports detailing the causes and incidence of maxillofacial trauma in The Netherlands. This retrospective report presents a study investigating the aetiology and incidence of patients with maxillofacial fractures in Amsterdam over a period of 10 years.

Section snippets

Materials and methods

The hospital and outpatient records of 579 patients treated for maxillofacial trauma from January 2000 to January 2010, were reviewed and analysed retrospectively. The patients were identified using the hospital database. Patients with all types of maxillofacial fractures that were treated surgically by open or closed reduction were included. Patients with dentoalveolar and nose fractures were excluded, as these patients are mostly treated by dentists and the department of ENT of our hospital

Fracture and injury cause according to gender

The study population consisted of 408 males and 171 females with a mean age of 35.9 (SD: ±16.3) years. The youngest patient was 2 years and the oldest 88 years. There was no significant difference in age between male and female patients.

As shown in Table 1a, Table 1b there were mainly mandibular and zygomatic bone fractures in both males and females accounting for approximately 80% of all fracture sites. No differences between male and female patients were noted.

In both groups traffic accidents

Discussion

Maxillofacial fractures are one of the most common injuries and can be challenging to diagnose and treat. (Erdmann et al., 2008, Katzen et al., 2003, Lee et al., 2010, Motamedi, 2003) The cause of facial injuries depends on a variety of contributing factors, including environmental, cultural and socioeconomic factors. (Al Ahmed et al., 2004, Ellis et al., 1985, Iida et al., 2001, van Beek and Merkx, 1999).

Several studies have reported that facial bone injuries are mostly the result of traffic

Conclusion

The results of this retrospective study provide important data for the design of future plans for injury prevention. Mandibular and zygomatic bone fractures remain the most frequent fractures. The trend of increasing violence related injuries and decreasing traffic related injuries continues. In Amsterdam bicycle accidents are a major cause of maxillofacial trauma.

Ethical approval

Not required.

Funding

None.

Competing interests

None declared.

References (17)

There are more references available in the full text version of this article.

Cited by (0)

View full text