The prevalence and pattern of mid facial fractures at Tygerberg oral health centre

Abstract

Background: Changing trends have been observed in the prevalence, etiology, imaging practice and pattern of presentation of mid facial fractures in different geographical regions. Conventional (plain) radiographs remain the most common initial investigative tool for general appraisal of suspected fractures, while advanced imaging is currently the most common final investigation. This study explored the clinico-radiologic patterns of mid facial fractures with main focus on demographic characteristics, etiology, fracture patterns and imaging practice. Aim: To determine the Prevalence, Clinical and Radiologic patterns of mid-facial fractures at Tygerberg Oral Health Centre, Faculty of Dentistry, University of the Western Cape Methodology: A retrospective cross sectional quantitative descriptive study of mid facial fractures was conducted at The University of the Western Cape’s Faculty of Dentistry based at the Tygerberg Oral Health Centre (TOHC). The study population comprised 239 patients who presented with mid facial fractures over 2 years, from January 2015 to December 2016. The data captured included demographic details, etiology, fracture site(s) and radiological investigations performed. Results: A vast male predominance was observed (M: F=5.3:1). The age range was 7-76 years (mean 31.94; SD 13.13). The most affected age category was 21 to 30 years (39.7%) while the least affected groups were children aged 0 to 10 years and patients above 70 years old. A total of 285 individual fractures were identified among the 239 patients (mean of 1.2 fractures per patient). The most common pattern of fracture was zygomatic complex (24.9%) while Le Fort fractures were the least common (5.3%). 20.1% of patients had concomitant fractures of other bones of the face and skull. There was no association between gender and site of fracture (p = 0.812). Panoramic radiography was the most common initial investigation. A panoramic radiograph in combination with various conventional extraoral views were sufficient for diagnosis in 18.8% of the patients. However, majority (53.6%) had all the three types of imaging performed (panoramic radiograph, conventional extra oral views and advanced imaging). The most common etiological factor was assault (73.6%). There was no association between gender and aetiology of fracture (p = 0.537)