Improvised explosive device injuries to the maxillofacial region: Diagnostic findings and treatment approaches in north-eastern Nigeria

Abstract

Introduction: The use of improvised explosive devices (IED) poses a significant threat, particularly in low- and middle-income countries. These homemade explosives incorporate certain objects that create unique injury patterns that present diagnostic and therapeutic challenges. This study examines the maxillofacial wounds and patterns of Boko Haram IED victims treated at the University of Maiduguri Teaching Hospital (UMTH). Understanding the different wounding patterns these injuries cause and management options will help with proper planning and management. 

Method: This retrospective study was carried out over five years at UMTH, Nigeria. The clinical records and treatment approaches of IED injuries to the maxillofacial region were obtained from patient case notes. Data were analyzed using the statistical software SPSS version 20. 

Results: The study involved 14 patients, 14–43 years old. There were three (21.4%) females, M:F ratio of 4.7:1. Primary blast injuries were seen in six (42.9%). Lacerations were the most common facial injury at 31.7%%. The most common facial fractures recorded were naso-orbitoethmoidal at 21.9%, maxillary at 18.8%, and frontal bone fractures at 15.6%. Globe rupture occurred in six (42.9%). The most common treatment was closed reduction with intermaxillary fixation (57.4%). 

Conclusion: Intermaxillary fixation emerged as the predominant treatment modality, reflecting the pragmatic use of available resources. Prevention is critical to reducing IED injuries.