Maxillofacial fractures among patients attended at Muhimbili National hospital, Dar es Salaam

Abstract

Background: Fractures of the facial regionoften result in with
functional and psychological and psychological consequedisturbannces, that includethe magnitude of which determines the morbidity and risk to life.
Objective: To determine the pattern of occurrence, types, and treatment and prognosis of patients with maxillofacial fractures at the dental school of the Muhimbili University College of Health SciencesNational Hospital, Dar es Salaam, Tanzania.
Methodology: All patients with maxillofacial fractures who presented from January 2003 to June 2004 were included in this prospective e study. Using a questionnaire and specially designed patients’ record form,s data on age, gender, education, site and, causes of fracture and treatment offered of fracture were recorded. Statistical testing was done where a p-value of 0.05 was considered to be significant. Majority of mandibular fractures were treated by closed reduction and immobilisation by maxillomandibular fixation. Few fractures were treated by open reduction. as outpatientsLe Fort I and II fractures were treated by zygomatico-maxillary suspension
while Le Fort III fractures were treated by frontomaxillary or craniomaxillary suspension with supplementary maxillomandibular fixation (MMF). Patients were followed up at three and six months post treatment. Majority of the patients healed uneventfully. Few had permanent deformities with functional and psychological effects.
Results: One hundred and eighteen patients with maxillofacial
fractures were seen and treated (M:F ratio = 3.7:1). Peak incidence
was in the 21-30 years age group who that accounted for 53 (46.3 %)
of the cases, followed by the 11 to 20 years age group which
comprised of 25 (accounting for 21.3%) of the cases (p<0.001).
Majority, 110 (85.9%) fractures, were occurred in the mandible,
while 16 (13.6%) occurred in the maxilla and 2 (1.6%) in the
zygoma. The most frequent cause was violence (social altercation,
domestic violence and assaults), which accounted for 64 (54.2%) of
all fracturescauses, followed by motor traffic accidents with 41
(34.7%).
Conclusion: The mandible was the most commonly fractured
bone. Violence was the major cause of maxillofacial fractures with
most of the patients belonging to the younger age groups of the low
social economic class. Treatment was mainly closed reduction and
immobilization. Most fractures healed with minimal complications
and the prognosis was generally good.

Key words: Maxillofacial fractures, epidemiology, treatment and prognosis, Muhimbili National Hospital