Injuries of the Upper and Medial Third of Face. Analysis of Their Causes

Overview

Background.
From the point of traumatologist, the size, locality and direction of the injuring force give the extent of the injury of facial skeleton. The aim of the paper is to present an overview on aetiology of injuries of the upper and medial third of face in relation with the incidence, gender and age of patients.Methods and Results. 282 adult patients (208 males and 74 females, average age 40 years) and 25 children (18 boys and 7 girls, average age 9 years) were treated since 1.1.1998 till 31.8.1999. 25 of them (9 %, 19 males and 6 females) had fracture of the middle third of the face. In 5 patients (20 %), fractures were accompained by commotion of the brain. Conservative treatment was used in 16 patients (64 %) and surgical approach in 9 of them (36 %). Isolated fractures of nasal bones were diagnosed in 230 adult patients (82 %, 168 males, 62 females, 25 children). In 19 adult patients (8 %) the fracture was open, in 25 of them the reposition of dislocated bones was done in general anaesthesia. 27 patients (10 %, 21 males, 6 females) had polytrauma, accompanied by the facial bones fractures of the upper and middle third. Facial fractures of the upper and middle third were caused by violence of other person (criminal injury) in 15 patients (60 %), downfall in 66 patients (29 %), sport injury in 38 patients (17 %), traffic injury in 16 patients (7 %). The most common cause of isolated fracture of nasal bones in children was downfall in 12 patients (48 %), violence of other person or schoolmate in 7 patients (28 %) sport injury in 5 patients (20 %), traffic injury in 1 patient (4 %). In 27 persons with polytrauma and facial fractures of the upper and middle third, the injury was caused by traffic accident in 13 patients (48 %), downfall in 8 patients (30 %), sport injury in 2 patients (7.4 %), criminal injury in 2 patients (7.4 %), work injury in 1 patients (7.4 %).Conclusions. Polytrauma belongs to the most serious injuries both due to their extent and their significance because in most of them the life of patients is directly threatened. Criminal injuries represent very common cause of the facial fractures of the upper and middle third with maximum prevalence in males of the third decade. Part of those injuries belong to polytrauma.

Key words:
facial injuries, criminal injuries, polytrauma, aggression.