Aim: This study aims to determine the prevalence and nature of facial fracture associated with head injury as seen in motorcycle accident using a cranial CT scan.
Patients and Methods: This was prospective study carried out at the University of Benin Teaching Hospital on patients who were involved in motorbike accident with history of head injury and associated injury to the face necessitating a cranial Computed Tomographic scan.
Results: A total of one hundred and six patients made up of 99 (93.4%) males and 7 (6.6%) females were recruited. The male to female ratio was 14:1. The mean age of the study population was 36.3 years ± 1.33 years (range18 years to 80 years). Majority (36.8%) of the patients were within the 20-29 years range followed by age group 30-39 years (22.6%). Seventy-three (73.7%) of the ninety-nine male patients were motorbike riders while 6 (85.7%) of the 7 female patients were passengers. Sixty cases had facial fractures associated with head injury representing a prevalence rate of 56.6%. Fracture of the upper third of the face - frontal bone n = 36 (57.1%) was the commonest finding on the CT scan. Eighty-one (76.4%) patients had evidence of one or more types of intracranial hemorrhage. Forty-four patients had both facial fracture and some forms of intracranial haemorrhage. Intracerebral haemorrhage 35 (58.3%) was the commonest form of intracranial haemorrhage.
Conclusion: There is a high prevalence of facial fractures associated with head injury in motorcycle accident victims. Males in the third decade of life are mostly affected. There is an urgent need for the regulatory bodies to enforce the existing traffic codes and engage in public enlightenment programs on the consequences of non-adherence to traffic rules.
Pattern of Radiographic Changes Associated with Traumatised Anterior Teeth Among Adult Patients in a Tertiary Hospital In Nigeria
INTRODUCTION: Giving the importance of radiographs in management of traumatic dental injuries, this study was designed to evaluate the periapical radiographic findings associated with traumatized anterior teeth in adults.
METHODOLOGY: This was a cross-sectional study of adult patients with traumatic dental injuries. The data collection instrument was a pre-tested interviewer administered questionnaire eliciting information on participants’ demographic characteristics, clinical history and radiographic changes.
RESULT: A total of 189 patients who presented with a traumatic episode to the teeth participated in this study. Radiographic changes of clinical significance were observed in 50.8% of cases. There was increasing incidence of radiographic changes of clinical significance with increasing age till 50 years and this was statistically significant. A higher proportion (65.2%) of those who presented late had radiographic changes of clinical significance and this was statistically significant. Periapical radiolucency was the most frequent radiographic changes 80.2%).
CONCLUSION: It is necessary for every dental trauma case to be evaluated radiographically especially those that present late as there may be concealed injuries that are not clinically detectable on visual inspection and palpation.
Self-injurious behavior in children with special health care needs: a report of three cases
Self-Injurious behaviours are repetitive acts that result in physical damage to the individual. They are associated with intellectual and developmental disabilities, autism spectrum disorders and some syndromes. In the maxillofacial region these behaviours include variable degrees of lip sucking and biting, tongue biting, cheek and digit biting and bruxism. This paper presents three cases of self-injurious behaviours with lip biting, bruxism and tongue avulsion.
Important clinical findings included bleeding, ulcers, tissue tenderness, mutilation and loss. Though some researchers have tried to establish a standard management protocol, management of these behaviours require an individualization of cases using simple devices and procedures as the health conditions of the patients and their characteristic oral lesions differ.
Management of naso-orbito-ethmoidal fractures with modification of the conventional closed technique
The management of naso-orbito-ethmoidal (NOE) fractures is often challenging due to the complex anatomy of the region. Trauma to the bones that make up the area often result in fractures which occur in a comminuted fashion and are usually compounded into the related sinuses.
We report a case of a 25-year-old male iron bender who sustained NOE fractures and had reduction and immobilization using per cutaneous tubed stents supported by intra nasal endotracheal tubes (ETT) for both nostrils. The fixation acquired enough strength and stability which permitted removal of splints at the end of three weeks.
Modification of the conventional closed reduction technique with the use of percutaneous tubed stents provides an acceptable pre-traumatic facial appearance including facial width, projection and height at a relatively low cost and technique sensitivity.