Causes, Patterns, and Management of Maxillofacial Fractures in Patients Presenting to the Dental Department of PAHS
Bikash Desar
ABSTRACT
Objective: The objective of this study was to determine the etiology, fracture patterns, and modes of management of maxillofacial injuries in patients presenting to a tertiary care center at Dental Department in Patan Academy of Health Sciences, Nepal.
Methodology: This retrospective study was conducted over a period of two years and six months, from January 2020 to June 2024. A total of 214 consecutive patients presenting to the indoor, outdoor, and emergency departments with maxillofacial injuries were included. Data regarding patient demographics, etiology of injury, occupation, socioeconomic status, and patterns of maxillofacial fractures were collected
and analyzed.
Results: The mandible was the most frequently fractured bone, accounting for 106 cases (49.5%). This was followed by panfacial (fullhouse) fractures (15.4%) and zygomatic complex fractures (15.4%). Associated midface fractures were observed in 12.6% of cases, while isolated nasal bone fractures were noted in 1.5%. Road traffic accidents (RTAs) were the most common cause of injury (58.4%), followed by falls (24%), firearm injuries (6.1%), interpersonal violence (2.8%), and sports-related and other injuries (8.4%). Employees (49.5%) and students (31.3%) in the 20–40-year age group were most commonly affected by RTAs, whereas falls (14.4%) were more prevalent in patients under 20 years of age. The primary modes of treatment included open reduction and internal fixation (ORIF) alone in 43.9% of cases, maxillomandibular fixation (MMF) with or without suspension in 38.8%, and ORIF combined with MMF in 14.5%.
Conclusion: The mandible was the most commonly fractured facial bone in this study. Road traffic accidents—particularly involving motorcycles and chingchi rickshaws—were the leading etiological factor. The findings suggest that personal behavior and occupational
environment may significantly influence the occurrence of maxillofacial injuries.
