Evaluation of 591 patients with midface fractures treated between 1991 and 2001 in the Department of Maxillofacial Surgery, University Hospital Zurich

Abstract

Introduction: Midface fractures represent a significant amount of the traumatological load handled by the Department of Maxillofacial Surgery (MFS), University Hospital, Zurich (USZ). Various fracture classifications have evolved from early descriptions of general patterns to modern, reproducible and computerised schematics. Although the modern classification systems are advantageous, particularly when it comes to statistical analysis and exact fracture recording, older systems prevail because of their simplicity. This is particularly true for the Le Fort and Rowe classification systems which are still in everyday usage. Objective: To quantify and analyse the number of
midface fractures with associated facial fractures from 1990 up to and including 2001 operatively treated in the Department of MFS USZ as well as various social and
general injury determinants. Materials and Methods: The hospitals databases and patient files were searched for relevant information and this was entered into a
computerised dataset. Using SPSS software descriptive statistics and logistic regression were performed. Results: 591 patients suffered from 1588 fractures
equalling 2.7 fractures per patient. 106 (17.9%) patients additionally suffered from 188 (11.7%) mandibular and 72 (12.2%) patients from a total of 83 (5.2%) supraorbital
fractures in addition to their midface fractures. The fractures were split into categories defined in literature, fracture distribution to each other and to injury mechanisms were analysed and neural trauma, polytrauma and panfacial trauma reviewed separately.
The average age was 39.4 years with a SD of 16.6 with a male peak at 25 to 30 years of age and a female peak slightly earlier at 20 to 25 years. The male to female ratio
was 3:1 overall. The most common cause of injury was traffic accidents, followed closely by sports accidents and assault. Discussion: Our midface fracture population
had more and more serious injuries than average according to literature. The results are discussed in detail.