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Causes and pattern of orbital fractures in Sharjah-Uae
21st ICOMS 2013—Abstracts: Oral Papers T7.OR061
T7.OR059 Flying with facial fractures—the truth is out there E. Tan-Gore Carson 1 1 2
1235
1,∗
1
2
1
, M. Thomas , R. Thanigaivel , B. Wilson , J.
Royal Darwin Hospital, Australia Royal Adelaide Hospital, Australia
There are no clear, evidence-based guidelines that dictate when it is safe for a patient to fly after a midface fracture, whether they are surgically managed or not. The Royal Darwin Hospital Maxillofacial Unit had 48 out of 201 patients with a midface fracture flown to the unit for definitive management. Despite flying 24% of our patients with midface fractures to our centre for management, there were no complications arising from the flight, nor was there any change to flight paths or patterns as a result of the patient’s fractures. We have shown that, on a variety of aircraft, there are no absolute contraindications to flying with midface fractures, but clinical assessment remains crucial for an informed decision to transport these patients by air. http://dx.doi.org/10.1016/j.ijom.2013.07.221 T7.OR060 Causes and pattern of orbital fractures in Sharjah-Uae S. Thomas ∗ , A. Alaree Ajman University of Science & Technology, United Arab Emirates Background and objectives: Orbital fractures are considered as one of the most common midfacial fractures encountered in trauma centre. They could be isolated or invariably involved in the different patterns of maxillofacial fractures. The study is to provide a seven-year retrospective statistical analysis of orbital fractures in patients admitted and treated in two hospitals of Sharjah city; to determine etiology of fracture, pattern of fracture, most frequent complications associated with the fracture, type of treatment modality used, most frequent complications associated with the treatment and timing of surgery. Methods: A retrospective study where the records of 199 patients were reviewed and information was gathered by a predesigned data form. The data was then computerized and statistical analysis was done using statistical package for the social sciences (SPSS) windows. Results: RTAs were the leading cause of trauma (62.3%), female to male ratio was 1:8. The most common fracture was ZMC (52.3%) among complex and blowout (11.1%) among isolated orbital fractures. The most common trauma complication was hypoethesia (35.2%) while most common post surgical complication was diplopia (3%). Surgical open reduction was the most frequent treatment modality (58.8%) and mostly in an early timing of surgery (26.6%). Conclusion: The study concluded that RTAs causes a great proportion of orbital fractures in Sharjah. Efforts should be increased regarding safety and preventive measures. Key words: orbital fractures; maxillofacial trauma; open reduction http://dx.doi.org/10.1016/j.ijom.2013.07.222
Penetrating neck injuries—a review of three years experience at a London major trauma unit A. Ujam ∗ , N. Ahmed, K. Fan Kings College London, United Kingdom Background: Penetrating neck injuries in the UK are on the increase and the most common weapon used is a knife. Life threatening vascular and aero-digestive injuries as well as nerve damage are the main concern. A systematic but dynamic protocol for managing such patients is required in order for the best outcomes to be achieved. Some patients will require immediate operative intervention, others may present with less dramatic signs and the correct imaging modality will be necessary to identify potential deep injuries. We present our 3 year experience as a major trauma centre and describe the current management principles in our department. Methods: A retrospective data collection over 3 years of all the major trauma patients that presented to our emergency department. All patients with a knife related injury and patients who were assaulted, injured accidentally or self-harmed were included. A proforma was used to collect the required data. Results: Of the 185 patients, assault (80%) was the most common cause of penetrating knife injury followed by self-inflicted (11%) and then accidental (9%). 20 penetrating knife injuries were sustained of which 2 required immediate surgical intervention. Using the Monsons classification for identifying the site of the injury, level 1 was the most common. Only 1 CT angiogram was positive out of 20 performed to identify significant vascular injury. Conclusion: A locally agreed protocol is essential to manage these patients successfully with a multidisciplinary approach involving radiologists, emergency doctors, maxillofacial, vascular and ENT surgeons is important. Not all patients will require expensive and unnecessary exposure to X-rays and CT scans and a protocol will help to identify such patients. Furthermore, our experience demonstrates that clinical examination can be as sensitive as radiological investigations to identify significant injuries requiring formal surgical intervention. http://dx.doi.org/10.1016/j.ijom.2013.07.223 T7.OR062 A comparitive study of interflex plates versus standard conventional miniplates for rigid fixation of mandibular symphysis/body fractures M. Vandekar ∗ , M. Padhye D.Y. Patil Dental College and Hospital, India Background and objectives: The objective of this study was to evaluate outcomes for 2 bone plating systems used in the treatment of mandibular symphysis/body fractures. Methods: 20 healthy individuals were selected with symphysis/body mandibular fractures and randomly divided into two groups of 10 patients each. Patients in Group A were treated with two (2.5 and 2.0 mm) miniplates. Patients in Group B were treated with a single 1.5 mm interflex plate. Data was collected and statistically analyzed to determine if the 2 treatments produced different outcomes. Results: There were no statistically significant differences in variables such as ease of plate adaptation, time taken for fixation of plates, reduction of osseous fragments, post operative occlusion,
T7.OR059 Flying with facial fractures—the truth is out there E. Tan-Gore Carson 1 1 2
1235
1,∗
1
2
1
, M. Thomas , R. Thanigaivel , B. Wilson , J.
Royal Darwin Hospital, Australia Royal Adelaide Hospital, Australia
There are no clear, evidence-based guidelines that dictate when it is safe for a patient to fly after a midface fracture, whether they are surgically managed or not. The Royal Darwin Hospital Maxillofacial Unit had 48 out of 201 patients with a midface fracture flown to the unit for definitive management. Despite flying 24% of our patients with midface fractures to our centre for management, there were no complications arising from the flight, nor was there any change to flight paths or patterns as a result of the patient’s fractures. We have shown that, on a variety of aircraft, there are no absolute contraindications to flying with midface fractures, but clinical assessment remains crucial for an informed decision to transport these patients by air. http://dx.doi.org/10.1016/j.ijom.2013.07.221 T7.OR060 Causes and pattern of orbital fractures in Sharjah-Uae S. Thomas ∗ , A. Alaree Ajman University of Science & Technology, United Arab Emirates Background and objectives: Orbital fractures are considered as one of the most common midfacial fractures encountered in trauma centre. They could be isolated or invariably involved in the different patterns of maxillofacial fractures. The study is to provide a seven-year retrospective statistical analysis of orbital fractures in patients admitted and treated in two hospitals of Sharjah city; to determine etiology of fracture, pattern of fracture, most frequent complications associated with the fracture, type of treatment modality used, most frequent complications associated with the treatment and timing of surgery. Methods: A retrospective study where the records of 199 patients were reviewed and information was gathered by a predesigned data form. The data was then computerized and statistical analysis was done using statistical package for the social sciences (SPSS) windows. Results: RTAs were the leading cause of trauma (62.3%), female to male ratio was 1:8. The most common fracture was ZMC (52.3%) among complex and blowout (11.1%) among isolated orbital fractures. The most common trauma complication was hypoethesia (35.2%) while most common post surgical complication was diplopia (3%). Surgical open reduction was the most frequent treatment modality (58.8%) and mostly in an early timing of surgery (26.6%). Conclusion: The study concluded that RTAs causes a great proportion of orbital fractures in Sharjah. Efforts should be increased regarding safety and preventive measures. Key words: orbital fractures; maxillofacial trauma; open reduction http://dx.doi.org/10.1016/j.ijom.2013.07.222
Penetrating neck injuries—a review of three years experience at a London major trauma unit A. Ujam ∗ , N. Ahmed, K. Fan Kings College London, United Kingdom Background: Penetrating neck injuries in the UK are on the increase and the most common weapon used is a knife. Life threatening vascular and aero-digestive injuries as well as nerve damage are the main concern. A systematic but dynamic protocol for managing such patients is required in order for the best outcomes to be achieved. Some patients will require immediate operative intervention, others may present with less dramatic signs and the correct imaging modality will be necessary to identify potential deep injuries. We present our 3 year experience as a major trauma centre and describe the current management principles in our department. Methods: A retrospective data collection over 3 years of all the major trauma patients that presented to our emergency department. All patients with a knife related injury and patients who were assaulted, injured accidentally or self-harmed were included. A proforma was used to collect the required data. Results: Of the 185 patients, assault (80%) was the most common cause of penetrating knife injury followed by self-inflicted (11%) and then accidental (9%). 20 penetrating knife injuries were sustained of which 2 required immediate surgical intervention. Using the Monsons classification for identifying the site of the injury, level 1 was the most common. Only 1 CT angiogram was positive out of 20 performed to identify significant vascular injury. Conclusion: A locally agreed protocol is essential to manage these patients successfully with a multidisciplinary approach involving radiologists, emergency doctors, maxillofacial, vascular and ENT surgeons is important. Not all patients will require expensive and unnecessary exposure to X-rays and CT scans and a protocol will help to identify such patients. Furthermore, our experience demonstrates that clinical examination can be as sensitive as radiological investigations to identify significant injuries requiring formal surgical intervention. http://dx.doi.org/10.1016/j.ijom.2013.07.223 T7.OR062 A comparitive study of interflex plates versus standard conventional miniplates for rigid fixation of mandibular symphysis/body fractures M. Vandekar ∗ , M. Padhye D.Y. Patil Dental College and Hospital, India Background and objectives: The objective of this study was to evaluate outcomes for 2 bone plating systems used in the treatment of mandibular symphysis/body fractures. Methods: 20 healthy individuals were selected with symphysis/body mandibular fractures and randomly divided into two groups of 10 patients each. Patients in Group A were treated with two (2.5 and 2.0 mm) miniplates. Patients in Group B were treated with a single 1.5 mm interflex plate. Data was collected and statistically analyzed to determine if the 2 treatments produced different outcomes. Results: There were no statistically significant differences in variables such as ease of plate adaptation, time taken for fixation of plates, reduction of osseous fragments, post operative occlusion,