![]() ![]() Significant displacement of the floor occurred in a small portion of patients (21.5%). Ī review of 93 facial trauma patients showed the infraorbital foramen was affected in 56.9% of cases, and displacement of the orbital floor was present in 86% of cases. The transmission of physiological forces during impact is distributed along the facial buttresses, and these are more likely to give during a fracture. Of the midface, the zygomatic arch is the most vulnerable due to its prominence. Ī study in New Zealand of 25,000 patients with facial fractures revealed a higher portion involved the midface (63.5%), and only 3.3% involved the upper third. Facial fractures in children under the age of 5 are rare, making up 1.4% of cases. There is no dominance of the male sex amongst the younger age groups, but this appears during later childhood years and adolescence. Īmongst patients under 18 years of age, the likelihood of fractures increases with age, possibly as a result of greater involvement in high-risk activities and changes in the anatomy. However, this male predominance decreases in the elderly cohort of patients, most likely because falls become the most common cause of fractures in general in the elderly population. A study in Royal Perth Hospital, Western Australia, also supported a prevalence in males (87%), with an average age of 27 years. This is thought to be due to the increased likelihood of participation in high-risk activities, contact sports, and interpersonal violence. The age group most affected was 11 to 20 years (34.5%), followed by 21 to 30 years (23.3%). The mean age was 30.6 years, with the youngest at seven months and the eldest at 87 years. Ī Malaysian study of 473 patients revealed a significant prevalence of maxillary injuries presenting in males (82.2%). Amongst the geriatric population, these injuries are often linked with other significant morbidities, increased severity of the fracture, and a higher risk of mortality. Lefort fractures are rare in the pediatric cohort and tend to present in major trauma cases, such as motor vehicle accidents, where a high-velocity impact is expected. įor the pediatric and geriatric cohort, the main cause of maxillary fractures are falls. Conversely, in countries such as Switzerland and Austria, skiing is the most common cause of sporting injuries. In Italy, Germany, and France, football is the main cause. Gaelic football (35.3%), football (22.3%), rugby (12.4%), and equine sports (12.4%) are chiefly responsible for the maxillary sporting injuries in Ireland, for example. The etiology is very much dependent on the sports culture within the country of study. Sporting injuries account for 6% to 33% of maxillary fractures. Interpersonal violence and assault, with or without the use of weapons, is commonly reported and made up 19% of all maxillary fractures in a Swiss study of 471 patients. A large portion of these injuries occurs in the context of alcohol use (53%) or illicit drugs (47%). The most common of the two is RTAs, of which motorcycle incidents most frequent (73.6%) compared to motor vehicle incidents (9.5%). The etiology of maxillary fractures varies depending on the socio-economic status of countries, sports cultures, motor vehicle regulations, and other laws.Īdult distribution of maxillary fractures tends to be predominantly as a result of high-risk behavior such as interpersonal violence or road traffic accidents (RTAs).
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