Facial Fractures: Large Epidemiologic Survey in Northern Brazil Reveals Some Unique Characteristics.

PURPOSE: Facial fractures are an important health problem worldwide that can cause temporary or permanent disability and an economic burden. Identifying the risk factors associated with facial fractures is a valuable tool to create preventive public health strategies. This study evaluated the epidemiologic profile of facial fractures in northern Brazil.

PATIENTS AND

METHODS

Medical records of 1,969 patients who sustained facial fractures were analyzed for characteristics of the population, types of facial fractures, and treatment performed.

RESULTS

The zygomatic complex was the most prevalent fracture site (28.8%). Road traffic accident (RTA) was the most common etiology (52%), followed by interpersonal violence (IPV; 34%). Among IPV cases, gunshot wounds were responsible for 14% of cases and 3% resulted from stab wounds. The third decade of life was the most prevalent age group, with a remarkable change in prevalence and etiology pattern at 15 years of age. Open reduction and internal fixation was the most used treatment, especially when the mandible was involved and at least 2 facial bones were fractured. There were 37 deaths (1.9%), with a higher risk observed for stab wounds (3.1-fold higher) and when at least 3 bones were fractured (4.1-fold higher).

CONCLUSIONS

This epidemiologic survey identified RTA and IPV as important risk factors for facial fractures and a high prevalence of fractures caused by gunshot wounds. A unique preponderance of facial fractures caused by stab wounds was found, which was responsible for the highest risk of mortality.