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Waheed Eissa

on 25 April 2013

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by: Waheed Abdel Hamid Management of Maxillofacial Fractures in Cairo Educational Hospitals
(a prospective study) Three Cairo Educational Hospitals Aim of the study To point out experience in Egypt with maxillofacial trauma, bearing in mind different socioeconomic and demographic factors.

To point out different etiologic factors, incidence of fractures, different treatment modalities and imaging techniques through a period of time.

To analyze demographic data and management of fractures of the oro-facial regions over a 12 month period for the patients seeking treatment at three educational hospitals in Cairo; namely, Ahmed Maher, Al-Mattareya, and Al-Sahel Educational Hospitals. Recommendations 1. Further studies should be conducted over a larger sample size. Patients & methods The number of individuals in the society suffering from facial trauma is increasing nowadays,
yet on the brighter side due to major advancements in health care, new treatment modalities, imaging techniques, and cumulative surgical experience
along with better team management;
maxillofacial trauma victims are able to fit back into a gainful life style. Intra-operative Intra-operative Intra-operative Case 2 one month post-operative Intra-operative Intra-operative Intra-operative Pre-operative panoramic view Open reduction with internal fixation: (ORIF)

Rigid fixation (e.g. plates and screws).

Non-rigid fixation (e.g. interosseous wiring, k-wires).

Titanium mesh reconstruction.

Combinations of various treatments as appropriate. Patients & methods Treatment patterns included:
1. Closed reduction comprising Patients & methods 3D Reconstruction CT scan Panoramic radiography Diagnostic imaging modalities Etiologic factors included:

Road traffic accident (RTA).

Interpersonal violence (IPV).

Accidental falls.

Animal hits and kicks.

Others (e.g., iatrogenic causes). Patients & methods 77 patients with different types of maxillofacial fractures treated at three educational hospitals located in densely populated districts of Cairo,
Egypt; during the year 2012, were investigated.
Data collected included:
1. Age.
2. Sex.
3. Cause of fracture(s).
4. Site(s) of facial fracture(s).
5. Diagnostic imaging modalities.
6. Administered treatment.
7. Post-treatment complications.
Associated injuries were excluded from this study. Patients & methods Aim of the study Immediate post-operative Pre-operative coronal CT Gunning splint Intermaxillary fixation Coronal and Axial CT scan Plain radiography Patients & methods Patients & methods 3D reconstruction Pre-operative axial CT 3D Reconstruction Pre-operative axial CT Pre-operative axial CT Post-treatment complications studied included: Patients & methods Ahmed Maher Educational Hospital
Al-Sahel Educational Hospital
Al- Mattareya Educational Hospital Introduction Patients &methods Case Presentation Immediate Post-operative panoramic view Post-operative panoramic view Results Results Results Results Results Results Results Results Treatment modalities (%) Results
Statistical results throughout different studies conducted in different countries and at different time intervals show that both the etiologic factors and incidence rate of fractures are not the same owing to ever changing socioeconomic and demographic factors.

Most of the complications encountered in the revised cases
in the three hospitals were secondary to open surgery in both jaws.

Maxillofacial surgery should be guided by the dictum;
the simplest method and treatment which will provide
the best functional and cosmetic results should be always the best method of choice.

Surgeons should not be tempted to go for open surgery as a rule,
unless it is really indicated, and is in the patients’ best interest. Conclusions 3. Follow – up should be considered in future studies to evaluate the success of different treatment modalities. Recommendations Case 1 2. More hospitals should be included in further studies, to cover different demographical regions. 4. Future surveys should be widely concerned with trauma in the oro-facial region, regarding patient assessment, diagnostic modalities, fracture sites, treatment modalities and options, in addition to post-operative follow-up and complications.
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