[Etiology of maxillofacial trauma--a 10-year survey at the Chaim Sheba Medical Center, Tel-Hashomer].

BACKGROUND: The management of cranio-maxillofacial trauma includes treatment of facial bone fractures, dentoalveolar trauma, and soft tissue injuries. Integration of several specialties is often needed due to the proximity of the cranial bones to important organs such as the eyeballs, the nose, the ears, and the brain. The epidemiology of facial fractures varies in type, severity, and cause depending on the population studied. The differences between populations in the causes of maxillofacial fractures may be the result of risk factors and cultural differences between countries but are more likely to be influenced by the injury severity. Many epidemiologic investigations of maxillofacial fractures have appeared in the scientific literature over the years. Six main causes of injury were identified: motor vehicle accidents, occupational accidents, sport accidents, falls, assaults, and gun shot wounds. However, few reports, representing continuous long-term data on maxillofacial fractures in the state of Israel, are to be found.

AIMS: This study was undertaken to provide information regarding gender, age, etiology and diagnosis of patients with maxillofacial fractures, gleaned from our experience in the last 10 years (1996-2005), and to compare this information to the findings from the years 1985-1995, at the Department of Oral and Maxillofacial Surgery in the Chaim Sheba Medical Center, Tel Hashomer.

METHOD: The present study reviews retrospectively hospital records of 775 patients. Data regarding the 753 patients treated at the department in the years 1985-1995 was taken from previous publication. The diagnosis was based on radiographic data and clinical examination. The statistical analysis was carried out by the Statistics Department of Tel Aviv University.

RESULTS: The majority of patients (74.2%) were males, the average age was 33.4 years, and the largest subgroup of patients (34%) was in the third decade of life. The most common cause of injury was falls (35%), followed by motor vehicle accidents (29%), and assaults (18%). The most frequent fractures in the male group involved the zygomatic complex (23.4%), followed by the subcondylar area (13.5%). In contrast, the most frequent fractures among females involved the subcondylar area (20.4%) followed by the zygomatic complex (18%). The average age of male patients was 31.2 years, whereas the average age of female patients was 39.6 years. In regard to gender, the first five decades were dominated by male patients, the sixth decade showed an equal distribution, and the females dominated the patient group in the seventh to tenth decades. A rise in the number of patients hospitalized due to falls and assaults, and a decrease in patients hospitalized due to motor vehicle accidents was noted during the years 1996-2005 compared to the years 1985-1995.

CONCLUSIONS: Data from the world literature is similar to our findings, as regard to gender and age. Major differences between males and females regarding age, etiology, and diagnosis were found in our study. Nevertheless, the two most common fracture sites among males and females are the Zygomatic complex and the subcondylar area. Apparently, the Israeli society is becoming more violent, whereas the technological improvements, especially in the field of motor vehicle passenger safety, may play an important role in the decrease of upper body injuries.