Treating maxillofacial trauma for over half a century: how can we interpret the changing patterns in etiology and management?

OBJECTIVE: The aim of this study was to reveal the changes in the etiology and treatment of maxillofacial fractures in Greece over the period of the last 53 years.

STUDY DESIGN: A patient-oriented retrospective review of clinical and epidemiologic data was performed to include all patients with maxillofacial fractures treated in the Oral and Maxillofacial Surgery Department of KAT General Hospital of Athens. We reviewed the causes of these injuries, their sites, and treatments (outcome variables) over the last 28 years and compared the results with those of a similar study from the same Department from 1960 to 1984 (predictor variable).

RESULTS: The zygomatic complex was the most frequent fracture site in the recent years, whereas the condyle and symphysis were the most common ones in the early period. We observed a remarkable increase of injuries from interpersonal violence (P < .0001) and a divergence from conservative treatment (P < .001) with time.

CONCLUSIONS: Universal agreement exists on the rapidly rising prevalence of facial fractures in the developed countries as a result of physical violence, and the present study confirmed this conclusion. Throughout the last 50 years, there has been a constant tendency of surgeons to adopt the concept of open reduction and internal fixation.