Classification of Midfacial Fractures on Computed Tomography Following Head Injury in a Nigerian Population
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Abstract
Background: Head injury is a global epidemic which results in fractures of the craniofacial region. Computed tomography (CT) is the gold standard in evaluating the head injured patient. The aim of this study was to assess the causes of head injury resulting in midfacial fractures and to characterize and classify the observed fracture patterns and associated findings on CT.
Patients and Methods: Between 2006 and 2008, 300 consecutive patients with acute head injury were evaluated with a helical General Electric (GE CT/e) CT scan machine. Data reviewed included cause of injury, age and gender distribution, types of facial fractures sustained, and associated intracranial and soft tissue injuries.
Results: The modal age group of the patients was the 30 to 39 year age group while the mean age was 32.78 years ± 18.51 standard deviation (SD) with a male: female ratio of 8:3. Abnormal CT scans were seen in 244 (81.4%) of the 300 patients studied. Of the 244 abnormal cases, 79 (32.4%) patients had midfacial fractures. The midfacial fractures were grouped
according to the proposed classification. Most of the fractures involved the sinonasal complex (SNC; 47.3%), while the remainder was almost equally distributed in the zygomatico-maxillary complex (ZGMC; 24.4%) and orbital complex (OC; 28.3%). Subgroups were assigned depending on the associated CT findings including soft tissue swelling, cranial fractures, and intracranial abnormalities.
Conclusion: Road traffic accidents (RTA) continue to be a major cause of head injury and midfacial fractures followed by falls and assault. We have described the CT findings in midfacial fractures following head injury in the study area and suggest a classification system for categorizing these fractures and associated findings.
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