Facio Maxillary Fractures Attended In A Tertiary Care Hospital.

Background: - Facio-maxillary injuries account for 93.3% of total injuries. Facial injuriesoccur in a significant proportion of trauma patients requiring prompt diagnosis of fracture and soft tissue injuries with possible emergency intervention. Facio-maxillary fractures may present with associated neural and spine injuries. In fact there may be associated limb injuries also.Aim of the Study: - To find out about the common causes, different types of fractures, male female ratio, different complications and patients who needed surgical intervention. Materials and Methods: - This is a prospective cross sectional study comprising of 60 patients who were having different facio-maxillary fractures and visited to L.G. Hospital from June 2017 to May 2018. Observation and Results: - Facio-maxillary fractures and their incidence varies with different places. Male to female ratio was 14:1 in our study. Facio-maxillary fractures are associated mostly with Road Traffic Accidents (RTA 80%), followed by fall (12%), assault (5%) and sports injuries (3%). Commonest facial bone to get fractured is nasal bone (53.3%),followed by mandible (43.3%), maxilla (40%), orbit (23.3%), zygoma (10%) and frontal (6.6%).Condylar fracture is most common amongst mandible fractures, 8 cases (30.8%). Most common isolated bone to get fractured is nasal bone (16.7%) followed by mandible (10%), maxilla (6.7%), orbit (6.7%), fontal (3.3%), zygoma (3.3%). Clinical examination of the patient is very important in terms of facial asymmetry and oedema, mouth opening and teeth occlusion. 3D CT face helps in diagnosis of facio-maxillary fractures. In uncomplicated cases of facio maxillary fractures of maxilla and mandible with proper mouth opening and teeth occlusion, conservative management was done and in patients with decreased mouth opening and improper teeth occlusion surgical management was done. In cases of nasal bone fractures, if there was external deviation of nose or nasal blockage, patient was managed surgically and if there was absence of external deviation or nasal blockage, patient was managed conservatively. Out of 60 patients, 24(40%) patients were operated while 36 (60%) patients were managed conservatively. Most of themandible fractures (76.9%) were operated (20 0ut of 26) while other bone fractures (Nasal-68.7%, Maxilla- 91.7%, Zygoma- 33.3%, Orbital and frontal- 100%) were managed conservatively. Most common complication following injury was hypoesthesia (4 out of 60 patients). Local site infection, angle of mouth deviation and haematoma were seen in only one patient each. Conclusion: - Based on this study we can conclude that facio maxillary injuries1account for major percentage of injuries following RTA (80%). Most of the facial bone fractures were treated conservatively (60%). 3D CT face is the gold standard investigation to rule out different facio maxillary fractures. This data is important for evaluation of existing preventing measures and useful in development of new methods of injury prevention and treatment.