title: Epidemiology and management of maxillofacial fractures in an Australian trauma centre.
abstract: OBJECTIVE
  Trauma is a leading cause of morbidity and mortality, with a considerable proportion of trauma patients sustaining concomitant maxillofacial (MF) injuries. The purpose of this study was to review and analyse the epidemiology, management and complications of patients with MF fractures managed by the Faciomaxillary Surgery Unit at the Alfred Trauma Hospital in Melbourne. The secondary objective of the study was to determine the risk factors for developing postoperative complications.
  
  
  METHODS
  A retrospective records review was performed for 980 patients who were treated for MF fracture(s) from January 2009 to December 2011. Descriptive statistics were used and independent demographic and injury-related factors assessed for association with outcome using multivariate logistic regression.
  
  
  RESULTS
  A total of 1949 MF fractures from 980 patients were treated over the study period. Males (n = 785, 80.10%) and patients aged 15-24 years (n = 541, 55.20%) were the most frequently affected (mean age (standard deviation, SD) 27.69 (19.22)). The most common aetiology was assault (n = 293, 29.90%). The majority presented with fractures of the orbit (n = 359, 36.33%). In total, 803 fractures from 500 patients were treated operatively. Mandibular fractures were most commonly treated surgically (79.82%). Postoperative complications occurred in 69 of 500 patients treated surgically (13.8%), most commonly due to infected metalware (n = 16, 3.20%). Multiple fractures were associated with a higher probability of requiring surgery (p < 0.001) and developing postoperative complications (p < 0.001) compared to isolated fractures.
  
  
  CONCLUSIONS
  MF fractures most commonly affected young males, often as a result of an assault. Per bony injury, mandibular fractures had the greatest proportion that was managed operatively. High-energy injuries were associated with an increased risk of sustaining multiple MF fractures and developing postoperative complications.
authors.affiliation: Plastic, Hand & Faciomaxillary Surgery Unit, The Alfred Hospital, Melbourne, VIC, Australia.
authors.forename: Miguel S
authors.initials: MS
authors.lastname: Cabalag
authors.affiliation: Victorian Adult Burns Service and School of Public Health and Preventive Medicine, Monash University, The Alfred Hospital, Melbourne, VIC, Australia.
authors.forename: Jason
authors.initials: J
authors.lastname: Wasiak
authors.affiliation: Translational Public Health Unit, Stroke and Ageing Research Centre, Southern Clinical School, Monash University, Melbourne, VIC, Australia.
authors.forename: Nadine E
authors.initials: NE
authors.lastname: Andrew
authors.affiliation: Plastic, Hand & Faciomaxillary Surgery Unit, The Alfred Hospital, Melbourne, VIC, Australia.
authors.forename: Jason
authors.initials: J
authors.lastname: Tang
authors.affiliation: Plastic, Hand & Faciomaxillary Surgery Unit, The Alfred Hospital, Melbourne, VIC, Australia.
authors.forename: Julia C
authors.initials: JC
authors.lastname: Kirby
authors.affiliation: Plastic, Hand & Faciomaxillary Surgery Unit, The Alfred Hospital, Melbourne, VIC, Australia. Electronic address: D.Morgan@alfred.org.au.
authors.forename: David J
authors.initials: DJ
authors.lastname: Morgan
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001265:Athletic Injuries / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D015841:Enophthalmos / Q000209:etiology; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D017759:Fractures, Malunited / Q000209:etiology; D005599:Fractures, Ununited / Q000209:etiology; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000209:etiology; D008337:Mandibular Fractures / Q000453:epidemiology / Q000601:surgery; D008440:Maxillary Fractures / Q000453:epidemiology / Q000209:etiology; D008446:Maxillofacial Injuries / Q000453:epidemiology* / Q000601:surgery*; D008875:Middle Aged; D009104:Multiple Trauma / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery; D009295:Nasal Bone / Q000293:injuries; D009917:Orbital Fractures / Q000453:epidemiology / Q000601:surgery; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000209:etiology; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D014193:Trauma Centers; D014754:Violence / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Australia; Complications; Epidemiology; Management; Maxillofacial fractures; Risk factors