Occurrence and patterns of maxillofacial fractures at Moi Teaching and Referral Hospital, Kenya

Abstract

Background: The prevalence of maxillofacial fractures is rising in Kenya, leading to increased hospitalization and risk of mortality. Its  etiology has been attributed to increased use of motorized transport, assault, sport and occupational injuries. 

Objective: This study  aimed to determine the occurrence and patterns of maxillofacial fractures at Moi Teaching and Referral Hospital (MTRH). 

Methodology:  A cross-sectional study conducted at the departments of dentistry, accidents and emergency as well as surgical wards of MTRH among  206 patients diagnosed with maxillofacial fractures who were sampled systematically. Physical examination and assessment of the clinical  investigations were performed prior to enrollment. Sociodemographic characteristics, injury history and fracture classification  data were collected using a semi-structured questionnaire. Pearson’s chi-square statistical test was used to assess the association  between etiology (independent variable) and pattern (dependent variable) of maxillofacial fractures. 

Results: Majority of the participants  were male (86.9%; n=179) with a mean (30.8 ± 11.3) and median age of 29.0 (IQR: 23.75, 37.0) years. 114 (55.3%) and 34 (16.5%) participants were victims of motorcycle and motor vehicle accidents respectively. 80.9% did not have any protective gear at the time of  injury. Maxillofacial fractures were classified as upper third (7.7%), middle third (60.8%) and lower-third of the face (24.1%) as well as  combined and other fractures (7.4%). Mandibular fractures (27.6%) were the most common, followed by those on the zygoma arch  (18.4%), zygoma body (14.1%) and maxilla (13.7%). Furthermore, 72 (35.0%) sustained multiple fractures on a single bone. Motorized  transport accidents were significantly associated with orbital wall (p=0.023) and maxilla (p=0.003) as well as multiple fractures (p=0.006).   

Conclusions: Maxillofacial fractures are common among male, married, selfemployed individuals with at least secondary level of  education who are victims of motorcycle accidents. The mandible is the most fractured maxillofacial bone, with a significant association  between etiology and the pattern of maxillofacial fractures seen.