Clinical indicators of midface fracture in patients with trauma

Hayden L Smith; Elizabeth Chrischilles; Todd J Janus; Richard A Sidwell; Marizen Ramirez; Corinne Peek-Asa; Sheryl M Sahr

doi:10.1111/edt.12006

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$Clinical indicators of midface fracture in patients with trauma$

Journal article

Peer reviewed

Clinical indicators of midface fracture in patients with trauma

Hayden L Smith, Elizabeth Chrischilles, Todd J Janus, Richard A Sidwell, Marizen Ramirez, Corinne Peek-Asa and Sheryl M Sahr

Dental traumatology, Vol.29(4), pp.313-318

08/2013

DOI: 10.1111/edt.12006

PMID: 23067335

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Abstract

Midface fractures are commonly present and difficult to diagnose in trauma patients. The objective of this study was to determine clinically accessible indicators of midface fracture. A case-control study design was used to determine clinical indicators of midface fracture. Population source was a level I trauma center registry for years 2007-2009. Cases had a documented midface fracture. Patient and trauma characteristics were compared between cases and controls. Multivariate logistic regression analysis determined significant indicators of midface fracture. Study sample included 83 cases and 83 frequency-matched controls. Cases had a total of 211 fractures with a median of two midface fractures per person. Common fractures were orbital (41%), malar and maxillary (28%), and nasal bones (19%). Patients with midface fracture were significantly different than patients without midface fracture in severity of injury and were more likely to have a traumatic brain injury. Significant clinical indicators of fracture were maxillary sinus opacification, ethmoid sinus opacification, forehead laceration, periorbital contusion, epistaxis, and injury mechanism (P < 0.05). Patients with midface fracture had a 63 times greater odds for maxillary sinus opacification. The multivariable model correctly classified the presence and absence of midface fracture in 95% of study sample. Determined indicators of midface fracture provided a high level of discrimination in fracture status. Indicators can be used by clinicians to help detect possible midface fractures. Future prospective research on midface fracture indicators can assist in establishing their generalizability and impact on fracture detection, care, and outcomes.

Facial Injuries - classification

Area Under Curve

Humans

Middle Aged

Skull Fractures - complications

Trauma Centers

Logistic Models

Male

Facial Injuries - diagnosis

Facial Bones - injuries

Trauma Severity Indices

Case-Control Studies

Skull Fractures - diagnosis

Adult

Female

Aged

Facial Injuries - epidemiology

Brain Injuries - etiology

Details

Title: Subtitle: Clinical indicators of midface fracture in patients with trauma
Creators: Hayden L Smith - Medical Education Services, Iowa Methodist Medical Center, Des Moines, IA 50309, USA. smithhl@ihs.org
Elizabeth Chrischilles
Todd J Janus
Richard A Sidwell
Marizen Ramirez
Corinne Peek-Asa
Sheryl M Sahr
Resource Type: Journal article
Publication Details: Dental traumatology, Vol.29(4), pp.313-318
DOI: 10.1111/edt.12006
PMID: 23067335
NLM abbreviation: Dent Traumatol
ISSN: 1600-4469
eISSN: 1600-9657
Publisher: Denmark
Language: English
Date published: 08/2013
Academic Unit: Neurology; Pharmacy; Public Health Administration; Occupational and Environmental Health; Epidemiology; Surgery; Nursing; Public Policy Center (Archive); Internal Medicine
Record Identifier: 9983995022802771

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