Abstract
Background: Maxillofacial fractures are of great medico-legal implications because they are of common occurrence
with other injuries, predominantly head injuries that might involve serious esthetic and functional problems, and so
clinically described as consequential injuries. The aims were to assess the medico-legal aspects of maxillofacial
fractured cases concomitant with closed head injury over a 6-year period (2011–2016) in the Trauma Unit of Assiut
University Hospitals, Egypt, and to evaluate the demographic feature and the trend of different patterns of such
fractures.
Patient and methods: A descriptive hospital-based study included all cases of maxillofacial fractures combined
with closed head injury attending the Trauma Unit of Assiut University Hospitals in the period of January 2011 to
December 2016.
Results: The study included 1221 cases, the percent of maxillofacial fractures with a closed head injury was 4%, the
age group 18–40 years was having the highest incidence, and mean age was 25.9 ± 15.3 years with male to female
ratio of 7:1. Road traffic accidents were the main etiology of injury (69.7%), followed by falls (15.1%) and violent
assaults (10.2%) while firearm injuries were the last (5%). Unintentional injuries were the commonest in 83.1%
followed by homicidal (16.3%); only 7 cases were due to suicidal attacks. The mandibular fracture was the
commonest (49.7%) followed by fracture maxilla (19.2%), fracture zygoma (16.8%), and lastly frontal bone and nasal
fracture. The trend of maxillofacial fractures over the 6-year period tended to be increased with the highest number
in 2011 (21.5%) and the lowest in 2014 (13.3%).
Conclusion: Maxillofacial fracture with a closed head injury in Upper Egypt is common in the middle age with
male predominance. Road traffic accident is the main etiologic factor, and accidental trauma is the commonest
manner. Mandibular fractures are the commonest pattern followed by fracture maxilla. Traumatic head injuries in
cases of maxillofacial fractures were mild in about half of the cases. The trend of maxillofacial fractures over the 6-
year period of the study (2011–2016) tended to be increased with the highest number in 2011 and the lowest in
2014.