Original article A prospective study on elderly patients with facial fractures in a developing country Stephen Joseph Royan 1 , Abdul Latif Hamid 2 , Ferdinand Jesudian Kovilpillai 3 , Nooral Zeila Junid 4 and Wan Mahadzir Wan Mustafa 5 1 Department of Oral Surgery, Melaka Hospital, Melaka; 2 Department of Oral Surgery, Seremban Hospital, Seremban; 3 Department of Oral Surgery, Taiping Hospital, Taiping; 4 Division of Oral Health, Ministry of Health, Putrajaya; 5 Department of Oral Surgery, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia doi:10.1111/j.1741-2358.2007.00189.x A prospective study on elderly patients with facial fractures in a developing country Background: This paper describes the incidence, aetiology, treatment and complications of facial fractures seen among the elderly in a developing country. Methods: A prospective study evaluated 85 patients over 60 years of age who were diagnosed with facial fractures over a period of 12 months in 23 public hospitals nationwide. Results: The elderly accounted for 4.5% of the total number of patients seen with facial fractures during the study period. Elderly men outnumbered women by a ratio of 4.31:1. Of the elderly patients, 35.3% had at least one medical condition, the commonest of which was hypertension. Road traffic accidents were the main cause of injury. The fractures were treated in only 26.2% of cases. Complications were uncommon. Conclusions: With a low incidence, and conservative treatment often being practised, the healthcare burden of treating facial fractures among the elderly in Malaysia is at present still low. Keywords: facial fractures, elderly, epidemiology, Malaysia. Accepted 05 June 2007 Introduction Traumatic injuries to the maxillofacial region have generally been associated with the young adult population 1–5 and this has been attributed to their energy and physical activity. Hence, most studies on maxillofacial trauma have concentrated on this age group and there is a lack of specific data relating to the elderly population, especially so in the developing world. The global demographic pattern is changing. In proportionate terms, it is the older age group which is growing faster than any other group 6 . This is mainly attributed to increased lon- gevity resulting in an increased proportion of the elderly in the population. It is estimated that by the year 2050, two billion of the world’s population will be aged 60 years and over, and 80% of these will be living in developing countries 7 . Although the general rules of fracture treatment remain un- changed, maxillofacial fractures in the geriatric patient may be complicated by special factors like edentulousness, delayed healing and existing medical conditions. The aim of this prospective descriptive study was to provide a specific account of the incidence, aetiology, pattern and treatment of maxillofacial fractures in the geriatric population in Malaysia. It reviews 85 cases seen over a 12-month period. Materials and methods From 1 June 2002 to 31 May 2003, detailed records of cases of facial fractures seen in the 23 hospitals under the Ministry of Health throughout Malaysia were collected using a prescribed format. The recording format was a modification of the one described by Meaders and Sullivan 8 and was pre- pared as a 21 page long booklet. Instructions relating to the collection of data using this booklet were given at a Ministry of Health Oral Surgeons meeting. The 23 hospitals represented referral centres for facial trauma in their respective regions. An in-house oral surgeon or in two hospitals a visiting oral surgeon were responsible for the Ó 2007 The Authors. Journal compilation 124 Ó 2007 The Gerodontology Association and Blackwell Munksgaard Ltd, Gerodontology 2008; 25: 124–128