The pattern of maxillofacial fractures in Sharjah, United Arab Emirates: A review of 230 cases Hamad Ebrahim Al Ahmed, DDS, a Mohamed A. Jaber, BDS, MSc, PhD, FDSRCSE, FDSRCS, b Salem H. Abu Fanas, BDS, MSc, PhD, c and Mark Karas, DDS, d United Arab Emirates AJMAN UNIVERSITY OF SCIENCE & TECHNOLOGY NETWORK AND AL QASSIMI HOSPITAL SHARJAH Objective. Maxillofacial injuries constitute a substantial proportion of cases of trauma. This descriptive analytical study assesses the cause, type, incidence, demographic, and treatment data of maxillofacial fractures managed at Al Qassimi Hospital in Sharjah, United Arab Emirates, during a 4-year period and compares them with the existing body of literature on the subject. Study design. The medical records and radiographs of 230 patients treated for maxillofacial fractures at the Al Qassimi General Hospital over a 4-year period (from 1999 to 2002) were reviewed. A number of parameters, including the patient’s age, gender, race, occupation, and mechanism of injury, type of facial injuries, treatment modality, and postoperative complications were recorded and assessed. Results. Men 20 to 29 years of age sustained the most maxillofacial fractures. The ratio of males to females was 11:1. Most fractures were caused by motor vehicle crashes (75%), followed by falls (12%) and violent assaults (8%). There were 150 (51%) mandibular, 102 (34%) maxillary, and 22 (7.4%) zygomatic fractures. Regarding distribution of mandibular fractures, the majority (25%, 38/150) occurred in the condyle, 23% (35/150) in the angle, and 20% (30/150) in the body. The distribution of maxillary fractures were 49.0% (50/102) dentoalveolar, 29.4% (30/102) Le Fort I, and 10.7% (11/102) were Le Fort II fractures. More than half of all cases were treated by closed reduction (67%). Complications occurred in 5.6% of patients. Conclusion. The findings of this study, compared with similar studies reported in the literature, support the view that the causes and incidence of maxillofacial injuries vary from one country to another and, as such, can provide a guide to the design of programs geared toward prevention and treatment. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:166-70) The management of fractures to the maxillofacial complex remains a challenge for oral and maxillo- facial surgeons, demanding both skill and a high level of expertise. It has been reported that incidence of maxillofacial fractures varies widely between different countries. 1-3 The large variability in reported prevalence is due to a variety of contributing factors, such as the environment, sex, age, and socioeconomic status of the patient, as well as the mechanism of injury. World Health Organization (WHO) statistics indicate that 1 million people die and between 15 and 20 million are injured annually in road traffic accidents. 4 Motor vehicle crashes (MVC) are the second major cause of deaths in the United Arab Emirates (UAE). 5 The death rate from MVC in the Arab Gulf countries 6-9 is reported to be much higher than that in the United States. 10 The reported findings of certain aspects of maxillofa- cial trauma have been widely substantiated; for example, a higher frequency of such fractures among males, 11-15 whereas the results for other aspects have differed. Investigators in countries such as Jordan, 11 Singapore, 16 Nigeria, 12,17 New Zealand, 18 Denmark, 19 and Japan 13 have found that MVC represent the most common cause of maxillofacial fractures in those countries, while others, in Finland, 20 the United States, 21 and Sweden, 22 have reported assault as the most common etiological factor. A clearer understanding of the demographic patterns of maxillofacial injuries will assist health care providers as they plan and manage the treatment of traumatic maxillofacial injuries. Such epidemiological information can also be used to guide the future funding of public health programs geared toward prevention. To this end, independent investigators have conducted numerous studies on population groups from every continent, all with the common goal of elucidating the nature of maxillofacial injuries. Although there have been previous reports on the subject of Road Traffic Accident (RTA) in the UAE, 5,7,8 none have dealt with maxillofacial injuries; thus the present study was a Resident, Faculty of Dentistry, Ajman University of Science and Technology Network. b Assistant Professor, Oral and Maxillofacial Surgery, Faculty of Dentistry, Ajman University of Science and Technology Network. c Associate Professor, Faculty of Dentistry, Ajman University of Science and Technology Network. d Consultant, Oral and Maxillofacial Surgeon, Al Qassimi Hospital. Received for publication Sep 16, 2003; returned for revision Nov 6, 2003; accepted for publication Jan 28, 2004. 1079-2104/$ - see front matter Ó 2004 Elsevier Inc. All rights reserved. doi:10.1016/j.tripleo.2004.01.020 166