Analysis of the pattern of maxillofacial fractures in Kaduna, Nigeria

There are considerable differences in the reported worldwide pattern of maxillofacial fractures. In the more developed countries of Europe, violence followed by road crashes are the predominant causes while in the developing world the causative factors are reversed with most being the result of road crashes. Interestingly, recent data indicated a 3:1 male:female ratio worldwide. Between 1991 and 2000, 443 cases of maxillofacial fractures were seen at the Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria. Road crashes were responsible for 246 cases (56%) followed by falls, 24% (n=108). In a previous report from this centre in 1980, 241 fractures were seen each year, so our lower rate of 44 cases a year is because the number of centres for the treatment of such injuries in Nigeria has increased. There has also been a fourfold increase in the number of women with facial fractures in this largely Moslem population, which reflects their greater exposure during the past 20 years. More patients were seen with mandibular than middle-third fractures, because more of the latter died. This shows that while more centres for treatment are available for patients with maxillofacial trauma, the lack of enforcement of legislation on the use of seat belts, drunken driving and inadequate emergency medical care have continued to cause considerable mortality and morbidity from these injuries in Nigeria. It is also difficult to compare data among centres because of inconsistent terminology.