Missed injuries associated with maxillofacial trauma

Area of Science:

• Trauma surgery
• Maxillofacial surgery
• Emergency medicine

Background:

• Maxillofacial trauma often occurs in polytrauma settings, with associated injuries ranging from minor to life-threatening.
• Timely detection of all injuries is critical for effective trauma management, preventing mortality and morbidity.
• Referrals from peripheral facilities to specialized units sometimes reveal inadequacies in initial diagnosis and transport.

Purpose of the Study:

• To identify, diagnose, and document injuries missed in patients with maxillofacial trauma.
• To evaluate the effectiveness of secondary screening in a specialized maxillofacial unit.

Main Methods:

• An observational study included 270 trauma patients referred from peripheral health care facilities between October 2017 and March 2019.
• A comprehensive head-to-toe clinical examination was performed in the maxillofacial unit as a secondary screening measure.
• All associated injuries, whether pure maxillofacial trauma or combined with other injuries, were documented.

Main Results:

• A significant number of patients presented with associated injuries alongside maxillofacial trauma.
• Secondary screening identified previously missed injuries, including spinal injuries, temporal bone fractures, styloid process fractures, and head injuries.
• The study highlights the potential for underdiagnosis of associated injuries at initial assessment points.

Conclusions:

• Frequent reassessment of trauma patients at all care levels is essential.
• Enhanced training for healthcare personnel, especially at peripheral and pre-hospital care facilities, is pivotal.
• Implementing robust secondary screening protocols can improve the detection of missed injuries in maxillofacial trauma patients.