Craniomaxillofacial injuries: experience in Tehran

This is a retrospective study of 1,608 patients (1,575 males and 33 females) who were treated in two university hospitals in Tehran, Iran from 1984 to 1990. The injuries were classified into three types: soft tissue injuries (132 patients), bony fractures (356 patients), and mixed injuries (1,120 patients). The craniofacial injuries were classified into seven anatomical levels: lower third; middle third; upper third; lower and middle third; lower and upper third; middle and upper third; and lower, middle, and upper third). The lower third craniofacial injuries were the most common (69%, n = 1,110) followed by the middle third (42%, n = 677). Injuries to the upper third were the least common (28%, n = 452). In the lower third injuries the mandible was the most common site; lateral midface injuries were the most common site in the middle third region; and frontal bone was the most common site in upper third injuries. Most of these injuries were caused by firearms (71%, n = 1,135) during the Iraq-Iran conflict; the least common cause was assault (0.80%, n = 13). There were many associated noncraniofacial injuries, such as head and ocular injuries and abdominal injuries. The head injuries were classified into five grades according to the clinical and computed tomography findings. Treatment of the craniofacial injuries ranged from minor repair or closed reduction to major soft tissue and bony reconstruction. The postinjury complication rate was very high, especially for firearm injuries. The follow-up period ranged from 3 months to 3 years.