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Analysis of radiographically confirmed blunt-mechanism facial fractures.

Publication ,  Journal Article
Mundinger, GS; Dorafshar, AH; Gilson, MM; Mithani, SK; Kelamis, JA; Christy, MR; Manson, PN; Rodriguez, ED
Published in: J Craniofac Surg
January 2014

Facial fractures resulting from blunt-mechanism trauma, although common, have been infrequently evaluated in large studies that do not include confirmation of fractures based on author review of available patient radiographic studies. An 8-year review (1998-2006) of the R Adams Cowley Shock Trauma Registry was performed with institutional review board approval. Patients diagnosed with blunt-mechanism facial fractures were identified by the International Classification of Diseases, Ninth Revision (ICD-9) codes and their facial fractures confirmed by author review of computed tomographic scans. Individual fractures were classified and grouped according to the facial thirds. Intra- and interreader variability was calculated, and confirmed fracture patterns were compared to fracture patterns listed by ICD-9 codes. Concomitant injuries and demographic data were additionally evaluated. Four thousand three hundred ninety-eight patients with 8127 fractures were identified. Intra- and interreader variability was 2% and 7%, respectively. ICD-9 coding misdiagnosed 12.5% of all fractures. Eighty-two percent of patients sustained associated injuries, including basilar skull fractures (7.6%) and cervical spine fractures (6.6%). 1.1% had at least one fracture in each facial third (panfacial fracture pattern). Significant relationships were found between demographic parameters, concomitant injuries, specific fractures, and fracture patterns. Studies investigating facial fractures should report fracture patterns confirmed by author review of available radiographic imaging. Large retrospective data sets containing confirmed fractures and capable of addressing rare fracture patterns can be compiled with low inter- and intrauser variability, and are useful for generating mechanistic hypotheses suitable for evaluation in prospective series or by directed biomechanical studies.

Duke Scholars

Published In

J Craniofac Surg

DOI

EISSN

1536-3732

Publication Date

January 2014

Volume

25

Issue

1

Start / End Page

321 / 327

Location

United States

Related Subject Headings

  • Zygomatic Fractures
  • Young Adult
  • Wounds, Nonpenetrating
  • Tomography, X-Ray Computed
  • Spinal Fractures
  • Skull Fractures
  • Retrospective Studies
  • Registries
  • Orbital Fractures
  • Nasal Bone
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Mundinger, G. S., Dorafshar, A. H., Gilson, M. M., Mithani, S. K., Kelamis, J. A., Christy, M. R., … Rodriguez, E. D. (2014). Analysis of radiographically confirmed blunt-mechanism facial fractures. J Craniofac Surg, 25(1), 321–327. https://doi.org/10.1097/SCS.0b013e3182a2e979
Mundinger, Gerhard S., Amir H. Dorafshar, Marta M. Gilson, Suhail K. Mithani, Joseph A. Kelamis, Michael R. Christy, Paul N. Manson, and Eduardo D. Rodriguez. “Analysis of radiographically confirmed blunt-mechanism facial fractures.J Craniofac Surg 25, no. 1 (January 2014): 321–27. https://doi.org/10.1097/SCS.0b013e3182a2e979.
Mundinger GS, Dorafshar AH, Gilson MM, Mithani SK, Kelamis JA, Christy MR, et al. Analysis of radiographically confirmed blunt-mechanism facial fractures. J Craniofac Surg. 2014 Jan;25(1):321–7.
Mundinger, Gerhard S., et al. “Analysis of radiographically confirmed blunt-mechanism facial fractures.J Craniofac Surg, vol. 25, no. 1, Jan. 2014, pp. 321–27. Pubmed, doi:10.1097/SCS.0b013e3182a2e979.
Mundinger GS, Dorafshar AH, Gilson MM, Mithani SK, Kelamis JA, Christy MR, Manson PN, Rodriguez ED. Analysis of radiographically confirmed blunt-mechanism facial fractures. J Craniofac Surg. 2014 Jan;25(1):321–327.

Published In

J Craniofac Surg

DOI

EISSN

1536-3732

Publication Date

January 2014

Volume

25

Issue

1

Start / End Page

321 / 327

Location

United States

Related Subject Headings

  • Zygomatic Fractures
  • Young Adult
  • Wounds, Nonpenetrating
  • Tomography, X-Ray Computed
  • Spinal Fractures
  • Skull Fractures
  • Retrospective Studies
  • Registries
  • Orbital Fractures
  • Nasal Bone