Multidetector Computed Tomographic Evaluation of Patterns of Facial Bone Fractures

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Multidetector Computed Tomographic Evaluation of Patterns of Facial Bone Fractures

Journal Title: Journal of Medical Science And clinical Research - Year 2018, Vol 6, Issue 10

Abstract

With the increasing numbers of road traffic accidents and violence, Facial injuries causing fracture have become common any emergency department. Multidetector computed tomography (MDCT) is the best choice for imaging facial bones in an emergency setting. The Objectives: 1. To study the efficacy of axial images in comparison with Coronal and 3 Dimensional CT reformatted images in detection of patterns of fracture in maxillofacial injuries. 2. To asses, the number of fractures, fracture extent and displacement of fracture fragments by comparing axial images with coronal and 3D images 3. To know about the prevalence of maxillofacial injuries. 4. To describe and classify the facial fractures. Materials and Methods: Our study population consisted of 140 patients with facial bone fractures who came to the emergency department of RMMCH. CT scan of facial bones was taken on the advice of the casualty medical officer and images were acquired using Alexion 4-Slice CT (Toshiba) scanner using analyzed at the CT console. 3D images were compared with axial images and scoring was made under the following headings – Fracture Detection, Extent of fracture and Displacement of fracture fragments. Axial and Coronal images were compared in terms of the detection of the fracture. Results: Our study group which comprised of a total of 140 patients, and the age at presentation was from 01 to 80 yrs. The Zygoma was the frequently involved bone followed in frequency by the frontal region fractures. The maxillary fractures were the affected region with fractures detected in 70 % of patients. Naso-orbito-ethmoid and mandibular fractures were detected in 52 and 43 % of patients. Conclusion: The 3D images are useful in the facial trauma, particularly in case of mandibular and zygomatic fracture. Frontal and maxillary bone fractures were detected easily using 3D and their displacement pattern in patients with complex midface region fractures could be easily described. Le Fort type fracture was better identified in the 3D study. The coronal reconstruction helped in the detection of fractures involving the maxilla and medial wall and floor of the orbit. Naso-orbito-ethmoid region fractures were less detected and were not informative on 3 D images. Minimal fracture displacement was also less detected on 3D reformats.

Authors and Affiliations

Dr Gomathiponshankar Ilayappan

Keywords

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