Analysis of the results of specialized medical care for patients with fractures of the lower and upper jaw in a level III trauma center

Goal. To study the frequency of traumatic fractures of the upper and lower jaws and the results of specialized care on the example of the Saratov region. Materials and methods. The basis for the study was the department of maxillofacial surgery, located in Saratov City Clinical Hospital No. 9. The study is continuous, single-center, retrospective. The primary material used was the medical records of patients treated at the above-mentioned medical institution in the period from September 1, 2023 to August 31, 2024. The criteria for inclusion in the study were: voluntary consent to the study, fractures of the upper and/ or lower jaw, age at least 18 years. Patients who turned out to be excluded from the study, persons under the age of 18, were excluded. Results. As the analysis shows, the majority of patients went to the departments of the maxillofacial region in the early stages up to 3 days after injury, but 5.4% of patients are admitted to a medical institution after the development of complications such as suppuration (manifestations of inflammatory processes), dentition defects, etc., which cannot but affect the results treatment. The average age of patients with injuries to the maxillofacial region is 34.3 years, of which a greater number are men, which demonstrates the need to strengthen work with the population of social services. The predominant cause of injury is domestic injuries, this proves that it is necessary to carry out educational work with the population, which will include teaching people safe household life, monitoring the serviceability of electrical wiring and electrical appliances, not walking on wet floors, following instructions on the use of equipment, etc. Fractures of the lower jaw are more common than fractures of the upper jaw, these indicators dictate the need to find new diagnostic methods, modern methods of treatment and prevention of complications. Conclusions. 1. Jaw fractures occur in 65,0% of cases, with fractures of the lower jaw prevailing over the upper, respectively, 52.1% and 12.8%. 2. In the structure of jaw fractures, domestic injuries accounted for 45,1% of cases, criminal showdowns caused a fracture in 15,8% of cases, in the remaining 4,0% of cases, traffic accidents caused fractures. 3. When analyzing the timing of patients seeking medical care, it was found that in the vast majority of cases — 73,5%, later than three days after receiving a facial injury, the remaining 26,4% of the victims were hospitalized. 4. Medical care at the prehospital stage was provided by emergency medical teams in 52,9% of cases. At the same time, out of this number of patients, the provision of medical care was regarded as complete in 48,4% of the cases. In the remaining 4,5% of cases, assistance was provided, but it was not in full or with errors. 47,1% of the patients were not treated, they were taken to a medical institution by passing transport.

1. Gilmanova G. S., Ksembaev S. S., Salakhov A. K., Gilmanov A. A., Ivanov O.A. Improvement of emergency care for victims with maxillofacial injury. Vyatka Medical Bulletin, 2022, Vol. 2, No. 74, рр. 9–12 (In Russ.).

2. Lepilin A. V., Bakhteeva G. R., Nozdrachev V. G., Shikhov M.Yu., Ramazanov A. H. Clinical and statistical analysis of traumatic injuries of the maxillofacial region and their complications based on the materials of the department of maxillofacial surgery for 2008–2012. Saratov Scientific Medical Journal, 2013, Vol. 9, No. 3, рр. 425–428 (In Russ.).

3. Masljakov V.V., Sidelnikov S.A., Barachevskij Ju.E. et al. Тhe level of knowledge of medical workers providing assistance to victims with traumatic injuries of the facial skull received as a result of road accidents. Emergency medical care, 2024, Vol. 25, No. 1, рр. 27–32 (In Russ.). https://doi.org/10.24884/2072–6716–2024–25–1–27–32.

4. Semenov M. G., Emirbekov E.A., Kirichenko K.N. et al. Features of the treatment of children with combined craniofacial trauma in the conditions of a city emergency hospital. Orthopedics, traumatology and reconstructive surgery of childhood, 2016, Vol. 4, No. 1, рр. 17–25 (In Russ.).

5. Levenets A. A., Gorbach N.A., Focas N. N. Maxillofacial injury as a social, economic and medical problem. Siberian Medical Review, 2013, Vol. 2, рр. 13–18 (In Russ.).

6. Bakhteeva G.R., Lepilin A.V., Soyher M.G. et al. Course and healing of fractures of the mandible accompanied by damage to the branches of the trigeminal nerve. Saratov Scientific Medical Journal, 2012, Vol. 8, No. 2, рр. 399–403 (In Russ.).

7. Yoshieva A.A., Yoshiev A.M. Causal relationships in the unified system of medical rehabilitation of patients with maxillofacial injuries. Bulletin of the Kyrgyz State Medical Academy named after I. K. Akhunbaev, 2019, Vol. 3, рр. 36–41 (In Russ.).

8. Myrzasheva N.M., Eshiev A.M. Dependence of the tactics of treatment of jaw fractures on the nature of injury. Central Asian Medical Journal named after M. M. Mirrakhimov, 2014, Vol. XX, No. 4, рр. 335–338 (In Russ.).