Assessment of Maxillofacial Soft Tissue Injuries in Trauma Patients: A Cross-Sectional Study

Malik Farhan Hameed; Zeenia Arbab; Syed Hassan Mehboob Bukhari; Muhammad Ali

doi:10.65293/jbkcd.v3i02.69

Authors

Malik Farhan Hameed Department of Oral and Maxillofacial Surgery, Sardar Begum Dental College, Peshawar, Khyber Pakhtunkhwa, Pakistan.
Zeenia Arbab Registrar, Department of Oral and Maxillofacial Surgery, Sardar Begum Dental College, Peshawar, Khyber Pakhtunkhwa, Pakistan.
Syed Hassan Mehboob Bukhari Department of Oral and Maxillofacial Surgery, Sardar Begum Dental College, Peshawar, Khyber Pakhtunkhwa, Pakistan.
Muhammad Ali Department of Oral and Maxillofacial Surgery, Sardar Begum Dental College, Peshawar, Khyber Pakhtunkhwa, Pakistan.

DOI:

https://doi.org/10.65293/jbkcd.v3i02.69

Keywords:

Maxillofacial Injuries, Soft Tissue Trauma, Road Traffic Accidents, Cross-Sectional Study, Injury Severity, Logistic Regression

Abstract

Background: Maxillofacial soft tissue injuries are common among trauma patients and place a considerable burden on emergency and surgical services. The pattern and severity of these injuries are influenced by demographic characteristics and mechanisms of trauma. To assess the pattern, severity, and predictors of maxillofacial soft tissue injuries among trauma patients in a hospital-based cross-sectional study.

Study Design: A Cross-sectional study.

Place and Duration of the Study: The study was conducted in the Department of Oral and Maxillofacial Surgery, Sardar Begum Dental College, Peshawar, over a period of six months from July 2024 to December 2024.

Materials and Methods: A total of 230 trauma patients presenting with maxillofacial soft tissue injuries were included in the study. Data on demographic characteristics, trauma etiology, injury type, and severity were collected and analyzed. Descriptive statistics summarized the data. Associations between categorical variables were examined using the Chi-square test. Binary logistic regression analysis was performed to identify independent predictors of severe injury. A p-value < 0.05 was considered statistically significant.

Results: Most patients were males (70.4%), with the highest proportion aged 26–35 years (29.6%). Road traffic accidents (45.2%) were the leading cause of injury, followed by assault (25.2%) and falls (18.3%). Lacerations were the most common injury type (41.7%). A significant association was observed between trauma etiology and injury severity (p < 0.001), with road traffic accidents contributing the largest proportion of severe injuries. Gender was also significantly associated with injury type (p = 0.018). Logistic regression analysis identified road traffic accidents as an independent predictor of severe injury (Adjusted OR = 4.21; 95% CI: 1.54–11.48; p = 0.005).

Conclusion: Road traffic accidents are the primary cause and strongest predictor of severe maxillofacial soft tissue injuries, particularly among young adult males. Strengthening road safety measures is essential to reduce the burden of these injuries.

Author Biography

Zeenia Arbab, Registrar, Department of Oral and Maxillofacial Surgery, Sardar Begum Dental College, Peshawar, Khyber Pakhtunkhwa, Pakistan.

Corresponding Author: dr.zinnia.arbab@gmail.com

References

1. Boffano P, Roccia F, Zavattero E, Dediol E, Uglešić V, Kovačič Ž, et al. European Maxillofacial Trauma (EURMAT) project: a multicentre and prospective study. J Craniomaxillofac Surg [Internet]. 2015;43(1):62–70. Available from: http://dx.doi.org/10.1016/j.jcms.2014.10.011

2. Lee KH. Interpersonal violence and facial fractures. J Oral Maxillofac Surg [Internet]. 2009;67(9):1878–83. Available from: http://dx.doi.org/10.1016/j.joms.2009.04.117

3. Gassner R, Tuli T, Hächl O, Rudisch A, Ulmer H. Cranio-maxillofacial trauma: a 10 year review of 9,543 cases with 21,067 injuries. J Craniomaxillofac Surg [Internet]. 2003;31(1):51–61. Available from: http://dx.doi.org/10.1016/s1010-5182(02)00168-3

4. Boffano P, Kommers SC, Karagozoglu KH, Forouzanfar T. Aetiology of maxillofacial fractures: a review of published studies during the last 30 years. Br J Oral Maxillofac Surg [Internet]. 2014;52(10):901–6. Available from: http://dx.doi.org/10.1016/j.bjoms.2014.08.007

5. Chrcanovic BR. Factors influencing the incidence of maxillofacial fractures. Oral Maxillofac Surg [Internet]. 2012;16(1):3–17. Available from: http://dx.doi.org/10.1007/s10006-011-0280-y

6. Arslan ED, Solakoglu AG, Komut E, Kavalci C, Yilmaz F, Karakilic E, et al. Assessment of maxillofacial trauma in emergency department. World J Emerg Surg [Internet]. 2014;9(1):13. Available from: http://dx.doi.org/10.1186/1749-7922-9-13

7. Bali R, Sharma P, Garg A, Dhillon G. A comprehensive study on maxillofacial trauma conducted in Yamunanagar, India. J Inj Violence Res [Internet]. 2013;5(2):108–16. Available from: http://dx.doi.org/10.5249/jivr.v5i2.331

8. Singaram M, G SV, Udhayakumar RK. Prevalence, pattern, etiology, and management of maxillofacial trauma in a developing country: a retrospective study. J Korean Assoc Oral Maxillofac Surg [Internet]. 2016;42(4):174–81. Available from: http://dx.doi.org/10.5125/jkaoms.2016.42.4.174

9. Al Ahmed HE, Jaber MA, Abu Fanas SH, Karas M. The pattern of maxillofacial fractures in Sharjah, United Arab Emirates: a review of 230 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod [Internet]. 2004;98(2):166–70. Available from: http://dx.doi.org/10.1016/j.tripleo.2004.01.020

10. Yang C-S, Chen SC-C, Yang Y-C, Huang L-C, Guo H-R, Yang H-Y. Epidemiology and patterns of facial fractures due to road traffic accidents in Taiwan: A 15-year retrospective study. Traffic Inj Prev [Internet]. 2017;18(7):724–9. Available from: http://dx.doi.org/10.1080/15389588.2017.1309650

11. Lin S, Levin L, Goldman S, Peled M. Dento-alveolar and maxillofacial injuries - a retrospective study from a level 1 trauma center in Israel. Dent Traumatol [Internet]. 2007;23(3):155–7. Available from: http://dx.doi.org/10.1111/j.1600-9657.2005.00418.x

12. Gururaj G, Uthkarsh PS, Rao GN, Jayaram AN, Panduranganath V. Burden, pattern and outcomes of road traffic injuries in a rural district of India. Int J Inj Contr Saf Promot [Internet]. 2016;23(1):64–71. Available from: http://dx.doi.org/10.1080/17457300.2014.945465

13. Subhashraj K, Nandakumar N, Ravindran C. Review of maxillofacial injuries in Chennai, India: a study of 2748 cases. Br J Oral Maxillofac Surg [Internet]. 2007;45(8):637–9. Available from: http://dx.doi.org/10.1016/j.bjoms.2007.03.012

14. Ansari MH. Maxillofacial fractures in Hamedan province, Iran: a retrospective study (1987-2001). J Craniomaxillofac Surg [Internet]. 2004;32(1):28–34. Available from: http://dx.doi.org/10.1016/j.jcms.2003.07.010

15. Lalloo R, Lucchesi LR, Bisignano C, Castle CD, Dingels ZV, Fox JT, et al. Epidemiology of facial fractures: incidence, prevalence and years lived with disability estimates from the Global Burden of Disease 2017 study. Inj Prev [Internet]. 2020;26(Supp 1):i27–35. Available from: http://dx.doi.org/10.1136/injuryprev-2019-043297

16. Wusiman P, Maimaitituerxun B, Guli, Saimaiti A, Moming A. Epidemiology and pattern of oral and maxillofacial trauma. J Craniofac Surg [Internet]. 2020;31(5):e517–20. Available from: http://dx.doi.org/10.1097/SCS.0000000000006719

17. Ahmad SS, Zulfiqar G, Iftikhar B. Maxillofacial trauma and its management presenting at a tertiary care hospital in Lahore during Covid-19 pandemic. J Pak Med Assoc [Internet]. 2024;74(2):229–35. Available from: http://dx.doi.org/10.47391/JPMA.7911

18. Khan FN, Akbar Z, Javaid S, Afzal M, Adeel MR, Saeed S. Pattern of maxillofacial fractures in combined military hospital, Peshawar. Pak Armed Force Med J [Internet]. 2024;74(1):197–201. Available from: http://dx.doi.org/10.51253/pafmj.v74i1.10325

19. Gul M, Afsar H, Zahoor A, Naseem M. Frequency of maxillofacial trauma in patients reporting to Oral and Maxillofacial Surgery unit, Lady Reading Hospital, Peshawar. J Gandhara Med Dent Sci [Internet]. 2025;12(2):3–8. Available from: http://dx.doi.org/10.37762/jgmds.12-2.653

20. Hanif T, Ahmad F, Ashfaq A, Danish SH. Cross-sectional survey on maxillofacial injuries in road traffic accidents in Karachi. Pak J Med Dent. 2017;6(2):1–6.

21. Akama MK, Chindia ML, Macigo FG, Guthua SW. Pattern of maxillofacial and associated injuries in road traffic accidents. East Afr Med J [Internet]. 2007;84(6):287–95. Available from: http://dx.doi.org/10.4314/eamj.v84i6.9539

22. Islam M, Qazafi M. Zygomatic complex fractures in Maxillofacial trauma frequency and causes in a tertiary care hospital. Indus Journal of Bioscience Research [Internet]. 2025;3(2):713–8. Available from: http://dx.doi.org/10.70749/ijbr.v3i2.783

23. Saeed S, Khan A, Ahmad J, Kumar M, Khan ZN, Inayat S. Frequency and Outcome of isolated zygomatic arch fractures (IZAF) in Road traffic accident (RTA) patients. Int J Pathol [Internet]. 2025;23(4):330–7. Available from: http://dx.doi.org/10.59736/ijp.23.04.980

24. Helmets: a road safety manual for decision-makers and practitioners. World Health Organization. World Health Organization. 2023;