Occurence and Patterns of Maxillofacial Fractures at Moi Teaching and Referral Hospital, Kenya.

Abstract Background: Maxillofacial fractures attributed to physical trauma are a major cause of morbidity and mortality, with a rising prevalence in Kenya. This has been attributed to the increasing use of motorized transport, maxillofacial fractures secondary to assault, sport and occupational injuries as well as an increase in the aging population. Currently, there are few local empirical studies describing the patterns of these injuries and their associated factors. Objective: This study aimed to determine the occurrence and patterns of maxillofacial fractures at Moi Teaching and Referral Hospital (MTRH). It also described the patients’ sociodemographic characteristics and assessed for an association between etiology and pattern of maxillofacial fractures. Methodology: A descriptive cross-sectional study conducted at the departments of dentistry, emergency and surgical wards of MTRH among 206 patients diagnosed with maxillofacial fractures who were sampled systematically. Physical examination and assessment of the clinical investigations were performed prior to enrollment. Sociodemographic characteristics, injury history and fracture classification data were collected using a semi-structured questionnaire. Descriptive data analysis included frequencies and proportions (%), mean and standard deviation (SD). Inferential analysis included Pearson’s chi-square test to determine the association between etiology (independent variable) and pattern (dependent variable) of maxillofacial fractures using a critical value of p≤0.05 using Statistical Package for Social Sciences (SPSS) software, version 26. Results: A majority (86.9%; n=179) were male with the rest (13.1%; n=27) being female. The mean age was 30.8 (±11.3) years. 51.0% were married, 98.5% were Christians, 57.3% had at least a secondary level of education and 14.6% were formally employed. Majority were victims of motorcycle (55.5%) or motor vehicle (16.3%) accidents with the rest being victims of either falls, assaults, or sports-related injuries. Four-fifths of them (80.9%) did not have any protective gear at the time of injury. Fracture of the mandible (27.6%) were the most common, followed by fractures of the zygoma arch (18.4%), zygoma body (14.1%), maxilla (13.7%), orbital wall (11.1%), supraorbital (8.0%) and orbital floor (7.1%). Furthermore, 72 (35.0%) participants sustained multiple fractures on a single bone. Fractures on the upper third of the face were at 7.7%, middle third of the face (60.8%), lower-third of the face (24.1%), combined and other fractures accounted for 7.4%. Motorized transport (motorcycle and motor vehicle) accidents were significantly associated with fractures of the orbital wall (p=0.023) and maxilla (p=0.003) as well as multiple fractures (p=0.006). Conclusions: This study reports that majority of those presenting with maxillofacial fractures were male, married, self-employed and at least secondary level of education. About three quarters of the participants were victims of motorized transport (motorcycle) accidents. The most commonly fractured maxillofacial site was the mandible. Etiology was associated with the pattern of maxillofacial fractures seen. Recommendations: There is need for targeted information among young male adult motorcycle riders aged 30 years and below on maxillofacial injuries and prevention approaches such as using protective gear. Proper planning and procurement of the specific armamentarium is needed in the management of maxillofacial fractures.