J Korean Assoc Oral Maxillofac Surg.  2021 Dec;47(6):432-437. 10.5125/jkaoms.2021.47.6.432.

Incidence and management of mandibular fractures in a low-resource health facility in Ghana

Affiliations
  • 1Oral and Maxillofacial Microvascular Reconstruction LAB, Sunyani, Ghana
  • 2Department of Restorative Dentistry, Brong Ahafo Regional Hospital, Sunyani, Ghana
  • 3Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea

Abstract


Objectives
The mandible and other parts of the maxillofacial region suffer significant morbid injuries following road traffic accidents. Our study gives epidemiological description of mandibular fractures in Ghana and also evaluates the relevance of closed reduction and indirect fixation for managing mandibular fractures in low-resource health facilities in low-income countries like Ghana.
Patients and Methods
This is a retrospective study involving 268 patients who reported to the Department of Oral and Maxillofacial Surgery of the Sunyani Regional Hospital with mandibular fractures from January 2010 to December 2019. Patient medical records were assessed for information on age, sex, fracture etiology, anatomic location of fracture, time of day of road traffic accident, and other associated injuries.
Results
A total of 268 patients were included in this study (males, 216 [80.6%]; females, 52 [19.4%]). Motor vehicular accident (MVA) was the lead-ing cause of mandibular fractures (202 injuries, 75.4%). Other etiologies included assault (39, 14.6%), gunshot (13, 4.9%), falls (12, 4.5%), and indus-trial accidents (2, 0.7%). Of the 161 male cases caused by MVA, 121 (75.2%) occurred at night and in the evening while the remaining 40 (24.8%) oc-curred in the morning and afternoon. Among all managed 222 patients, 212 (79.1%) were treated with closed reduction and indirect fixation technique while 10 (3.7%) were treated with open reduction and direct fixation.
Conclusion
Closed reduction with indirect fixation could successfully be used to manage mandibular fractures in low resourced health facilities, es- pecially in low-income countries. The poor lightening system on roads in Ghana is a major contributory factor to motor vehicular accidents.

Keyword

Mandibular fracture; Closed fracture reduction; Motor vehicular accident; Poor lightening
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