Facial Fractures in the Elderly: Epidemiology and Outcome in 103 Patients

Facial fractures are a worldwide health problem as they constitute a potential cause of functional and morphological disabilities and death. In elder patients more than in the younger, facial fractures expose to difficulties of treatment and risks of unfavourable outcome due to limited physiological reserves, osteoporosis, frequent defective dental status and underlying medical conditions. The aim of this study was to analyse facial fractures' frequency, aetiologies, gender distribution and treatment outcome in elder patients at a referral hospital in Burkina Faso. The medical records of patients with facial fractures and who were 60 years of age at least, during a 13 year-period, were retrospectively analysed. All the patients had clinical and radiological evidence of facial fractures. Surgical treatment of the facial fracture was performed by plates and screw system or by a 0.5mm-diameter soft stainless steel wire internal fixation which was always combined with jaws immobilization in patients with occlusal fractures. Out of 2400 facial fractures patients, 103 (4.3%) were 60 years old or over. Patients’ age ranged from 60 to 85 years and fractures' frequency decreased gradually with age. There were 107 males and 27 females (male to female ratio 3.9:1). The leading circumstance of trauma was road traffic crashes (87.3%) followed by far by interpersonal violence (7.8%). Nearly two third of facial fractures involved the midface with at first rank the zygomatic complex (45.7%) while mandibular fractures accounted for 29.1%. In 29 patients (28.1%), extra facial lesions were noted which consisted mostly in cranial trauma and limb fractures. There was a need of surgical treatment in 23 of the 103 patients (22.3%) but 7 patients (6.8%) declined this approach. Out of the 96 patients treated according to indication, 88 (91.6%) had an uneventful and satisfactory treatment outcome. Complications or unsatisfactory outcome comprised operative site infection, facial sensory disturbance, delayed bone union, diplopia, and temporomandibular joint dysfunction. The findings of this study command enforcement of road traffic security in Burkina Faso