Epidemiological Profile and the Prevalent Anatomic Regions of Some Maxillo Facial Fractures Treated at National Trauma's Centre

The aim of this study is to investigate the epidemiological profile and the prevalent anatomic regions treated at National Center of Trauma during January 2011 to November 2011. Material and methods : The dates of 42 patients with maxillofacial trauma treated during this period were analyzed according to sex, age, cause of injury and region of facial fracture. Statistics : Descriptive statistics, Chi-square Test. Main age and standard deviation were 29,6 years and 11.44. Most patients were male (90.2 %). Marital status : 44.8 % single and 45.2 % married. 95.2 % of patients had the primary and middle education. The majority of fractures were in the 21-30 age group (57.1 %). The main causes of trauma were traffic accidents (65.31 %); a distribution of traffic accidents according group age was found (χ 2 = 23.14, p= 0.0032). 57.7% of patients had only one fracture;42.3 % had two fractures : 9.6 % had fractu res of paramedian and ATM, 10.9 % had fractures of paramedin and angulus; 21.8 % had fracture of paramedian and ramus. The most common sites of fractures were the mandibulae : paramedian 40.8%, angular 26.3%, ramus 12.4 % and ATM 12.4 %.During the periode a distributions according group age of paramedian and angulus were founded : χ 2 = 12.23 dhe p = 0.0318 (paramedian) and χ 2 = 15.15 dhe p=0.0097 (angular). The most of surgical intervents were treated by method of ostheosynthesis.


Introduction
Maxillofacial fractures actually represent in the world a great number of surgical and orthopedic treatments.The various scholars introduce systematically different A. Teliti cases of fractures of contents of Mandibula and Maxilla [1], [2], [5], [6], [7], [8], [9], [10], [12], [15], [16]   .The Ethological and epidemiological assessment of the damages and maxillofacial fractures represent a special interest to identify the prospective trend of their occurrence, preventive measures and effective medical policies.In this article it is aimed to be given an assessment for the epidemiological profile and the prevalent anatomic regions of some maxillo facial fractures treated at National Trauma's Centre ( Albania) for the period February 2011-November 2011.

Method
In this study are observed data for 42 patients that are treated during this period with one or more surgical intervention.

Results
There have been accomplished 52 surgical treatments, 57,7% of the patients have been treated for a fracture of the mandibule or maxilla, 42.3 % of the patients have been treated for fracture of the paramedian and ramus,paramedian and angle or paramedian and ATM.The distribution of the traumas according to sex is 90.2% are male and 9.8% females, the ratio male females is approximately 10:1.The highest percentage of the fractures belongs to the middle Albania.The majority of the treated fractures belong to the paramedian region (43.4%),angular region (24.5%),ramus 11.3% and ATM 13.2%.Some patients ( 42.3 %) are trea-ted for two fractues : 10.9% for paramedian and angulus, 9.6 % for paramedian and ATM, 21.8 % for paramedian and ramus.Surgical treatments make 90.2% of the cases and 9.8% of the cases are orthopedic.The group age 21-30 years makes 36.6% of the fractures and is the most affected age.

Discussion
The achieved results in the investigated period speak about the continuity of some typical etiological and epidemiological data evidenced those recent years at the maxillo facial servis of National Center of Trauma.The most affected target group of males with maxilla facial is the age 20-24 years.The road accidents comprise the main etiological factor, among the causes of the maxilla facial traumas.From three studies undertaken in the periods December 2007-June 2008, January 2010-October 2010 and January 2011-November 2011 is observed in this study that during the last period we have an increase of the ratio male : female in relation to the two first studies: the approximant values of the most affected age, and a reduce of 7.6% of the number of the road accidents.The perce ntage for male, female, the group age 20-40 years and the road accidents are given on the Analyzing the results for the road accidents in two periods is noted that in both periods is seen that they are higher than the data presented in last yen years in many various studies : 30.62 % in Hospital General Blumenau SC (Portugal) [13] ; 45.7 % in Brazil [13] 45.7 % in Kosovo [17] 37 %, in Roma (Italy) [17] , 26 % in Finland [17] , 56 % in Pakistan [17] , Loxha.P.M [17] , etc.The world trend of last ten years is minimization of road accidents and number of their victims.By European Observation on Health Systems and Policies [11] the last 30 years the number of victims from road accidents has presented small differences from on year to another, the trend being descendant.Actualy in Albania the car's number per 1000 population is 121, lower tha some nei-ghbour countries as Serbia ( 227), in Macedonia (144) ,Bosnia -Herzegovina(135).Regardless the high number of the road accidents in the roads of Albania the number of the victims by those accidents is not very high and Albania is actually compared with the neighbour countries.The number of victims per 100.000population presented by the European Status Report on Road Safety in (2007) is 13.9 for Albania; 14.9 for Greece 13.2 for Bullgary; 12.7 Rumany; 10.9 for Bosnia and Herzegovina; 13.6 for Croatia; 9.8 for Serbia; 10.4 for Sllovenia, 13.4 for Turkey.In the road accidents are included individuals of the various group ages., but the most affected is the group age 21-30 years (37.5%).From this study results that the distri -bution of the accidents according to the group ages is characterized by figures : 25 % for 0-20 years, 37.5% for 21-30 years,28.12%for 31-40 year,6.25 % for 41-50 year and 3.13% for 51-60 year.A graphical illustration in the percentage of distribution of road accidents by group age is given by chart 2

Chart 2
For the period of the study the road accidents are given with a meaningfull statistical distribution accordnig to the target group because from the application of Chisquare test result the values χ 2 = 23.14, p= 0.0032.The patients of the group 21-30 years group have had not only fractures caused by road accidents,but also fractures caused by physical violence and falling from heights The fractures by the physical violation make 9.5% of the cases.Even though it is a higher figure than the period January 2010-October 2010 it is considered still lower than some of the other countries: : 22.6 % [7] , 38.58 % [8] , 29 % [ 21] , 24.3 % [ 14] .A low figure is also evidenced also for the fractures caused by the falling from the heights.They make only 4.7% of the cases and this figure reflects the special official measures that are taken those last years toward the companies of the construction.The highest percentage 80.8% of the fractures belongs to the middle Albania, that is due to high demographic movements; high concentration of population on the big cities Tirana and Durres and the big number of cars in these cities.Regarding to edu -cational level of the patients treated results that 92% are of elementary education or secondary education.Regarding their marital status results that 45.2 % are married and 44.8% are single.Two cases were children less than two years.Most of the patients were employed in part time jobs.

Table 4
As we can see from the table we have a spread of the values in the case of the para median and angulus fractures.From the application of the criteria χ 2 ( Chi Square ) for the spread of the fractures are taken the values χ 2 = 12.23 and p = 0.0318 for parame dian, χ 2 = 15.15 and p=0.0097 for angulus.A distribution of the fractures according to the geographical areas is noted too.The results of the study are given on the table5