Associated Injuries are Frequent and Severe Among Geriatric Patients with Zygomatico-Orbital Fractures

Publication date: Available online 5 November 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Miika Toivari, Johanna Snäll, Anna Liisa Suominen, Satu Apajalahti Consultant, Christian Lindqvist, Hanna Thorén

Abstract

Purpose

Associated injuries (AIs) are hypothesized to be frequent in geriatric zygomatico-orbital (ZMO) fractures. The study aim was to determine the relationship between ZMO fractures and AIs in geriatric patients in comparison to younger adults.

Materials and methods

A retrospective case-control study was carried out on geriatric patients aged 65 years or more (n = 93) and younger adults aged 20 to 30 years (n = 68) diagnosed with pure unilateral ZMO fractures. The main exposure was age, the primary outcome was AI outside the face, and secondary outcomes were the type and severity of AI, ocular injuries, restriction of mandible movement, and ZMO buttress asymmetry. The confounding variables were gender, trauma mechanism, type of ZMO fracture, and dislocation. Statistical analyses included x² tests, risk evaluation with 2 x 2 tables, and logistic regression analysis.

Results

AIs outside the face, and particularly brain injuries, were significantly more frequent among the elderly patients than the controls (P < .001). The significant predictors of AIs outside the face were a fall from height (66.7%), MVAs (66.7%), and the absence of ZMO dislocation (59.5%) (P < .001). The adjusted risk of brain injury was 2.5-fold in the absence of dislocation. The geriatric patients had an over five-fold higher risk of brain injuries compared to the younger controls (P = .003).

Conclusions

AIs in general, and particularly brain injuries, are frequent in geriatric ZMO fractures. Intracranial injuries should be rolled out, particularly in geriatric patients diagnosed with a non-dislocated ZMO fracture.

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