Trends of maxillofacial fractures in the Garhwal Himalayas at Government Medical College, Srinagar, Uttarakhand

CONTEXT: Evaluation of Maxillofacial fractures in hilly region of Garhwal Himalyas and its relation with age, gender, anatomical location, seasonal variation and treatment provided. AIMS: The aim of the present study is to analyze the pattern of maxillofacial fractures in the Garhwal Himalayan region of India and to compare the results with similar studies in India and the rest of the world. SETTINGS AND DESIGN: This was a prospective study conducted on 102 patients with 128 facial fractures. MATERIALS AND METHODS: This study was conducted on 102 patients who were admitted for the treatment of maxillofacial fractures in the Department of Dentistry at Government Medical College, Srinagar, Uttarakhand, India. STATISTICAL ANALYSIS USED: All analyses were performed using Chi-square test and level of significance. RESULTS: Peak incidence was noted in the second to fourth decades of life. Male: female ratio was 4:1. Road traffic accident was the main etiology (42.2%), followed by fall (37.2%) and assault (11.8%). Among other etiology of injury, distinguishing feature was bear bite, which was only seen in winters causing 5.9% of total injury. Fall was reported high in females whereas road traffic accident in males. Mandible was fractured in 73.5% of patients while mid-face in 26.5% of patients. Open reduction with internal fixation was the choice of treatment in 60.8% of cases. Nearly 79.4% of patients were treated under local anesthesia. The mean duration of hospitalization was (standard deviation 5.2 days) 5.3 days. CONCLUSIONS: Road traffic accidents still remain the main cause of maxillofacial fractures in developing countries such as India. In hilly area, road traffic accident can be minimized by better wide roads with guide walls/parapet, strict law enforcement for overspeed, overload, and to use seat belts while driving, and use of helmet while riding two-wheeler. Open reduction internal fixation remains the first choice of treatment in facial fractures due to early return of function with minimal morbidity and better nutritional status in patients compared to closed reduction.