Patterns of ZMC and Le Fort Fractures under the Impact of the COVID-19 Pandemic—“A Changing Face?”
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Collection
2.2. Baseline Characteristics and Midface Fracture Patterns
2.3. Circumstances of Fractures
2.4. Changes in Hospital Admission/Hospital Circumstances
2.5. Statistical Analysis
3. Results
3.1. Baseline
3.2. Fracture Patterns
3.3. Circumstances of Fractures
3.4. Changes in Hospital Circumstances
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Wu, J.; Min, A.; Wang, W.; Su, T. Trends in the incidence, prevalence and years lived with disability of facial fracture at global, regional and national levels from 1990 to 2017. PeerJ 2021, 9, e10693. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Cornelius, C.-P.; Audigé, L.; Kunz, C.; Buitrago-Téllez, C.H.; Rudderman, R.; Prein, J. The Comprehensive AOCMF Classification System: Midface Fractures-Level 3 Tutorial. Craniomaxillofacial Trauma Reconstr. 2014, 7 (Suppl. S1), 68–91. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Kunz, C.; Audigé, L.; Cornelius, C.-P.; Buitrago-Téllez, C.H.; Frodel, J.; Rudderman, R.; Prein, J. The Comprehensive AOCMF Classification System: Midface Fractures-Level 2 Tutorial. Craniomaxillofacial Trauma Reconstr. 2014, 7 (Suppl. S1), 59–67. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Patel, B.C.; Wright, T.; Waseem, M. Le Fort Fractures. In StatPearls; StatPearls Publishing: Treasure Island, FL, USA, 2024. [Google Scholar] [PubMed]
- Sindi, A.M.; Abaalkhail, Y.M.; Malas, M.M.; Alghamdi, A.M.; Joharji, M.S. Patients with Nasal Fracture. J. Craniofacial Surg. 2020, 31, e275–e277. [Google Scholar] [CrossRef] [PubMed]
- Farber, S.J.; Nguyen, D.C.; Skolnick, G.B.; Woo, A.S.; Patel, K.B. Current Management of Zygomaticomaxillary Complex Fractures: A Multidisciplinary Survey and Literature Review. Craniomaxillofacial Trauma Reconstr. 2016, 9, 313–322. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Bergeron, J.M.; Raggio, B.S. Zygomatic Arch FractureIn: StatPearls; StatPearls Publishing: Treasure Island, FL, USA, 2024. [Google Scholar] [PubMed]
- Schneider, M.; Besmens, I.S.; Luo, Y.; Giovanoli, P.; Lindenblatt, N. Surgical management of isolated orbital floor and zygomaticomaxillary complex fractures with focus on surgical approaches and complications. J. Plast. Surg. Hand Surg. 2020, 54, 200–206. [Google Scholar] [CrossRef] [PubMed]
- Roșu, A.-M.; Severin, F.; Roșu, O.C.; Cobzeanu, B.M.; Gherasimescu, S.; Sava, F.P.; Palade, D.O.; Drochioi, C.I.; Costan, V.V.; Cobzeanu, M.D. Patterns and Characteristics of Midface Fractures in North-Eastern Romania. Medicina 2023, 59, 510. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Jones, C.M.; Schmalbach, C.E. Zygomaticomaxillary Fractures. Facial Plast. Surg. Clin. N. Am. 2022, 30, 47–61. [Google Scholar] [CrossRef] [PubMed]
- Hsu, C.-R.; Lee, L.-C.; Chen, Y.-H.; Chien, K.-H. Early Intervention in Orbital Floor Fractures: Postoperative Ocular Motility and Diplopia Outcomes. J. Pers. Med. 2022, 12, 671. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Kim, H.S.; Jeong, E.C. Orbital Floor Fracture. Arch. Craniofacial Surg. 2016, 17, 111–118. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Gerbino, G.; Ramieri, G.A.; Nasi, A. Diagnosis and treatment of retrobulbar haematomas following blunt orbital trauma: A description of eight cases. Int. J. Oral Maxillofac. Surg. 2005, 34, 127–131. [Google Scholar] [CrossRef] [PubMed]
- Rozema, R.; Doff, M.H.J.; Delli, K.; Spijkervet, F.K.L.; van Minnen, B. Diagnostic accuracy of physical examination findings for midfacial fractures: A systematic review and meta-analysis. Clin. Oral Investig. 2022, 26, 3405–3427. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- de Carvalho, M.F.; Vieira, J.N.M.; Figueiredo, R.; Reher, P.; Chrcanovic, B.R.; Chaves, M.G.A.M. Validity of computed tomography in diagnosing midfacial fractures. Int. J. Oral Maxillofac. Surg. 2021, 50, 471–476. [Google Scholar] [CrossRef] [PubMed]
- Pollard, C.A.; Morran, M.P.; Nestor-Kalinoski, A.L. The COVID-19 pandemic: A global health crisis. Physiol. Genom. 2020, 52, 549–557. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- McCabe, R.; Schmit, N.; Christen, P.; D’Aeth, J.C.; Løchen, A.; Rizmie, D.; Nayagam, S.; Miraldo, M.; Aylin, P.; Bottle, A.; et al. Adapting hospital capacity to meet changing demands during the COVID-19 pandemic. BMC Med. 2020, 18, 329. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Kovacevic, P.; Djajic, V.; Momcicevic, D.; Zlojutro, B.; Jandric, M.; Kovacevic, T.; Latinovic, M.; Seranic, A.; Bokonjic, D.; Skrbic, R.; et al. Boosting ICU capacity during the COVID-19 pandemic in the western Balkan region, The Republic of Srpska experience. J. Public Health Res. 2023, 12, 22799036231151762. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Diaz, A.; Sarac, B.A.; Schoenbrunner, A.R.; Janis, J.E.; Pawlik, T.M. Elective surgery in the time of COVID-19. Am. J. Surg. 2020, 219, 900–902. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Lytras, T.; Tsiodras, S. Lockdowns and the COVID-19 pandemic: What is the endgame? Scand. J. Public Health 2020, 49, 37–40. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Yeung, A.W.K.; Parvanov, E.D.; Horbańczuk, J.O.; Kletecka-Pulker, M.; Kimberger, O.; Willschke, H.; Atanasov, A.G. Public interest in different types of masks and its relationship with pandemic and policy measures during the COVID-19 pandemic: A study using Google Trends data. Front. Public Health 2023, 11, 1010674. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Özkan, M.; Saraç, Ö.; Kesimer, M.D.; Doğan, Z.A.; Kocaaslan, F.N.D.; Sacak, B. Impact of COVID-19 pandemic on hand injuries. Ulus. Travma Acil Cerrahi Derg. 2022, 28, 911–919. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Solanke, F.; Easton, S.; Selby, A.; James, D.; Roberts, G. Impact of COVID-19 pandemic on emergency department attendances for young people. Arch. Dis. Child. 2022, 107, e1–e7. [Google Scholar] [CrossRef] [PubMed]
- Meisgeier, A.; Pienkohs, S.; Moosdorf, L.; Neff, A. Impact of the COVID-19 pandemic on maxillofacial trauma surgery in Germany-implications from the national DRG database. Oral Maxillofac. Surg. 2024. [Google Scholar] [CrossRef] [PubMed]
- Dudde, F.; Schuck, O.; Schunk, J.; Filip, B. Influence of COVID-19 pandemic on mandible fracture patterns in a German cranio-maxillofacial trauma center: PreCOVID (2019) versus IntraCOVID (2020). Dent. Traumatol. 2024, 40, 425–434. [Google Scholar] [CrossRef] [PubMed]
- de Sousa Lima, A.; Câmara, J.V.F.; Pierote, J.J.A.; Santos, L.A.; Ferrari, C.R.; de Almeida Lopes, M.C.; Fialho, A.C.V. Repercussions of the COVID-19 pandemic on the epidemiology of facial fractures: A retrospective cohort study. Oral Maxillofac. Surg. 2024, 28, 945–955. [Google Scholar] [CrossRef] [PubMed]
- Salzano, G.; Orabona, G.D.; Audino, G.; Vaira, L.A.; Trevisiol, L.; D’agostino, A.; Pucci, R.; Battisti, A.; Cucurullo, M.; Ciardiello, C.; et al. Have There Been any Changes in the Epidemiology and Etiology of Maxillofacial Trauma during the COVID-19 Pandemic? An Italian Multicenter Study. J. Craniofacial Surg. 2021, 32, 1445–1447. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Nhongo, S.S.; Sklavos, A.; Lee, K.; Chan, S.T.F.; Austin, S. The changing face of maxillofacial trauma during the 2020 COVID-19 lockdowns in Melbourne, Australia. Oral Maxillofac. Surg. 2023, 27, 125–130. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Philip, G.; Dominic, S.; Poorna, T.A.; Ek, J. Pattern of maxillofacial fractures in a Tertiary Referral Centre in Central Kerala-A comparison between the Pre-COVID and COVID periods. J. Oral Biol. Craniofacial Res. 2022, 12, 45–48. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Wunsch, K.; Kienberger, K.; Niessner, C. Changes in Physical Activity Patterns Due to the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2022, 19, 2250. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Lee, D.W.; Choi, S.Y.; Kim, J.W.; Kwon, T.G.; Lee, S.T. The impact of COVID-19 on the injury pattern for maxillofacial fracture in Daegu city, South Korea. Maxillofac. Plast. Reconstr. Surg. 2021, 43, 35. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Liu, X.; Jing, Y.; Sheng, Y. Work from home or office during the COVID-19 pandemic: The different chain mediation models of perceived organizational support to the job performance. Front. Public Health 2023, 11, 1139013. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Boom, L.J.; Wolvius, E.B.; Rozeboom, A.V.J. Impact of COVID-19 lockdown on incidence of maxillofacial fractures: A retrospective analysis. Adv. Oral Maxillofac. Surg. 2022, 6, 100289. [Google Scholar] [CrossRef] [PubMed Central]
- Choi, H.; Lee, J.H.; Park, H.K.; Lee, E.; Kim, M.S.; Kim, H.J.; Park, B.E.; Kim, H.N.; Kim, N.; Jang, S.Y.; et al. Impact of the COVID-19 Pandemic on Patient Delay and Clinical Outcomes for Patients with Acute Myocardial Infarction. J. Korean Med. Sci. 2022, 37, e167. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
- Khan, Y.; Verhaeghe, N.; Devleesschauwer, B.; Cavillot, L.; Gadeyne, S.; Pauwels, N.; Van den Borre, L.; De Smedt, D. The impact of the COVID-19 pandemic on delayed care of cardiovascular diseases in Europe: A systematic review. Eur. Hear. J. Qual. Care Clin. Outcomes 2023, 9, 647–661. [Google Scholar] [CrossRef] [PubMed]
- Chung, S.H.; Romatoski, K.S.; Rasic, G.; Beaulieu-Jones, B.R.; Kenzik, K.; Merrill, A.L.; Tseng, J.F.; Cassidy, M.R.; Sachs, T.E. Impact of the COVID-19 Pandemic on Delays to Breast Cancer Surgery: Ripples or Waves? Ann. Surg. Oncol. 2023, 30, 6093–6103. [Google Scholar] [CrossRef] [PubMed]
- Starr, S.; Oke, R.; Okullu, S.; Ariokot, M.G.; Wange, A.H.; Agwang, E.; Ekuchu, P.; Juillard, C.; Ajiko, M.M.; Dicker, R.A. Increased Surgical Delays Seen during the COVID-19 Pandemic in a Regional Referral Hospital in Soroti, Uganda: Perspective from a Low-Resource Setting. World J. Surg. 2023, 47, 1379–1386. [Google Scholar] [CrossRef] [PubMed] [PubMed Central]
Variable | Pre-COVID (February 2019–January 2020) (n = 88) | Intra-COVID (February 2020–January 2021) (n = 57) | p-Value |
---|---|---|---|
Age (years) | 53.73 ± 22.66 | 59.88 ± 24.57 | 0.125 |
Gender | 0.629 | ||
Male | 56 (63.6) | 34 (59.6) | |
Female | 32 (36.4) | 23 (40.4) |
Variable | Pre-COVID (February 2019–January 2020) (n = 88) | Intra-COVID (February 2020–January 2021) (n = 57) | p-Value |
---|---|---|---|
Concomitant soft tissue injury | 49 (55.7) | 29 (50.9) | 0.571 |
Tooth loss | 4 (4.5) | 5 (8.8) | 0.303 |
Tooth avulsion | 1 (1.1) | 0 (0) | 0.419 |
Tooth extrusion | 4 (4.5) | 1 (1.8) | 0.368 |
Tooth intrusion | 3 (3.4) | 1 (1.8) | 0.552 |
Tooth fracture | 5 (5.7) | 5 (8.8) | 0.473 |
Operation (ORIF) | 54 (61.4) | 27 (47.4) | 0.097 |
Conservative treatment (MMF) | 34 (38.6) | 30 (52.6) | 0.097 |
Fracture location | |||
ZMC Fracture | 36 (40.9) | 25 (43.9) | 0.576 |
Isolated orbital floor fracture | 36 (40.9) | 20 (35.1) | 0.323 |
Isolated zygomatic arch fracture | 7 (8.0) | 5 (8.8) | 0.861 |
Le Fort I fracture | 7 (8.0) | 4 (7.0) | 0.835 |
Le Fort II fracture | 1 (1.1) | 3 (5.3) | 0.138 |
Le Fort III fracture | 1 (1.1) | 0 (0) | 0.419 |
Variable | Pre-COVID (February 2019–January 2020) (n = 88) | Intra-COVID (February 2020–January 2021) (n = 57) | p-Value |
---|---|---|---|
Fall | 38 (43.2) | 38 (66.7) | 0.006 |
Sports accident | 17 (19.3) | 4 (7.0) | 0.040 |
Epileptic accident | 2 (2.3) | 0 (0) | 0.431 |
Road Traffic accidents | 15 (17.0) | 10 (17.5) | 0.938 |
Car | 5 (5.7) | 4 (7.0) | 0.745 |
Bicycle | 7 (8.0) | 4 (7.0) | 0.835 |
E-Scooter | 3 (3.4) | 2 (3.5) | 0.974 |
Motorcycle | 0 (0) | 0 (0) | / |
Walking | 0 (0) | 0 (0) | / |
Interpersonal violence | 29 (33.0) | 8 (14.0) | 0.011 |
Domestic violence | 7 (8.0) | 8 (14.0) | 0.240 |
Accident at home | 21 (23.9) | 32 (56.1) | <0.001 |
Alcohol-related | 27 (30.7) | 6 (10.5) | 0.005 |
Virus/Flu-associated Syncope | 2 (2.3) | 10 (17.5) | 0.001 |
Month | 0.136 | ||
January | 4 (4.5) | 5 (8.8) | |
February | 8 (9.1) | 2 (3.5) | |
March | 8 (9.1) | 8 (14.0) | |
April | 8 (9.1) | 5 (8.8) | |
May | 9 (10.2) | 6 (10.5) | |
June | 5 (5.7) | 3 (5.3) | |
July | 6 (6.8) | 7 (12.3) | |
August | 8 (9.1) | 3 (5.3) | |
September | 6 (6.8) | 7 (12.3) | |
October | 14 (15.9) | 0 (0) | |
November | 6 (6.8) | 6 (10.5) | |
December | 6 (6.8) | 5 (8.8) | |
Weekday | 38 (43.2) | 36 (63.2) | 0.019 |
Weekend | 50 (56.8) | 21 (36.8) | 0.019 |
Time of accident | |||
Morning | 21 (23.9) | 32 (56.1) | <0.001 |
Evening | 44 (50.0) | 21 (36.8) | 0.120 |
Night | 23 (26.1) | 4 (7.0) | 0.004 |
Work-related accident | 7 (8.0) | 8 (14.0) | 0.240 |
Variable | Pre-COVID (February 2019–January 2020) (n = 88) | Intra-COVID (February 2020–January 2021) (n = 57) | p-Value |
---|---|---|---|
Days from trauma to presentation | 1.25 ± 1.84 | 2.19 ± 3.31 | 0.029 |
Days from trauma to operation | 1.42 ± 1.66 | 2.56 ± 3.89 | 0.016 |
Days in hospital | 4.63 ± 3.02 | 4.28 ± 3.51 | 0.531 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Dudde, F.; Schunk, J.; Telschow, T.; Barbarewicz, F.; Schuck, O.; Giese, M.; Bergmann, W. Patterns of ZMC and Le Fort Fractures under the Impact of the COVID-19 Pandemic—“A Changing Face?”. J. Clin. Med. 2024, 13, 4662. https://doi.org/10.3390/jcm13164662
Dudde F, Schunk J, Telschow T, Barbarewicz F, Schuck O, Giese M, Bergmann W. Patterns of ZMC and Le Fort Fractures under the Impact of the COVID-19 Pandemic—“A Changing Face?”. Journal of Clinical Medicine. 2024; 13(16):4662. https://doi.org/10.3390/jcm13164662
Chicago/Turabian StyleDudde, Florian, Johannes Schunk, Thomas Telschow, Filip Barbarewicz, Oliver Schuck, Manfred Giese, and Wilken Bergmann. 2024. "Patterns of ZMC and Le Fort Fractures under the Impact of the COVID-19 Pandemic—“A Changing Face?”" Journal of Clinical Medicine 13, no. 16: 4662. https://doi.org/10.3390/jcm13164662