Management of maxillofacial and orthopedic injuries: Is there a need for maxillofacial units in orthopedic hospitals?

Background: The study compared the pattern of consultation and the treatment outcome of maxillofacial patients referred by different orthopedic units. Materials and Methods: All consecutive major trauma patients referred from two orthopedic units to the maxillofacial unit of our institution, over a 4-year period, was retrospectively analyzed. Patients' demographics, time, and types of injury, the time interval between injury and maxillofacial consultation, time of treatment, and anesthesia requirement were obtained. Results: Of the 156 referred cases, there were 138 (88.5%) males and 18 (11.5%) females with a male: female ratio of 7.7:1. Their ages ranged from 12 to 66 years, mean 34.5 (9.89) years. Road traffic accident ( n = 145; 92.9%) was the most common etiology. Mandibular ( n = 87; 55.8%) and zygomatic ( n = 30; 19.2%) fractures were the most predominant maxillofacial injuries. For the orthopedic injuries, lower limb fracture were the commonest (60.9%). Majority ( n = 66; 91.7%) of patients co-managed with the Aminu Kano Teaching Hospital Team were seen within 24 h compared to a period of 4 days to over 1-week for patients referred from National Orthopedic Hospital (NOH). The mean period required to treat maxillofacial patients referred from NOH was significantly longer than for intra-hospital consultation ( P < 0.001). Conclusion: Establishment of maxillofacial units in trauma and orthopedic hospitals will improve the overall management of the multiple trauma patients that may occasionally present with concomitant maxillofacial injuries.