Maxillofacial injuries in a group of South Africans under 18 years of age

Objective — To find out the incidence of maxillofacial injuries in South African children aged 18 years or less. Design — Retrospective study of casenotes. Setting —Six teaching hospitals affiliated to the University of Witwatersrand, Johannesburg, serving a population of about 5 million people. Subjects — All 326 children treated for facial injuries in the maxillofacial and oral departments of the six hospitals between 1 January 1989 and 30 June 1992. Main outcome measures — Classification of the types of injury, associated injuries, cause of the injury, and methods of diagnosis. Results — Of the total of 4192 patients of all ages treated for facial injuries, 326 (8%) were within the age range of the study. The female:male ratio was 1 : 2.3. Most of the injuries (227, 70%) occurred in the 13–18 age group, and assaults, fights and gunshot wounds accounted for 155 injuries (48%). Of the 326 children, 173 (53%) had single injuries and 153 (47%) had multiple injuries. Mandibular fractures were the most common (64%) followed by maxillomandibular fractures (25%). Violence was the most common cause of injury, as in the USA and Zimbabwe, but unlike the rest of the world in which it is motor vehicle accidents. Soft tissue injuries were the most common associated injuries, and conventional plain radiography was the usual investigation. Conclusion — The incidence of 8% compares favourably with those in other countries, but far too many injuries are the result of violence.