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Incidence and management of mandibular fractures in a low-resource health facility in Ghana

Journal of the Korean Association of Oral and Maxillofacial Surgeons / Journal of the Korean Association of Oral and Maxillofacial Surgeons, (P)2234-7550; (E)2234-5930
2021, v.47 no.6, pp.432-437
https://doi.org/10.5125/jkaoms.2021.47.6.432
Paul Frimpong (Brong Ahafo Regional Hospital, Sunyani, Ghana)
Thi Hoang Nguyen (Seoul National University, Seoul, Korea)
Buyanbileg Sodnom-Ish (Seoul National University, Seoul, Korea)
Edinam Salia Nimatu (Brong Ahafo Regional Hospital, Sunyani, Ghana)
Nana Yaa Asantewaa Dampare (Brong Ahafo Regional Hospital, Sunyani, Ghana)
Roberta Rockson (Brong Ahafo Regional Hospital, Sunyani, Ghana)
Samuel Baffour Awuah (Brong Ahafo Regional Hospital, Sunyani, Ghana)
Emmanuel Kofi Amponsah (Brong Ahafo Regional Hospital, Sunyani, Ghana)
Cardinal Newton (Brong Ahafo Regional Hospital, Sunyani, Ghana)
Soung Min Kim (Brong Ahafo Regional Hospital, Sunyani, Ghana)

Abstract

Objectives: The mandible and other parts of the maxillofacial region suffer significant morbid injuries following road traffic accidents. Our study gives epidemiological description of mandibular fractures in Ghana and also evaluates the relevance of closed reduction and indirect fixation for man-aging mandibular fractures in low-resource health facilities in low-income countries like Ghana. Patients and Methods: This is a retrospective study involving 268 patients who reported to the Department of Oral and Maxillofacial Surgery of the Sunyani Regional Hospital with mandibular fractures from January 2010 to December 2019. Patient medical records were assessed for information on age, sex, fracture etiology, anatomic location of fracture, time of day of road traffic accident, and other associated injuries. Results: A total of 268 patients were included in this study (males, 216 [80.6%]; females, 52 [19.4%]). Motor vehicular accident (MVA) was the lead-ing cause of mandibular fractures (202 injuries, 75.4%). Other etiologies included assault (39, 14.6%), gunshot (13, 4.9%), falls (12, 4.5%), and indus-trial accidents (2, 0.7%). Of the 161 male cases caused by MVA, 121 (75.2%) occurred at night and in the evening while the remaining 40 (24.8%) oc-curred in the morning and afternoon. Among all managed 222 patients, 212 (79.1%) were treated with closed reduction and indirect fixation technique while 10 (3.7%) were treated with open reduction and direct fixation. Conclusion: Closed reduction with indirect fixation could successfully be used to manage mandibular fractures in low resourced health facilities, es-pecially in low-income countries. The poor lightening system on roads in Ghana is a major contributory factor to motor vehicular accidents.

keywords
Mandibular fracture, Closed fracture reduction, Motor vehicular accident, Poor lightening

Journal of the Korean Association of Oral and Maxillofacial Surgeons