Classification of Mid-facial fractures on Computed Tomography following head injury in a Nigerian population

Background: Head injury is a global epidemic, which results in fractures of the cranio-facial region. Computed Tomography (CT) is the gold standard in evaluating the head injured patient. The aim of this study was to assess the causes of head injury resulting in mid-facial fractures and to characterize and classify the observed fracture patterns and associated findings on CT. Patients and Methods: Between 2006 and 2008, three hundred (300) consecutive patients with acute head injury were evaluated with a helical General Electric (GE CI/e) CT scan machine Data reviewed included cause of injury, age and gender distribution, types of facial fractures sustained, associated intracranial and soft tissue injuries. The Mid-facial fractures were grouped according to the proposed classification Sub groups were assigned depending on the associated CT findings including soft tissue swelling, cranial fractures and intracranial abnormalities. Results: The range of patient age was between 30 to 39 years (mean 32.78years ± 18.515D) with a male: female ratio of 8:3. Abnormal CT scans were seen in 244 (81.4%) of the 300 patients studied. Of the 244 abnormal cases, 79 (32.4%) patients had mid-facial fractures. Most of the fractures involved the sino-nasal complex (47.3%) while the remainder was almost equally distributed in the zygomatico-maxillary complex (24.4%) and orbital complex (28.3%). Conclusion: Road traffic accidents (RTA) continue to be a major cause of head injury and mid-facial fractures followed by falls and assault. We have described the CT findings in mid-facial fractures following head injury in the Nigerian population and suggest a classification system for categorizing these fractures and associated findings.