Gunshot injuries in the maxillofacial region : a retrospective analysis and management

Abstract

Aim: To analyze gunshot wounds to the face, assessing the characteristics, immediate treatment, late treatment, complications and after effects. Methods: A retrospective observational study was carried out involving 75 cases of victims of gunshot wounds to the face treated at the Oral and Maxillofacial Traumatology Unit of the Dr. Arthur Ribeiro de Saboya Hospital in the city of São Paulo (Brazil).Data analysis used the chi-square test with the level of significance set at 5% (p dd 0.05). Results: There was a predominance of the 21-to-30-year-old age group (38.7%), male gender (92%) and wounds occurring due to assaults (37.3%). There was a predominance of entry wounds on the left side of the face (58.5%). The most affected sites were the mandible (50.7%), maxilla (18.3%), zygomatic region (7.0%), eye socket (4.2%) and nose (1.4%). Comminuted fractures (88.2%) and simple fractures (10.3%) were recorded. No fracture occurred in 1.5% of the cases. The predominant treatment was rigid internal fixation (RIF) (57.2%), followed by exploratory surgery (23.2%) and conservative treatment (19.6%). Among the cases in which the RIF system was used, there was predominance in the mandible (64.0%). The chi-square test revealed a significant correlation between the 2.4-mm RIF system and the mandible in 48.0 % of cases. Conclusions: In conclusion, gunshot wounds tended to pierce the face, mainly affecting the mandible and caused comminuted fractures treated with rigid internal fixation. Immediate complications occurred in 25% of cases and after effects occurred in 11.7%.