CERVICAL SPINE INJURY PATIENTS WITH MANDIBULLAR FRACTURE IN DRAJAT PRAWIRANEGARA HOSPITAL SERANG BANTEN

Abstract

Purpose : The purpose of this Study was to determine the incidence, risk factor and pattern of mandibullar fracture concomitant with cervical injury and other associated injury in trauma center of Drajat Prawiranegara Hospital Serang Banten

Method  : This is a retrospective cohort study of all trauma patients with mandibullar fracture concomitant with cervical injury from January 1, 2015, through July 30 2020.Patients were include as an eligible sample if they had CT Scan and MRI of mandibullar fracture and cervical injury. The primary Variable  was the site of mandibullar fracture, concomitant cervical injury and other associated injury. The other variables were demographic caracteristics, Site of cervical fracture,etiology and Glasgow Coma scale (GCS)

Results : 6850 patients in trauma registry, 630 patients had maxillofacial fracture and 30 patients had cervical injury.The frequency of of cervical injury inthe overall mandibullar farcture pastients wa 4,7 %(n:30). The mean age of patients with mandibullar fracture concomitant with cervical injury was 26 years (range 24-63 Years), 80 % were men. Patients with ramus mandibular fracture,motor vehicle crash etiology and upper  cervical injury had a highest frequency of cervical injury. Ramus mandibulalr fracture and Thorax/pelvic injury were independent risk fracture for Cervical injury in the multivariate model (p=0,0178 and p<0,0001).

Conclusion  : Patients with mandibular fracture due to motor vehicle crash after comprehensive cervical spine clinical examintion must be obtain cervical CT Scan or MRI to diagnosed concomitant cervical injury.  The aim of this protocol is to minimize the incidence of undiagnosed or delayed  diagnosed of cervical injury to prevent permanent neurologic impairment due to cervical injury. Fracture of Ramus Mandibular and chest and pelvic associated injury is ‘a danger sign’ of the risk of concomitant cervcal injury.