Nova razvrstitev vojnih poškodb srednjega dela obraza = A new classification of the midface war injuries
Aljinović-Ratković, Naranđa ; Virag, Mišo
Missile wounds caused by bullets and fragments are different from other woundsnot only by the patterns of injury but also in resulting bone damage. Therefore maxillofacial war wounds can hardly be ...classified according to the standard peacetime classifications which are primarily defined for blunt trauma. The precise evaluation of war injuries, treated during the war in Croatia, was presumed to be an adequate base for the development of a proper classification of maxillofacial war injuries. The differences between peacetime and war time aetiology, the basic surgical anatomy of the facial bones and the standard classifications of facial bone fractures are reviewed. The wound ballistics, especially the characteristics of the maxillofacial wound ballistics are discussed. The evaluation of the war wounds was performedin 262 casualties, treated in the Department of Maxillofacial Surgeryin Zagreb, from 1st August 1991 till 30th November 1995. All of them were wounded by either bullet or fragments from various explosive devices. Theanalysis has proved that all of the midface injuries can be classified in five groups. This five groups are proposed as a new classification: transorbital, transmaxillar, palatoalveolar, central and tangential injuries. Comparing the standard classifications for midface fractures, the results haveshown that only 20%, can be properly classified according to the standard clasification, and 100% according to the proposed new one. The main advantagesof the new classification are that it can be applied in all maxillofacial war injuries, it is simple and based on the clinical and radiological findings. War injuries classified according to the new classification can be compared and evaluated, and also recognized and reconstructed without clinical and radiological documentation for each casualty.
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