Management of head and neck trauma in a developing country

To investigate cases of trauma in head and neck region; to elucidate the characteristic problems in a developing country. Prospective study; 324 patients with trauma related to head and neck analysed in a tertiary care center from August 1999 to August 2005 33.6% of patients fell in 21-30 year age group. Road traffic accidents (41.4%) were the most common cause of trauma. Nasal bone fractures were the most common fractures. 72.84% presented with bleeding and 72.22% with pain. 92.9% had tenderness. Only 15% of the patients could afford a CT scan. Plain radiograph diagnosed fractures in 83.33% of cases. ORIF was the treatment of choice in cases of fractures of the zygoma, maxilla and mandible. Open reduction and internal fixation (ORIF) gave good long-term results with satisfactory cosmosis. Most of our patients did not have any significant sequelae. Cerebral concussion was the most common associated injury (35.48%). In developing countries, one cannot follow the approaches used for RTAs in developed countries. Treating surgeons will have to select investigation tools and treatment options according to the socioeconomical and cultural variations, which differ from country to country, and also within different parts of the country.