Maxillofacial Gunshot Injury Profile in Semi-urban and Urban Teaching Hospitals in Southwest Nigeria.

Abstract

Background: Despite the strict gun control policy in Nigeria, maxillofacial gunshot injuries are still alarming, and the profile of injuries varies based on rurality. This study assessed maxillofacial gunshot injury profile in a semi-urban and an urban teaching hospital in south-west, Nigeria.

Objectives: The study sought to determine patients' demographic profile, cause of injury, association between firearms used and injuries sustained, treatment characteristics and complications seen in the two centres.

Methodology: The study was a 10-year hospital-based retrospective multicentre study of 27 patients with gunshot injuries from two teaching hospitals located in Southwest Nigeria. Patients with gunshot injury to the face and other parts of the body and brought in dead were excluded. Data retrieved from patient's medical record include age and sex, mode of gunshot infliction, clinical presentation, treatment given and associated complications. Statistical significance was inferred at P < 0.05.

Results: Of the 27 patients recruited, semi-urban (18) accounted for twice the number of cases. The female-male ratio was (1:5.8). The mean age was 33.37 ± 10.47 years. Although injuries from hunting and firearm servicing were found only in the semi-urban cohort, police brutality and armed robbery were observed in both centres. Rifle injuries resulted more in avulsive soft-tissue injuries, whereas penetration occurred more as a result of Dane gun injuries. Mandibular body and orbital floor fracture were the most common sites of fracture. Fracture comminution of the involved bone was common with Dane gun compared to rifle, although the finding was not statistically significant (P = 0.550). Open reduction and internal fixation was the preferred treatment option in the urban cohort. The common complications were blindness and scar formation.

Conclusions: Victim of gunshot injury was mostly male in their prime age. Although there is dissimilarity between the cause of injury based on rurality, police brutality is becoming a disturbing societal issue in the semi-urban cohort. Sadly, the consequence of blindness resulting from indiscriminate use of firearm is grave coupled with the poor healthcare facilities in low- and middle-income country. There is a need for strict monitoring of firearm acquisition and use by untrained individuals as well as urgent police reforms.