Abstract
Aims: The aim of this study was to describe a new classification for missile
wounds with the treatment for each type, describing a classification for bullets
and blast missiles and other effects of explosion. Moreover; to determine the
factors affecting morbidity of wounds. Materials and Methods: The study
comprised 213 patients who were admitted to AL-Jumhurri Teaching Hospital
in Mosul City, Iraq in the period extending from 1/2/ 2007 to 1/2/2011 who
have sustained different injuries in the Maxillofacial region resulting from
different types of war missiles. All patients were evaluated by clinical
examination, plain radiography of the maxillofacial region and history of
accident was recorded. The study focused on three groups: Group A: Included
(80) patients with bullet injuries in which the bullets were still inside the body
in the maxillofacial region, Group B: Included the victims of (5) explosions
that included (93) patients with blast missiles, Group C: Included (40) patients
injured with high and low velocity bullets that involved soft or soft and hard
tissue. The recommended surgical operations for missile extraction and
definitive treatment application were employed by the same oral and
maxillofacial surgeon. The type, shape of missiles, description of injuries and
treatment were recorded. Results: The study showed that the most common
bullets were the classical type 67.5% while the most common explosion effect
was from shells 39.7%.The study also described a new classification for
missile wounds with description of treatment for each type. No statistical
significant difference was disclosed in the morbidity of injuries between low
and high velocity missiles that involved soft tissues only or a combination of
both soft and bone tissues at p value <0.05, while there was a highly significant
difference in the morbidity of injuries between soft tissues and soft with bone
tissues involvement in low velocity missiles at p value<0.01 and there was a
very highly significant difference in high velocity missile sat p-value < 0.001.
Conclusions: The present research placed a new specific classification for
missile wounds and their management, and placed a classification for missile
and explosion effects. The study also concluded that the morbidity of missile
injury in the maxillofacial region depends on the type of tissue involvement
more than the effect of missile velocity.
