Pattern of Maxillofacial Gunshot Injuries Managed at University of Port Harcourt Teaching Hospital, Rivers State

Gunshot injuries to the maxillofacial region present unique reconstructive challenges due to the high-energy tissue destruction involved, the complex anatomy of the face, and the limited reconstructive resources in many Nigerian tertiary centers. This retrospective descriptive study reviews the pattern, management, and outcomes of maxillofacial gunshot injuries at the University of Port Harcourt Teaching Hospital (UPTH), Rivers State, in the South South geopolitical zone, over a five-year period from 2019 to 2023. Clinical records, operative notes, and follow-up registers of 54 confirmed gunshot injury cases were analyzed. Data captured include patient demographics, mechanism of injury, anatomical region affected, presence of associated injuries, surgical interventions performed, and functional outcomes at six-month follow-up. Results indicate a predominance of young adult male victims, consistent with published literature from conflict-affected Nigerian regions. Mandibular involvement was the most common finding, often associated with significant bone and soft tissue loss. Management included wound debridement, external fixation, and staged reconstructive procedures. Functional outcomes, particularly for speech and mastication, were poorer in patients with extensive hard tissue loss where bone grafting was delayed or not performed. The study highlights the need for advanced reconstructive surgical capacity and bone banking infrastructure at South South teaching hospitals. Keywords: gunshot injuries, maxillofacial reconstruction, mandible, Port Harcourt, conflict-related trauma.