A Retrospective Analysis of Facial Fracture Etiologies

TLDR

Retrospective analysis of 437 patients with 929 facial fractures classified fracture patterns by presence in four anatomic subunits (frontal, upper midface, lower midface, mandible). Assault (36%) was the most common trauma etiology, followed by MVC (32%), fall (18%), sports (11%), occupational (3%) and GSW (2%); nasal bone fractures were most frequent, MVC and GSW predicted panfacial fractures and higher injury severity, sports predicted isolated upper midface fractures, assault predicted isolated mandible fractures, confirming previously anecdotal patterns.

Abstract

The medical records of 437 patients with 929 facial fractures were retrospectively analyzed. Fracture patterns were classified based on the presence or absence of fractures in each of 4 anatomic subunits (frontal, upper midface, lower midface, and mandible). The most common etiology of trauma was assault (36%), followed by motor vehicle collision (MVC, 32%), fall (18%), sports (11%), occupational (3%), and gunshot wound (GSW, 2%). The most common fracture type was nasal bone fracture (164). MVC was found to be a significant predictor of panfacial fractures, as was GSW. Sports injuries were a significant predictor of isolated upper midface fractures, and assault was a significant predictor for isolated mandible fractures. MVC and GSW each were found to lead to significantly higher severity of injury than assault, fall, and sports. The results confirm intuitive aspects of the etiology of facial fractures that have been anecdotally supported in the past.