Facial fractures and associated injuries in high- versus low-energy trauma: all are not created equal

• Published in: Maxillofacial plastic and reconstructive surgery 2020, 42(6), , pp.1-6
• Main Authors: Hilaire, Cameron St, Johnson, Arianne, Loseth, Caitlin, Alipour, Hamid, Faunce, Nick, Kaminski, Stephen, Sharma, Rohit
• Format: Article
• Language: English
• Subjects: Anticoagulants; Assaults; Dentistry; Face; Facial fractures; Fractures; High-energy mechanisms; Injuries; Low-energy mechanisms; Medicine; Mortality; Oral and Maxillofacial Surgery; Outcomes; Patients; Plastic Surgery; Trauma; Ventilators; 치의학
• ISSN: 2288-8101; 2288-8586; 2288-8586
• DOI: 10.1186/s40902-020-00264-5

Introduction Facial fractures (FFs) occur after high- and low-energy trauma; differences in associated injuries and outcomes have not been well articulated. Objective To compare the epidemiology, management, and outcomes of patients suffering FFs from high-energy and low-energy mechanisms. Methods We conducted a 6-year retrospective local trauma registry analysis of adults aged 18–55 years old that suffered a FF treated at the Santa Barbara Cottage Hospital. Fracture patterns, concomitant injuries, procedures, and outcomes were compared between patients that suffered a high-energy mechanism (HEM: motor vehicle crash, bicycle crash, auto versus pedestrian, falls from height > 20 feet) and those that suffered a low-energy mechanism (LEM: assault, ground-level falls) of injury. Results FFs occurred in 123 patients, 25 from an HEM and 98 from an LEM. Rates of Le Fort (HEM 12% vs. LEM 3%, P = 0.10), mandible (HEM 20% vs. LEM 38%, P = 0.11), midface (HEM 84% vs. LEM 67%, P = 0.14), and upper face (HEM 24% vs. LEM 13%, P = 0.217) fractures did not significantly differ between the HEM and LEM groups, nor did facial operative rates (HEM 28% vs. LEM 40%, P = 0.36). FFs after an HEM event were associated with increased Injury Severity Scores (HEM 16.8 vs. LEM 7.5, P