Epidemiological trends of facial fractures in the United States

Abstract

Background: Sustaining facial fractures may pose significant challenges to patients' health and quality of life. In the United States (U.S.), facial fractures account for 20 % of all sports-related injuries in pediatrics and many of these injuries are associated with traumatic brain injury. The objective of this study was to identify overall and sports-related incidence rates of facial fractures presenting to U.S. hospital emergency departments from 2014 to 2023 and define demographic risk factors for these injuries.

Methods: The National Electronic Injury Surveillance System was queried to identify facial fractures from 2014 to 2023 as well as associated demographic data. United States Census data were utilized to calculate incidence rates (IR) in 100,000 person-years by year, age, and sport. Incidence rate ratios (IRR) were then calculated by age, sex, and sport.

Results: A total of 1,309,495 facial fractures (IR: 40.57) were identified over the study period. 55.26 % of these injuries occurred in males (IR: 45.47) with an IRR of 1.27 as compared to females. Stratified by decade, the greatest incidence occurred in individuals 80 years and older (IR: 186.57). Of the total observed facial fractures, 34.2 % occurred in the setting of home structures/construction materials, while 33.4 % (IR: 15.35) were sustained in association with sports and recreation. Cycling (IR: 3.07), baseball/softball (IR: 2.67), and ATVs/Mopeds/Minibikes (IR: 1.76) were the leading sports and recreation-related activities associated with facial fractures during the study period. Sports-related injuries followed a unimodal distribution peaking in the 10- to 19-year-old age group (IR: 46.94) and displayed a similar male predominance with males sustaining 74.0 % (IR: 23.05, IRR: 2.97) of sports-related fractures.

Conclusions: The incidence of sports-related facial fractures has increased significantly over the past decade. Older age and male sex are risk factors overall for facial fractures in the United States population, while younger males are predominantly affected by sports-related facial fractures. Youth sports coaches, officials, athletes, and parents should be aware of the risk of sustaining facial fractures in sports and should don the appropriate sport-specific head gear in effort to prevent head injuries.

Keywords: Epidemiology; Facial fracture; Injury.