An Epidemiologic Review of Maxillofacial Trauma: A 3-Decade Experience in a Tertiary Medical Center

Abstract

Introduction: The epidemiology of facial fractures varies across populations, with limited local data on facial skeleton injuries in Israel. Understanding etiology and epidemiology is crucial for health care development, surgeon training, and injury prevention.

Objective: The authors analyzed facial skeleton fractures treated at the Department of Oral and Craniomaxillofacial Surgery at Chaim Sheba Medical Center between 2006 and 2015, comparing results with the 1985 to 2005 period. Presenting and analyzing the significant experience of a large tertiary medical center with facial bone trauma over 3 decades.

Methods: A retrospective study included patients with facial bone fractures (excluding nasal bone and dental fractures). Diagnosis relied on clinical and radiologic assessments. Statistical analyses used Wilcoxon, Kruskal-Wallis, χ2, and Fisher exact tests.

Results: During the 3 decades between 1985 and 2015 our department treated 2511 patients with facial fractures. In the period between 2006 and 2015. Most patients were male (78%, P<0.001), with a mean age of 35.7 ± 21.3 years, similar to previously examined decades. Although males exhibited a peak incidence in the second and third decades of life, females displayed a more uniform distribution across ages. Falls (36.2%, P<0.01) and motor vehicle accidents (MVA, 29%, P<0.01) were primary etiologies, followed by assaults (21.6%, P<0.01). Zygomatic complex and subcondylar fractures were the most common fracture site. Falls predominantly led to sub-condylar fractures, whereas MVAs often resulted in zygomatic complex fractures. Between 1985 and 2015, the mean number of fractures per patient increased significantly (1.56-1.8). Assaults and falls as etiologies showed a rising trend. last decade saw increased maxillofacial trauma admissions (P<0.001).

Conclusion: The authors' findings align with global literature on sex and age. Notably, age and etiology differences exist between males and females. A rise in assaults as an etiology may indicate societal changes, warranting attention. An increase in the number of fractures per MVA case coupled with a decrease in MVA-related facial fractures may reflect changing safety measures. Further research representing areas that differ demographically and socioeconomically can illuminate society-wide trends and variations.

Keywords: Facial bone fractures; facial trauma; maxillofacial trauma.