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

摘要

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