Blunt trauma craniofacial injuries: A comprehensive analysis

Background and Objectives. An 11-year retrospective review was performed of all patients admitted to the Maryland Institute of Emergency Medical Service Systems with traumatic craniofacial injuries. The purpose was to define the population, incidence, severity, and etiology of maxillofacial trauma and associated injuries. Method and Materials. The records of 7,296 patients, admitted from July 1983 to June 1994 with craniofacial soft tissue injuries resulting from blunt trauma, were retrieved and assessed for demographic information and severity of craniofacial injuries. Results and/or Conclusions. The average age at presentation was 33.4 years. There was a 2:1 male predominance. The most common mechanism of injury was motor vehicle collision (MVC) for all age groups. Overall mortality was 5.9%. This percentage increased to 17.3% with an associated hemispheric brain injury and to 18.8% with an associated brainstem injury. With brainstem and hemispheric involvement, mortality increased to 40.0%. Mortality declined over time from 9.2% (1983 to 1986) to 6.0% (1987 to 1990), to 3.5% (1991 to 1994). Soft tissue injuries to the face occurred generally along a T-shaped distribution, involving the forehead, periorbital area, nose, lip, and chin. Midface was the region most susceptible to fracture among all mechanisms of injury examined. Use of seat belts did not demonstrate a difference in mortality and frequency of MVC injuries.