Facial fractures in a level I trauma centre: the importance of protective devices and alcohol abuse

Urban trauma centres have recently noted a shift in the causative mechanism of facial fractures away from motor vehicle crashes (MVC) to blunt assault s (BA). This study was conducted to examine the incidence and aetiology of facial fractures at our institution as well as the relationship with alcoho l and protective device use. Trauma registry records of all patients admitt ed to a level I trauma centre from 1 January 1988 to 1 January 1999 were re viewed. There were 13594 trauma admissions during the Ii-year period. Facia l fractures were sustained by 1429 patients (10.5%) and this group forms th e subject of this study. MVC was the predominant aetiology (59.9%) followed by BA (18.8%). Facial fractures were found in 9.5% of restrained MVC patie nts compared to 15.4% of unrestrained patients (P < 0.001). Non-helmeted mo torcyclists were four times more likely to sustain facial fractures (4.3% v s. 18.4%) than helmeted patients (P < 0.001). 39.6% of patients in the MVC group were legally intoxicated compared to 73.5% in the BA group (P < 0.001 ). 45.4% of unrestrained patients with facial fractures were intoxicated co mpared to 11.8% of restrained MVC patients with facial fractures (P < 0.001 ). MVC continue to be the primary aetiology of facial fractures in our trau ma population. Protective devices decrease the incidence of facial fracture s. Lack of protective device use and the consumption of alcohol correlate w ith sustaining facial fractures. Published by Elsevier Science Ltd.