Facial fractures affect up to 15 per cent of trauma patients and can flag life-threatening brain injuries that might otherwise be missed, new research has revealed.
Facial injuries range from soft tissue damage and burns to dental trauma and fractures of the facial skeleton.
Such fractures are a known marker for other serious harm, with up to one in five patients also sustaining a potentially life-threatening injury.
A University of Helsinki doctoral thesis reports that in patients with facial fractures, particularly midface fractures (middle facial bones) or mandibular fractures (jaw), potentially life-threatening associated injuries should be actively ruled out with targeted imaging.
The study found that mandibular fractures from high-energy trauma and midface fractures carry increased risk of cervical spine injury (neck), blunt cerebrovascular injury (damage to blood vessels in the neck or brain) and traumatic intracranial haemorrhage (bleeding inside the skull).
Esa Färkkilä, medical and dental specialist in oral and maxillofacial surgery, said: “Particularly these latter fractures are known risk factors for serious associated injuries.
“Alarmingly, up to one in five patients with a facial fracture has a concurrent, potentially life-threatening injury.
“While these injuries are not always apparent externally, they may be life-threatening if not identified in time.”
The researcher analysed patient data from two major hospitals spanning a decade.
The studies were conducted at Harvard University and Massachusetts General Hospital in Boston, as well as at the University of Helsinki and Päijät-Häme Central Hospital in Lahti.
Nearly 4,000 patients with facial fractures were treated in Boston, and about 15 per cent of those admitted were diagnosed with a concurrent cervical spine injury.
Midface and mandibular fractures were clearly associated with increased risk.
Findings from Finland were comparable, with one in five facial fracture patients at Päijät-Häme Central Hospital found to have an associated injury.
Midface fractures were the most frequent fracture type, and falls the most common injury mechanism.
