Assault-related facial fractures: does the injury mechanism matter?

Abstract

This study clarified the injury characteristics and occurrence of associated injuries in patients with assault-related facial fractures. Data from 840 assaultrelated facial fracture patients were included; demographic factors, facial fracture type, associated injuries, alcohol use, and injury mechanisms were recorded. Assault mechanisms most often included combinations of different mechanisms (57.5%) and resulted in the victim falling (50.1%). The perpetrator was most commonly a stranger (52.5%) and acted alone (57.7%). A total of 123 patients (14.6%) had associated injuries, with the most common being traumatic brain injury. Associated injuries occurred most frequently in patients with combined fractures of the facial thirds (24.2%) and upper third fractures (42.9%). The most significant differentiating factors for associated injuries were the number of perpetrators, falling, the use of an offensive weapon, and if the events of the assault remained unknown. In adjusted logistic regression analyses, statistically significant associations with associated injuries were found for age (odds ratio (OR) 1.05, 95% confidence interval (CI) 1.03-1.07; P < 0.001), falling due to the assault (OR 2.87, 95% CI 1.49-5.50; P = 0.002), and upper third facial fractures (OR 6.93, 95% CI 2.06-23.33; P = 0.002). A single punch also caused severe injuries and should therefore not be overlooked, as this can be as dangerous as other assault mechanisms.

The Causes and Prevalence of Maxillofacial Fractures in Iran: A Systematic Review

“…Several studies have shown that motor vehicle accidents are the leading cause of maxillofacial fractures in young adults 46 , 47 . This age group is also more likely to engage in physical altercations, which can result in maxillofacial trauma 48 .…”

“…This again supports the argument that MVAs are the primary cause of mandibular fractures in Iran, as these accidents typically result in high-impact forces that affect the mandibular body and condyle 60 . In contrast, physical assaults typically result in fractures of the zygomatic arch or orbital bones, as these areas are more exposed and vulnerable to direct impact 48 .…”

Trends and Patterns of Long Bone Fractures in Relation to The Road Traffic Accidents, Assaults, and Falls Among Patients Admitted to Emergency Treatment Unit in Teaching Hospital Karapitiya

“…Upper limb fractures were the commonest in assaults as shown in this study could be due to natural defense mechanisms to protect themselves using upper limbs. The surveyed literature describes facial bone injuries as the common injuries in assaults [19,20].…”