Epidemiology of Craniofacial Injuries in a Tertiary University Hospital in Tehran, 2013-14

Craniofacial injuries are a major cause of trauma-related disability and damage. Knowledge of the common causes of injuries to the head and facial areas and the resulting effects on the bone structures or brain tissue will be useful for healthcare personnel.

The aim was to investigate the common causes of injuries in patients with craniofacial trauma, and to describe the resulting bone and soft tissue injuries.

In this one-year cross-sectional study (2013 - 14) which was carried out in a tertiary referral hospital, 416 patients who suffered from various forms of craniofacial traumatic injuries (resulting from traffic accidents, assaults, falls, etc.) were enrolled in the study on a consecutive basis. Their medical records and radiographs were examined, and interviews were conducted with the patients and their family members to determine the exact causes of the injuries.

Of the 416 cases, 356 were males (85.6%). Mean (SD) age was 33.1 (21.1) years. The most common cause of injury was falls (137 cases, 32.9%) followed by motorcycle accidents (86 cases, 20.7%). Of the 206 patients with skull fractures (49.5% of the sample), 125 (58.4% of the group) were in non-motor vehicle accidents versus 81 patients (40.1%) who were in the motor vehicle accident group (P < 0.0001). Facial bone fractures were more common among those with non-motor vehicle accident injuries (28.5%) versus those who had been in motor vehicle accidents (12.4%, P < 0.0001). Conversely, intracranial hemorrhage (74.3% vs. 58.9%, P = 0.001) and brain tissue injuries including a contusion, edema, herniation, or burst lobe (44.6% vs. 24.8%, P < 0.0001) were respectively more prevalent in motor vehicle accident traumas than in non-vehicle motor accident injuries. At follow-up, 34 patients had died during hospitalization, 69 patients had undergone cranial surgery, and 67 required facial surgery.

Craniofacial injuries were more common in males in their thirties, with falls and motorcycle accidents as the most common causes. In motor vehicle accidents, we observed a significantly higher proportion of intracranial hemorrhages and brain tissue injuries. In non-motor vehicle accidents (including falls, assaults, accidentally hitting the head/face with a sharp/hard object, etc.), skull/facial bone fractures were more common. These findings can be considered by clinicians as well as forensic medicine specialists