Older women who sustain facial injuries may have increased risk of facial fractures

Racial, sex and age differences related to osteoporosis fractures of the hip or other extremities are well known. Whether these findings apply to facial fractures is unknown.

Peter F. Svider, M.D., of Wayne State University, Detroit, and coauthors analyzed data from the National Electronic Injury Surveillance System (NEISS) for emergency department visits from 2012 to 2014 related to facial trauma. Data were examined by race, sex and age group (older patients were 60 or older and younger patients were 59 or younger).

The authors identified 33,825 NEISS entries extrapolated to 1.4 million emergency department visits for adult facial injury. Of the visits, 14.4 percent involved fracture; 55.2 percent of the individuals were male and 44.8 percent female.

The authors report:

• Overall, fracture risk was higher among individuals 60 or older than in younger adults.
• Facial injuries diagnosed as fractures decreased among men with advancing age but increased among women, especially in women 60 or older.
• Older women had a greater risk of fracture compared with younger women (15 percent vs. 12.5 percent)
• Black individuals had the lowest facial fracture risk in both the younger and older groups, while white individuals had the greatest fracture risks.
• Younger patients, especially men, were more likely to sustain facial fractures by participating in recreational activities.
• The top causes of injury in older women were all related to falls involving structural housing elements and furniture.

Although older women experienced increased fracture risk after facial trauma, the reasons why were beyond the scope of the current study, although the findings are consistent with postmenopausal acceleration in bone loss, according to the authors.

The study has some limitations as a result of the data.

"Overall, Asians and whites had significantly greater risks of sustaining a fracture with facial injuries. Mechanism of injuries also varied significantly by age, race and sex," the study concludes.