Browse > Article

Correlation Between Facial Fracture and Cranial Injury  

Lee, Seung Won (Department of Emergency Medicine, Sanggye Paik Hospital, College of Medicine, Inje University)
Cho, Suk Jin (Department of Emergency Medicine, Sanggye Paik Hospital, College of Medicine, Inje University)
Ryu, Seok Yong (Department of Emergency Medicine, Sanggye Paik Hospital, College of Medicine, Inje University)
Lee, Sang Lae (Department of Emergency Medicine, Sanggye Paik Hospital, College of Medicine, Inje University)
Kim, Sung Eun (Department of Emergency Medicine, Sanggye Paik Hospital, College of Medicine, Inje University)
Kim, Sung Jun (Department of Preventive Medicine, Sanggye Paik Hospital, College of Medicine, Inje University)
Ahn, Ji Young (Department of Emergency Medicine, Seoul Paik Hospital, College of Medicine, Inje University)
Publication Information
Journal of Trauma and Injury / v.19, no.2, 2006 , pp. 150-158 More about this Journal
Abstract
Purpose: There are two theories about the relationships between facial fractures and cranial injuries. One is that facial bones act as a protective cushion for the brain, and the other is that facial fractures are the marker for increased risk of cranial injury. They have been debated on for many years. The purpose of this study is to identify the relationship between facial fractures and cranial injuries. Methods: A retrospective study was performed on 242 patients with facial fractures. The data were analyzed based on the medical records of the patients: age, gender, cause of injury, Injury Severity Score (ISS), alcohol intake, type of facial fractures, and type of cranial injury. The patients were divided into two groups: facial fractures with cranial injury and facial fractures without cranial injury. We compared the general characteristics between the two groups and evaluated the relationship between each type of facial fracture and each type of cranial injury. Results: Among the 242 patients with facial bone fractures, 96 (39.7%) patients had a combination of facial fractures and cranial injuries. Gender predilection was demonstrated to favor males: the ratio was 3:1. The mean age was $36.51{\pm}19.63$. As to the injury mechanism, traffic accidents (in car, out of car, motorcycle) were statistically significant in the group of facial fractures with cranial injury (p=0.038, p=0.000, p=0.003). The ISS was significant, but alcohol intake was not significant. No significant relationship between facial fractures and skull fractures was found. Only maxilla fractures, zygoma fractures, and cerebral concussion had a significant difference in cranial injury (p=0.039, p=0.025). Conclusion: There is a no correlation between facial fractures and skull fractures, which suggests that the cushion effect is the predominent relationship between facial fractures and cranial injuries.
Keywords
Facial fracture; Cranial injury;
Citations & Related Records
Times Cited By KSCI : 2  (Citation Analysis)
연도 인용수 순위
1 Lee KF, Wagner LK, Lee YE, Suh JH, Lee SR. The impact-absorbing effects of facial fractures in closed-head injuries: An analysis of 210 patients. J Neurosurg 1987;66:542-7   DOI
2 Rimel RW, Giordani B, Barth JT, Boll TJ, Jane JA. Disability caused by minor head injury. Neurosurgery 1981;9:221-8   DOI
3 Davidoff G, Jakubowski M, Thomas D, Alpert M. The spectrum of closed head injuries in facial trauma victims: Incidence and impact. Ann Emerg Med 1988;17:6-9   DOI
4 Max W, Mackenzie E, Rice D. Head injuries: Costs and consequences. J Head Trauma Rehabil. 1991; 27:332-43
5 Gautam V, Leonard EM. Bony injuries in association with minor head injury: Lessons for improving the diagnosis of facial fracture. Injury 1994;25:47-9   DOI   ScienceOn
6 Keenan HT, Brundage SI, Thomson DC, Maier RV, Rivara FP. Does the face protect the brain- A case control study of traumatic brain injury and facial factures. Arch Surg 1999;134:14-7   DOI   ScienceOn
7 Slupcgtnskyj OS, Berkower AS, Byrne DW, Cayten CG. Association of skull base and facial fractures. Laryngoscope 1992;102:1247-50   DOI   ScienceOn
8 Frable MA, Hong K, Jang JH, Park YW. Facial fracture at an urban hospital: A review continued. Va Med 1978;105:700-1
9 Dacey RG Jr, Alves WM, Rimel RW, Winn HR, Jana JA. Neurosurgical complications after apparently minor head injury: Assessment of risk in a series of 610 patients. J Neurosurg 1986;65:203-10   DOI
10 Martin RC, Spain DA, Richardson JD. Do facial fractures protect the brain or are they a marker for severe head injury. Am Surg 2002;68:477-81
11 Jess FK, Thomas MR, Corinne P, David LM. Facial trauma and the risk of intracranial injury in motocycle riders. Ann Emerg Med 2003;41:18-26   DOI   ScienceOn
12 Gwyn PP, Carraway JH, Horton CH, Adamson JE, Madick RA. Fractures associated injuries and complications. Plast Reconstr Surg 1971;47:225-30   DOI   ScienceOn
13 Baek EH, Ko SO, Shin HK. A Clinical study of infraorbital wall fractures. J Korean Asso Maxillofacial Plast and Reconstr Surg. 2000;3: 288- 93
14 McCabe JB, Angelos MG. Injury to head and face in patients with cervical spine injury. am J Emerg Med 1984;2:333-5   DOI   ScienceOn
15 Haug RH, Prather J, Indresano AT. An epidemiologic survey of facial fractures and concomitant injury. J Oral Maxillofacial Surg. 1991;48:926-32   DOI   ScienceOn
16 Kim JD, Kim TY, Chun CY. A Clinical and Statistical Analysis of the facial bone fracture. J Korean Assoc of Plast and Reconstr Surg 1992: 19:38-42
17 Sastry SM, Sastry CM, Paul BK, Bain L. Leading cause of facial trauma in the major trauma outcome study. Plast Reconstr Surg. 1995;95:196-7   DOI   ScienceOn
18 Turvey TA. Midfacial fractures. a retrospective analysis of 593 cases. J Oral Surg. 1997;35:887-91
19 Lamberg MA. Maxillofacial fractures. An epidemiological and clinical study on hospitalized patients. Proc Finn Dent Soc 1979;75:20-5
20 Yoo JH, Lee JK, Choi JP, Park JS. A study of Facial Fracture and Associated injuries. J Korean Soc Emerg Med. 2004;15:88-94
21 Pappacban B, Alexander M. Correlating facial fractures and cranial injuries. J Oral Maxillofac Surg 2006;64:1023-9   DOI   ScienceOn
22 Maynard EJ, Doge JS. Introducing a community health center at Mosgiel, Newzeland:Effects on use of the hospital accident and emergency department. Med Care 1983;21:379-88   DOI   ScienceOn
23 Schultz RC. One thousand consecutive cases of major facial injury. Rev Surg 1970;27:394-410