Abstract: Facial Fractures In the Aging Population (Plastic Surgery 2012)

Saturday, October 27, 2012: 10:50 AM

Dunya M. Atisha, MD , Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, NC

Alexander C. Allori, MD, MPH , Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, NC

David Nolen, MD , Division of Otolaryngology- Head and Neck Surgery, Duke University Medical Center, Durham, NC

Edward J. Ruane, MD , Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, NC

Brian M. Christie, MD , Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, NC

Ketan Sharma, BS , Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, NC

Ryan T. Kellogg, MD , Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, NC

Amelia W. Maiga, MD, MPH , Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, NC

Liana Puscas, MD , Division of Otolaryngology- Head and Neck Surgery, Duke University Medical Center, Durham, NC

Jeffrey R. Marcus, MD , Plastic Surgery, Duke University Medical Center, Durham, NC

Detlev Erdmann, MD, PhD, MHSc , Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, NC

Presentation PDF file

Purpose: As the US population ages and life expectancy increases, the incidence of traumatic injuries is rising. The number of elderly patients seeking treatment for facial fractures will proportionally increase, therefore, an understanding of age related differences in the pattern, etiology, and management of these fractures is essential for the care of the aging population.

Methods: In an effort to evaluate age related differences among patients with facial fractures, a ten year retrospective cohort study was performed at a level one trauma center. Older patients were defined as those with an age greater than or equal to 65 at the time of injury and younger patients were defined as younger than age 65. Descriptive statistics were used to evaluate clinical outcomes.

Results: 2023 adult patients (mean age = 39.0 yrs) sustained at least one facial fracture from 2001 to 2011. 209 patients were older than or equal to the age of 65 (mean age= 76.9 yrs) and 1814 were younger (mean age= 34.7 yrs). Significant gender differences exist in the incidence of facial fractures by age such that older females were more likely than older males (57,9% vs. 42.1%) and younger males were more likely than younger females (76.4% vs 23.6%) to sustain a facial fracture (p<0.0001). Regarding etiology of injury; older patients were more likely to fall and younger patients were likely to be injured through assaults, MVCs, or sports (p<0.0001).

Patterns of facial fractures significantly differed between the age cohorts such that older patients had a higher incidence of maxillary (16.3% vs. 11.4%; p= 0.0401), nasal (54.1% vs 45.3%; p=0.0156), and orbital floor fractures (28.2% vs. 18.1%; p=0.004) and a lower incidence of mandible fractures (10.1% vs 21.3%; p=0.0001). Older patients also had a lower rate of operative repair of their fractures (24.9% vs. 43%; p<0.0001) and they were significantly less likely to experience complications regardless of management type (5.3% vs. 10.5%; p=0.0162).

Conclusion: This analysis reveals that elderly patients differ significantly in the etiology, pattern, management, and consequences of facial fractures possibly due to low-energy mechanisms of injury and the influence of morphologic changes that occur in the aging face.

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20851 Facial Fractures In the Aging Population