Comparison between interpersonal violence and motor vehicle accidents in the aetiology of maxillofacial fractures

Background: Maxillofacial fractures commonly present to the emergency department, interpersonal violence (IPV) and motor vehicle accidents (MVA) being two of the main causes. There is a changing trend in these two aetiologies, which is reflected in a change in demographics, the pattern of fractures and the treatment of maxillofacial fractures. Methods: A prospective database of patients presenting to the Oral and Maxillofacial Surgery service at Christchurch Hospital during an 11-year period was reviewed. Of a total of 2581 patients with radiographic confirmation of facial fractures, 1135 patients sustained injuries following IPV and 286 patients following MVA. Variables examined include demographics, type of fracture, mode of injury, and treatment. Results: The male : female ratio was 9:1 in patients following IPV and 7:3 following MVA; 16-30-year-olds accounted for greatest proportion of injuries (48 and 68%, respectively). There was alcohol involvement in 87% of fractures caused by IPV, compared with 58% for MVA. Mid-facial fractures were more frequently seen in MVA, whereas mandibular fractures were more prevalent in IPV. Sixty-two per cent of the patients from MVA required active treatment and 87% were hospitalized, compared with 56% actively treated and 59% hospitalized in the IPV group. Conclusions: Interpersonal violence has continued to be the main cause of maxillofacial fractures. Both IPV and MVA commonly involve alcohol and young male adults. They frequently require hospitalization and surgical intervention.