(407) Facial Fracture Trends Following Motor Vehicle Collisions in Seat-Belted Occupants: A National Trauma Database Study

Introduction: Facial fractures are a common injury among individuals in motor vehicle collisions (MVCs) and represent a significant proportion of operative consultation for trauma and reconstructive surgeons. This study aims to characterize recent trends in facial fracture rates among seat belted MVC occupants as a result of changing safety features in modern vehicles.

Methods: We performed a retrospective analysis of the National Trauma Data Bank between the years 2017-2023. This included seat-belted occupants and drivers of motor vehicles found by using E-codes describing the cause of injury. Facial injuries were identified using ICD-10 diagnosis codes. Annual incidence rates were calculated relative to all seat-belted MVC injuries. Trends were evaluated using logistic regression and trend testing. Mortality, Injury Severity Scale, Glasgow Coma Scale, and Length of Stay were other factors also included as markers of injury severity.

Results: Among 335,315 seat-belted MVC patients between the years 2017-2023, 10094 sustained facial fractures. Between the years 2017 to 2023, the facial fracture incidence has steadily risen (p=.016). Nasal bone fractures were the most common facial injury, accounting for 34% of all facial fractures but was among the lowest in mortality. Average injury severity, length of stay, and mortality rate among MVC patients with facial fractures were higher than MVC patients without a form of facial fracture. As we hypothesized, complex fracture patterns were associated with worse clinical outcomes evidenced by injury severity scale, length of stay, and Glasgow coma scale.

Conclusions: Despite the advances in car safety technology, the rate of facial fractures among seat-belted occupants has increased over recent years. Our findings suggest that mechanisms for facial fractures in MVCs are evolving, leaving important implications for facial reconstruction workload as well as injury prevention strategies in motor vehicles.