Chih-Hao Chen

  • Geriatric Maxillofacial Fractures: from Anthropometry, Biomechanics to Outcome Analysis in a Taiwanese Population

    Purpose:
    As the global population ages and life expectancy increases, the number of geriatric patients seeking trauma care and treatment for facial fractures will increase. Understanding age-related differences in the pattern, cause, and management of these maxillofacial fractures is essential for improving health care.

    Materials and Methods:
    Anthropometry and biomechanics analysis were performed to evaluate the difference between geriatric and young age groups. A retrospective review of adults presenting to a Level I trauma center was performed to evaluate age-related differences in facial fractures. Descriptive statistics were used to compare fracture number, type, cause of injury, management, and adverse events between geriatric and younger cohorts. Logistic regression was used to evaluate the effect of age on fracture type while controlling for potential confounding variables.

    Results:
    Regarding cause of injury, older patients were more likely to fall, and younger patients were more likely to be injured through assaults, motor vehicle collisions, or sports (p < 0.01). Geriatric patients sustained a higher incidence of maxillary (p < 0.05), and orbital floor fractures (p < 0.05) and a lower incidence of mandible fractures. The geriatric patients had significantly less operative intervention (p < 0.01) and were less likely to experience complications (p < 0.05).

    Conclusions:
    Aging results from a combination of soft tissue and bony changes, with bone loss in specific areas of the facial skeleton contributing significantly to the features of the geriatric face. It is conceptually important to appreciate that in most individuals with premature aging, the facial skeleton can be inherently inadequate. Accordingly, the changes in the facial skeleton that results from the aging process must be addressed to obtain a natural-appearing facial rejuvenation. Geriatric patients tend to suffer from less severe facial fractures, requiring less need for operative intervention, likely secondary to low-energy mechanisms of injury.

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