Trends in maxillofacial injuries in war-time (1914-1986)

In view of evidence of increasing ophthalmic injury in modern warfare we examined available data for evidence of any changes in the incidence of head and neck injuries since 1914. Although data concerning maxillofacial injuries were available for only five of 26 conflicts, we could find no evidence of increasing incidence of head and neck injury. Overall mean incidence of head and neck injury was 16%; greater than expected in terms of random wounding and the proportion of whole body surface area (12%). Data from the Falklands Campaign and Northern Ireland indicate that 3-8% of all casualties sustained middle or lower third fractures of the facial skeleton. Specialists who have expertise in maxillofacial surgery therefore remain an indispensable part of casualty care in modern warfare. Terrorist activity appeared to give rise to more head and neck injury than either rural attack or minor or major conventional war.