Are Facial Soft Tissue Injury Patterns Associated With Facial Bone Fractures Following Motorcycle-Related Accident?

The unprotected nature of motorcycle riding exposes motorcyclists to an elevated risk of sustaining facial soft tissue injuries (STIs); however, its link with underlying facial bone fractures remains unexplored. The purpose of this study is to determine whether the type and site of STI sustained by motorcyclists were associated with the presence of underlying facial bone fractures.

This was a retrospective cohort study of patients identified from the Oral and Maxillofacial Surgery Department of Universiti Kebangsaan Malaysia Medical Center trauma census who had motorcycle-related injury and met the inclusion criteria. The primary predictor variable was the type (laceration, contusion, abrasion, and no injuries) and site of STIs sustained. The site of the facial STI was categorized as per 17 different zones based upon the modified MCFONTZL classification. The primary outcome variable was the presence or absence of facial bone fractures as determined from the computed tomography scan. Descriptive and bivariate statistics were computed to measure the association between sustaining facial bone fractures and type/site of STI.

Seventy three patients (65 men and 8 women) were included in this study. The average age was 31.9 years (standard deviation ± 13.6) with a range of 18 to 70 years. There were 1,241 facial zones being assessed with 285 (23%) and 214 (17%) zones having STI and fractures, respectively. Laceration (124/285, 43%) and the orbital zone (53/285, 19%) were the most common type and site of STI, respectively, among motorcyclists. Facial bone fractures are more commonly seen following STI in the midface (71% of STI had fractures) compared to upper face (53%) and lower face (31%). Sustaining laceration type of STI was not associated with a higher rate of facial bone fracture when compared with other type of STI (54.8% vs 55.9%, P = .858) with the exception of laceration in the frontal zone (42.9% vs 10.5%, P = .022).

The different types of STI in the facial area cannot be used as a predictor for sustaining underlying facial bone fractures.