Patterns of facial laceration from blunt trauma

The clinical characteristics of craniofacial injuries resulting from various modes of blunt trauma, including motor vehicle accidents, falls, and assault, have been described extensively in the literature. In this study, specifically targeted blunt trauma to selected areas of the face was used to recreate soft-tissue laceration injuries on 19 cadaver heads. The patterns of laceration produced were then examined by location, size, penetrated skin depth, and associated muscle and bony involvement. Results showed reproducible patterns of lacerations on the forehead, bilateral superior orbital rim, nose, perimaxillary region, and chin. Six of 19 cadaver faces were undermined prior to blunt trauma to determine the effects of subcutaneous attachments on laceration patterns. Results showed no consistent difference in laceration patterns between undermined skin and intact skin. Our findings suggest that in response to blunt trauma, the skin breaks along selected lines of least resistance that closely parallel cleavage lines of the face and that the patterns of laceration generated are associated with inherent structural and biomechanical properties of the skin, independent of subcutaneous attachments. Blunt trauma lacerations to the face therefore may occur in a consistent and reproducible manner and may be subject to classification.