Associated Injuries Are Frequent and Severe Among Geriatric Patients With Zygomatico-Orbital Fractures

Abstract

Purpose: Associated injuries (AIs) are hypothesized to be frequent in geriatric zygomatico-orbital (ZMO) fractures. The study aim was to determine the relation between ZMO fractures and AIs in geriatric patients compared with younger adult patients. Patients and Methods: A retrospective case-and-control study was carried out on geriatric patients at least 65 years of age (n = 93) and younger adult patients 20 to 30 years of age (n = 68) diagnosed with pure unilateral ZMO fractures. The main exposure was age, the primary outcome was AI outside the face, and the secondary outcomes were type and severity of AI, ocular injuries, restriction of mandibular movement, and ZMO buttress asymmetry. The confounding variables were gender, trauma mechanism, type of ZMO fracture, and dislocation. Statistical analyses included c 2 tests, risk evaluation with 2 Â 2 tables, and logistic regression analysis. Results: AIs outside the face, and particularly brain injuries, were significantly more frequent in the geriatric group than in the control group (P < .001). The significant predictors of AIs outside the face were fall from a height (66.7%), motor vehicle accidents (66.7%), and absence of ZMO dislocation (59.5%; P < .001). The adjusted risk of brain injury was 2.5-fold in the absence of dislocation. The geriatric group had a more than 5-fold higher risk of brain injuries compared with the younger control group (P = .003). Conclusions: AIs in general, and particularly brain injuries, are frequent in geriatric ZMO fractures. Intracranial injuries should be ruled out, particularly in geriatric patients diagnosed with a non-dislocated ZMO fracture.

Characteristics and Patterns of Facial Fractures in the Elderly Population in the United States Based on Trauma Quality Improvement Project Data

“…A single institution retrospective case and control study that evaluated the relationship between associated injuries, like brain injury, and geriatric zygomatico-orbital fractures in elderly (n = 93) and younger adults (n = 68) found that brain injuries were significantly more frequent ( p < 0.001) in the geriatric group (over 65 years old) than in the control group (20–30years of age). 26 Skull fractures occur when a significant force (greater than mechanical integrity of the calvarium) strikes the head. These were seen more commonly in younger adults coinciding with higher velocity mechanisms.…”

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Assault-related facial fractures: does the injury mechanism matter?

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