Facial fractures occur for a variety of reasons related to sports participation: contact between players (eg, a head, fist, elbow); contact with equipment (eg, balls, pucks, handlebars); or contact with the environment, obstacles, or a playing surface (eg, wrestling mat, gymnastic equipment, goalposts, trees). Direct body contact accounts for the majority of sports-related injuries, and the most commonly associated soft tissue injuries were found in the head and neck region.
Sports like football, baseball, and hockey account for a high percentage of facial injuries among young adults. (Ref 29)
Although most sports-related facial injuries are minor, the potential for serious damage exists. A physician examining these injuries must rapidly assess the patient in a consistent and methodical manner, allowing for prompt diagnosis and appropriate treatment, while considering the physical demands of the sport, as well as the athlete’s return to play.
Facial fractures may be associated with head and cervical spine injuries.
A review by Boden et al of catastrophic injuries associated with high school and college baseball demonstrated 1.95 direct catastrophic injuries annually, including severe head injuries, cervical injuries, and associated facial fractures.
Fractures of the facial bones require a significant amount of force. The physician must take into account the mechanism of the injury as well as the physical examination findings when assessing the patient.
Forces that are required to produce a fracture of the facial bones are as follows:
Nasal fracture – 30 g
Zygoma fractures – 50 g
Mandibular (angle) fractures – 70 g
Frontal region fractures – 80 g
Maxillary (midline) fractures – 100 g
Mandibular (midline) fractures – 100 g
Supraorbital rim fractures – 200 g