Exploring the correlation of epidemiological and clinical factors with facial injury severity scores in maxillofacial trauma: a comprehensive analysis.

Abstract

Introduction: The Facial Injury Severity Scale (FISS) provides a numerical value based on individual fractures that can be a valuable tool for management of maxillofacial trauma patients. The aim of this study was to evaluate the association of epidemiological and clinical factors with facial fracture patterns and their correlations with FISS.

Methods: A retrospective study was conducted based on 511 medical records from a 4-year period of patients with facial trauma who underwent open reduction internal fixation (ORIF) under general anesthesia. Fracture patterns were categorized into 3 anatomic subunits: upper, middle and lower face. Single-unit and panfacial fractures groups were analyzed separately. Data regarding demographics, hospitalization, etiology of injury, fracture site and complications were collected. The overall risk of fracture within the viscerocranium requiring an ORIF was presented in graphical form.

Results: Single-unit fractures were more typical in younger patients. There was a significant association between FISS score and traumatic etiology, hospitalization time, length of surgery in each group (p < 0.001). For panfacial fractures, FISS >6 indicated prolonged surgery (>2 h) and hospitalization (>1 week).

Discussion: Despite the questionable clinical utility of FISS, classifying maxillofacial trauma can facilitate comprehensive treatment planning and multidisciplinary collaboration, particularly in complex cases such as panfacial fractures.