Facial injuries and facial fractures are not the first things that jump to mind when considering the risks of osteoporosis in old age. Hip fractures are much common type of osteoporosis fracture and much research has been spent looking at how ethnicity, sex, and age impacts vulnerability. Now, researchers have taken a look at whether the findings for hip fractures could carry over and be applicable to facial trauma from falls. Those most at risk? Postmenopausal, older women.
The researchers used the National Electronic Injury Surveillance System (NEISS) to look at adult emergency department visits between 2012 and 2014 that were related to facial trauma. The 33,825 NEISS entries were sorted by younger (18-59) and older (60+) adults, as well as by sex and race along with type of injury. The following trends were noticed:
- 14.% of the NEISS entries were for facial fractures
- Among younger adults, fractures were more common among men (15.5%) than women (12.5%)
- Among older individuals, women became more likely to experience facial fractures (15%) than men (14%)
- Facial fractures were more common among white and Asian individuals of both sexes
- Falls were the most common cause of facial fractures among older adults
Identifying the reason for this change in vulnerability was beyond the scope of the study. However, the results are in line with the fact that menopause causes accelerated bone loss, so it may be that postmenopausal women are more susceptible to osteoporosis.
Since this study was a case series, a review of past clinical reports or records, there is more potential for error and bias-influenced results than in other forms of research. With that in mind, it is best to think of these findings as suggesting a trend that warrants further investigation, rather than one that makes a clear declaration. Still, facial fractures are a serious, painful, and decidedly inconvenient injury. Any work on learning more about who may be more vulnerable and what can be done to reduce risk is a step in the right direction.
Hanba, C., et. al., “Race and Sex Differences in Adult Facial Fracture Risk,” JAMA Facial Plastic Surgery, 2016; 10.1001/jamafacial.2016.0714