Be careful where you aim: craniomaxillofacial trauma from the utility of metal hammers

Abstract

Purpose

A hammer is a popular tool among the “do it yourself” (DIY) population who pursue home-improvement projects. While we are aware that hammers have health hazards, no study has yet to explore the craniomaxillofacial injuries that could arise from the use of hammers. The purpose of this study is to describe the characteristics of craniomaxillofacial injuries from hammers.

Materials and methods

This is a 20-year cross-sectional study conducted using the National Electronic Injury Surveillance System (NEISS). Injuries from hammers were included in this study if they involved the head, face, eyeball, mouth, or ear. The study predictor was the mechanism of injury. The study outcome was the admission rate from the emergency department (ED) and anatomical site injured. Patient and injury characteristics were compared using chi-squared and independent sample tests.

Results

Our final sample had a total of 2967 hammer-induced injuries. Most of the sample consisted of white (55.3%) males (80.2%). Summer was the most injury-congested season (30.1%). The majority of the patients were over the age of 18 (65.6%). Laceration (47.3%) was the most common primary diagnosis, followed by contusion/abrasion (21.9%). The head (42.9%) was the most commonly injured craniomaxillofacial region followed by the face (29.0%). Craniomaxillofacial injury most frequently transpired at the patient’s home (63.6%). Concerning the mechanism of injury, accidentally self-induced injuries with a hammer were the most common (32.4%). Patients who were injured from the debris were more likely (P < 0.01) to be admitted (7.6%) relative to patients who were not (2.5%). The head was most likely to get injured from a falling hammer (P < 0.01). The face was most likely to get injured through accidental self-injury (P < 0.01). The eyeball was most likely to get injured from debris (P < 0.01). The mouth was, similar to the face, most likely to get injured through accidental self-injury (P < 0.01).

Conclusions

Craniomaxillofacial injuries secondary to hammers illustrated a predilection to the head. Hammer falling from a height was most likely to injure the head. Debris from hammer strikes was the most dangerous mechanism of injury and was most likely to injure the eyeball. Hence, the authors urge the use of protective gear for the head (i.e., helmet) and eyeball (i.e., glasses) when handling hammers for constructive purposes.