Skip to main content

Advertisement

SpringerLink
Log in

Acute facial trauma in falling accidents: MDCT analysis of 500 patients

  • Original Article
  • Published:
Emergency Radiology Aims and scope Submit manuscript

Abstract

The aim of this study is to assess multidetector computed tomography (MDCT) findings of facial trauma due to a falling accident. Using picture-archiving and communications system, we retrieved all MDCT requests for suspected facial injury during a 62-month period. Images were interpreted by two researchers. Five hundred patients met the inclusion criteria and 329 (66%) had a total of 515 fractures. Falls on stairs were seen in 109 (22%) patients and slips or trips in 391 (78%). The corresponding number of fractures was 169 (33%) and 346 (67%). Males (N = 241) had more fractures than females (N = 259), 327 vs. 188, respectively. The zygomatic complex was the most common fracture, seen in 40% of patients suffering a fracture. Twenty patients (4%) had fractures involving the sinus walls without paranasal sinus effusions. Facial fractures due to falls are common. The zygomatic complex is the most common fracture. A clear sinus sign may be less reliable than previously thought.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Tinetti ME (1994) Prevention of falls and fall injuries in elderly persons: a research agenda. Prev Med 23:756–762, DOI 10.1006/pmed.1994.1130

    Article  CAS  PubMed  Google Scholar 

  2. Lehtola S, Koistinen P, Luukinen H (2006) Falls and injurious falls late in home-dwelling life. Arch Gerontol Geriatr 42:217–224, DOI 10.1016/j.archger.2005.07.002

    Article  PubMed  Google Scholar 

  3. Bloem BR, Steijns JAG, Smits-Engelsman BC (2003) An update on falls. Curr Opin Neurol 16:15–26

    Article  PubMed  Google Scholar 

  4. Linnau KF, Stanley RB Jr, Hallam DK, Gross JA, Mann FA (2003) Imaging of high-energy midfacial trauma: what the surgeon needs to know. Eur J Radiol 48:17–32, DOI 10.1016/S0720-048X(03)00205-5

    Article  PubMed  Google Scholar 

  5. Novelline RA, Rhea JT, Rao PM, Stuk JL (1999) State of art: helical CT in emergency radiology. Radiology 213:321–339

    CAS  PubMed  Google Scholar 

  6. Linsenmaier U, Krötz M, Häuser H, Rock C, Rieger J, Bohndorf K, Pfeifer KJ, Reiser M (2002) Whole-body computed tomography in polytrauma: techniques and management. Eur Radiol 12:1728–1740, DOI 10.1007/s00330-001-1225-x

    Article  PubMed  Google Scholar 

  7. Salonen EM, Koivikko MP, Koskinen SK (2007) Multidetector computed tomography imaging of facial trauma in accidental falls from heights. Acta Radiol 48:449–455, DOI 10.1080/02841850701199959

    Article  CAS  PubMed  Google Scholar 

  8. Manolidis S (2004) Frontal sinus injuries: associated injuries and surgical management of 93 patients. J Oral Maxillofac Surg 62:882–891, DOI 10.1016/j.joms.2003.04.020

    Article  PubMed  Google Scholar 

  9. Lambert DM, Mirvis SE, Shanmuganathan K, Tilghman DL (1997) Computed tomography exclusion of osseous paranasal sinus injury in blunt trauma patients: the “clear sinus” sign. J Oral Maxillofac Surg 55:1207–1210, DOI 10.1016/S0278-2391(97)90167-1

    Article  CAS  PubMed  Google Scholar 

  10. Campbell AJ, Robertson MC (2006) Implementation of multifactorial interventions for fall and fracture prevention. Age Ageing 35-S2:60–64, DOI 10.1093/ageing/afl089

    Google Scholar 

  11. Iida S, Hassfeld S, Reuther T, Schweigert H-G, Haag C, Klein J, Mühling J (2003) Maxillofacial fractures resulting from falls. J Craniomaxillofac Surg 31:278–283, DOI 10.1016/S1010-5182(03)00069-6

    PubMed  Google Scholar 

  12. Parizel PM, Van Goethem JW, Özsarlak Ö, Maes M, Phillips CD (2005) New developments in the neuroradiological diagnosis of craniocerebral trauma. Eur Radiol 15:569–581, DOI 10.1007/s00330-004-2558-z

    Article  CAS  PubMed  Google Scholar 

  13. Bassim MK, Ebert CS, Sit RC, Senior BA (2005) Radiation dose to the eyes and parotids during CT of the sinuses. Otolaryngol Head Neck Surg 133:531–533, DOI 10.1016/j.otohns.2005.06.018

    Article  PubMed  Google Scholar 

  14. Brem MH, Zamani AA, Riva R, Zou KH, Rumboldt Z, Hennig FF, Kikinis R, Norbash AM, Schoepf UJ (2007) Multidetector CT of the paranasal sinus: potential for radiation dose reduction. Radiology 243:847–852, DOI 10.1148/radiol.2433050207

    Article  PubMed  Google Scholar 

  15. Hein E, Rogalla P, Klingebiel R, Hamm B (2002) Low-dose CT of the paranasal sinuses with eye lens protection: effect on image quality and radiation dose. Eur Radiol 12:1639–1696, DOI 10.1007/s00330-001-1279-9

    Article  Google Scholar 

  16. Aitasalo K, Lehtinen R, Valkama H, Laurikainen E (1996) Väkivalta syynä kolmasosaan kasvomurtumista Lounais-Suomessa vuosina 1985–1989. Suom Lääkäril 51:669

    Google Scholar 

  17. Kontio R, Suuronen R, Ponkkonen H, Lindqvist C, Laine P (2005) Have the causes of maxillofacial fractures changed over the last 16 years in Finland? An epidemiological study of 725 fractures. Dent Traumatol 21:14–19, DOI 10.1111/j.1600-9657.2004.00262.x

    Article  PubMed  Google Scholar 

  18. Kennedy RL, Grant PT, Blackwell D (2001) Low-impact falls: demands on a system of trauma management, prediction of outcome, and influence of comorbidities. J Trauma 51:717–724

    Article  CAS  PubMed  Google Scholar 

  19. American Geriatrics Society, British Geriatrics Society, American Academy of Orthopaedic Surgeons Panel on Falls Prevention (2001) Guideline for the prevention of falls in older persons. J Am Geriatr Soc 49:664–672, DOI 10.1046/j.1532-5415.2001.49115.x

    Article  Google Scholar 

  20. Koski K, Luukinen H, Laippala P, Kivelä S-L (1996) Physiological factors and medications as predictors of injurious falls by elderly people: a prospective population-based study. Age Ageing 25:29–38

    Article  CAS  PubMed  Google Scholar 

  21. Schillings AM, Mulder Th, Duysens J (2005) Stumbling over obstacles in older adults compared to young adults. J Neurophysiol 94:1158–1168, DOI 10.1152/jn.00396.2004

    Article  CAS  PubMed  Google Scholar 

  22. Cumming RG (1998) Epidemiology of medication-related falls and fractures in the elderly. Drugs Aging 12:43–53

    Article  CAS  PubMed  Google Scholar 

  23. Kurzthaler I, Wambacher M, Golser K, Sperner G, Sperner-Unterweger B, Haidekker A, Pavlic M, Kemmler G, Fleischhacker WW (2005) Alcohol and benzodiazepines in falls: an epidemiological view. Drug Alcohol Depend 79:225–230, DOI 10.1016/j.drugalcdep.2005.01.012

    Article  CAS  PubMed  Google Scholar 

  24. Kanis JA, Johansson H, Johnell O, Oden A, De Laet C, Eisman JA, Pols H, Tenenhouse A (2005) Alcohol intake as a risk factor for fracture. Osteoporos Int 16:737–742, DOI 10.1007/s00198-004-1734-y

    Article  PubMed  Google Scholar 

  25. Watt K, Purdie DM, Roche AM, McClure RJ (2005) The relationship between acute alcohol consumption and consequent injury type. Alcohol Alcohol 40:263–268, DOI 10.1093/alcalc/agh164

    PubMed  Google Scholar 

  26. Gerdhem P, Ringsberg KAM, Åkesson K, Obrant KJ (2005) Clinical history and biologic age predicted falls better than objective functional tests. J Clin Epidemiol 58:226–232, DOI 10.1016/j.jclinepi.2004.06.013

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Helsinki Medical Imaging Center, Department of Radiology, Töölö Trauma Center, Helsinki University Hospital, Topeliuksenkatu 5, 00029 HUS, Helsinki, Finland

    Elina M. Salonen, Mika P. Koivikko & Seppo K. Koskinen

  2. Department of Oral Radiology, Institute of Dentistry, University of Helsinki, Mannerheimintie 172, 00014, Helsinki, Finland

    Elina M. Salonen

Authors
  1. Elina M. Salonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mika P. Koivikko
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Seppo K. Koskinen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Elina M. Salonen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Salonen, E.M., Koivikko, M.P. & Koskinen, S.K. Acute facial trauma in falling accidents: MDCT analysis of 500 patients. Emerg Radiol 15, 241–247 (2008). https://doi.org/10.1007/s10140-008-0717-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10140-008-0717-2

Keywords

Search

Navigation