What is the order of frequency of facial fractures from most common to least common?

From the Guidelines

Facial fractures, from most common to least common, occur in the order of nasal bones, orbital floor, zygomaticomaxillary complex, maxillary sinuses, and mandibular ramus. This order is based on the most recent evidence from 2022, which highlights the frequency of facial fractures in patients presenting to emergency departments in the United States 1. The study notes that the most common structures involved in facial fractures are nasal bones, followed by orbital floor, zygomaticomaxillary complex, maxillary sinuses, and mandibular ramus.

Key factors influencing the frequency of facial fractures include the mechanism of injury, with assaults, motor vehicle collisions, falls, sporting activities, gunshot wounds, and occupational accidents being the most common causes 1. The severity of facial injury is also increased in motor vehicle collisions and gunshot wounds.

Some of the key points to consider when evaluating facial trauma include:

• The primary survey should focus on airway, breathing, and circulation to ensure patient stabilization 1
• Maxillofacial trauma can lead to airway compromise secondary to hemorrhage, soft-tissue edema, and loss of facial architecture from fractures
• Associated injuries to the brain, cervical spine, and cerebrovascular structures may be present, depending on the mechanism of injury and severity of the maxillofacial fractures 1
• Diagnostic imaging is vital in the evaluation of patients with maxillofacial trauma to accurately diagnose the full extent of facial trauma and plan treatment decisions 1

Overall, understanding the order of frequency of facial fractures is crucial for healthcare providers to prioritize diagnosis and treatment, ultimately improving patient outcomes in terms of morbidity, mortality, and quality of life.

From the Research

Order of Frequency of Facial Fractures

The order of frequency of facial fractures from most common to least common is as follows:

• Nasal fractures are the most common facial fracture, as reported in studies 2, 3, 4
• The frequency of other facial fractures varies across studies, but the general order is:
  • Nasal fractures
  • Orbital fractures or zygomaticomaxillary fractures, depending on the study 3, 5, 6
  • Mandible fractures or maxillary/malar fractures, depending on the study 3, 5, 6
• The study 5 found that orbital fractures were the most common overall facial fracture, while nasal fractures were the most common isolated fracture
• The study 6 found that zygomaticomaxillary fractures were the most common, followed by fractures of the mandible
• The study 3 found that nasal fractures were the most common injuries sustained by all mechanisms, and that motor vehicle collisions were most likely to cause nasal and malar/maxillary fractures