Interpersonal Violence-Related Facial Fractures: 12-Year Trends and Surgical Outcomes in a Southern European Level-I Trauma Centre.

Background and

Objectives

Interpersonal violence (IPV) has overtaken road traffic collisions as a leading cause of facial fractures, yet regional data from Southern Europe are limited. Materials and

Methods

We retrospectively reviewed all adults (≥18 y) treated between 1 January 2011 and 31 December 2022 for radiologically confirmed IPV-related facial fractures. Recorded variables were demographics, AO-CMF (Arbeitsgemeinschaft für Osteosynthesefragen-Craniomaxillofacial) fracture site, Facial Injury Severity Score (FISS), presence of facial soft-tissue wounds, treatment modality, and length of stay; associations between variables were explored.

Results

A total of 224 victims were identified; 94% were men (median age 26 y, IQR 22-34). The mandible was the most frequently involved bone (42%), followed by the orbit (25%); 14% sustained fractures at multiple sites. Facial soft-tissue wounds occurred in 9% of cases, three-quarters of which were associated with mandibular injury (p = 0.005). The median FISS was 2 and was higher in males, patients > 34 y, those with multiple fractures, and those with wounds (all p < 0.05). FISS showed a weak positive correlation with hospital stay (r = 0.23), which averaged 4.1 ± 1.6 days. Open reduction and internal fixation were required in 78% of patients, most often 24-72 h after admission. Annual IPV-related admissions remained stable throughout the 12-year period.

Conclusions

IPV in this region consistently injures young men, with the mandible and orbit most at risk. FISS is a practical bedside indicator of resource use. The unchanging incidence-likely underestimated because isolated nasal fractures and minor injuries are often managed outside maxillofacial services or never reported-highlights the urgency of targeted prevention programs, routine screening, and streamlined multidisciplinary pathways.