The changing picture of facial fractures. 5-Year review.

A decline in the overall number and severity of facial fractures has been observed at Madigan Army Medical Center, Tacoma, Wash. Hospital records of patients (N = 262) who were treated for fractures of the zygoma, maxilla, and mandible between 1983 and 1987 were reviewed. The three leading causes of facial fractures were assault (35%), vehicular accidents (26%), and sports (12%). The preferred treatment modality consisted of open reduction and internal fixation with plates. Societal influences have been responsible for this declining trend in the number and severity of facial fractures. This pattern will impact on training programs that necessitate physician rotations at large trauma centers to provide necessary exposure to maxillofacial injuries.