title: Biomechanical investigation of the supraorbital arch - a transient FEA study on the impact of physical blows.
abstract: BACKGROUND
  As fractures of the supraorbital region are far less common than midfacial or orbital fractures, a study was initiated to investigate whether fist blows could lead to fractures similar to those often seen in the midface.
  
  
  METHODS
  A detailed skull model and an impactor resembling a fist were created and a fist blow to the supraorbital region was simulated. A transient finite element analysis was carried out to calculate von Mises stresses, peak force, and impact time.
  
  
  RESULTS
  Within the contact zone of skull and impactor critical stress values could be seen which lay at the lower yield border for potential fractures. A second much lower stress zone was depicted in the anterior-medial orbital roof.
  
  
  CONCLUSIONS
  In this simulation a fist punch, which could generate distinct fractures in the midface and naso-ethmoid-orbital region, would only reach the limits of a small fracture in the supraorbital region. The reason is seen in the strong bony architecture. Much higher forces are needed to create severe trauma in the upper face which is supported by clinical findings. Finite element analysis is the method of choice to investigate the impact of trauma on the human skeleton.
authors.affiliation: Department of Oral & Maxillofacial Plastic Surgery, Leipzig University, Liebigstr, 10-14, 04103 Leipzig, Germany. heike.huempfner-hierl@medizin.uni-leipzig.de.
authors.forename: Heike
authors.initials: H
authors.lastname: Huempfner-Hierl
authors.forename: Andreas
authors.initials: A
authors.lastname: Schaller
authors.forename: Thomas
authors.initials: T
authors.lastname: Hierl
mesh_terms: D001696:Biomechanical Phenomena; D005147:Facial Bones / Q000293:injuries*; D005151:Facial Injuries / Q000503:physiopathology; D020342:Finite Element Analysis; D006801:Humans; D012887:Skull Fractures / Q000503:physiopathology*; D014754:Violence
references.citation: Plast Reconstr Surg. 2006 Jun;117(7):2373-80; discussion 2381
references.pmid: 16772944
references.citation: J Neurotrauma. 1995 Aug;12(4):659-68
references.pmid: 8683617
references.citation: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Mar;93(3):238-46
references.pmid: 11925530
references.citation: J Biomech. 2013 Oct 18;46(15):2667-73
references.pmid: 24001928
references.citation: Am J Orthod Dentofacial Orthop. 2009 Sep;136(3):361-6
references.pmid: 19732670
references.citation: J Craniomaxillofac Surg. 2013 Dec;41(8):710-7
references.pmid: 22417768
references.citation: J Biomech. 2002 Jun;35(6):767-73
references.pmid: 12020996
references.citation: Plast Reconstr Surg. 1991 Apr;87(4):657-61
references.pmid: 2008463
references.citation: Br J Plast Surg. 1999 Dec;52(8):607-12
references.pmid: 10658130
references.citation: Proc Inst Mech Eng H. 1989;203(4):215-22
references.pmid: 2701959
references.citation: J Oral Maxillofac Surg. 2013 Feb;71(2):335-42
references.pmid: 23351762
references.citation: Br J Plast Surg. 2003 Jan;56(1):3-9
references.pmid: 12706141
references.citation: J Biomech. 2003 Jul;36(7):897-904
references.pmid: 12757797
references.citation: J Craniomaxillofac Surg. 2010 Jul;38(5):385-90
references.pmid: 19944616
references.citation: J Craniomaxillofac Surg. 2010 Jun;38(4):306-13
references.pmid: 19880325
references.citation: Laryngoscope. 1975 Jan;85(1):140-56
references.pmid: 1113592
references.citation: J Can Dent Assoc. 2006 Jul-Aug;72(6):537-40
references.pmid: 16884645
references.citation: Am J Phys Anthropol. 1993 Mar;90(3):291-306
references.pmid: 8460653
references.citation: J Craniofac Surg. 2010 Jan;21(1):202-7
references.pmid: 20098185
references.citation: Med Eng Phys. 2004 Jan;26(1):61-9
references.pmid: 14644599
references.citation: Acta Orthop Scand. 1987 Dec;58(6):620-5
references.pmid: 3442206
references.citation: Am J Sports Med. 1988 Mar-Apr;16(2):130-6
references.pmid: 3377096
references.citation: Int J Oral Maxillofac Surg. 2012 Jan;41(1):66-73
references.pmid: 21996084