title: Facial Fractures in the Aging Population.
abstract: BACKGROUND
  As the U.S. population ages and life expectancy increases, the number of elderly patients seeking trauma care and treatment for facial fractures will increase. Understanding age-related differences in the pattern, cause, and management of these fractures is essential for improving care.
  
  
  METHODS
  A retrospective review of adults presenting to a Level I trauma center was performed to evaluate age-related differences in facial fractures. Descriptive statistics were used to compare fracture number, type, cause of injury, management, and adverse events between elderly (older than 64 years) and younger cohorts (aged 18 to 64 years). Logistic regression was used to evaluate the effect of age on fracture type while controlling for potential confounding variables.
  
  
  RESULTS
  Two thousand twenty-three adult patients sustained a facial fracture from 2001 to 2011. Two hundred nine patients were elderly and 1814 were younger. Regarding cause of injury, older patients were more likely to fall and younger patients were more likely to be injured through assaults, motor vehicle collisions, or sports (p < 0.0001). Elderly patients sustained a higher incidence of maxillary (16.3 percent versus 11.4 percent; p = 0.0401), nasal (54.1 percent versus 45.3 percent; p = 0.0156), and orbital floor fractures (28.2 percent versus 18.1 percent; p = 0.004) and a lower incidence of mandible fractures (10.1 percent versus 21.3 percent; p = 0.0001). The elderly had significantly less operative intervention (24.9 percent versus 43 percent; p < 0.0001) and were less likely to experience complications (5.3 percent versus 10.5 percent; p = 0.0162).
  
  
  CONCLUSIONS
  Elderly patients tend to suffer from less severe facial fractures, requiring less need for operative intervention, likely secondary to low-energy mechanisms of injury.
  
  
  METHODS
  Risk, II.
authors.affiliation: Tampa, Fla.; and Durham, N.C. From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Morsani College of Medicine, University of South Florida; and the Divisions of Plastic, Reconstructive, Oral and Maxillofacial Surgery and Otolaryngology and Head and Neck Surgery, Department of Surgery, Duke University Medical Center.
authors.forename: Dunya M
authors.initials: DM
authors.lastname: Atisha
authors.forename: Tucker van Rensselaer
authors.initials: TVR
authors.lastname: Burr
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Allori
authors.forename: Liana
authors.initials: L
authors.lastname: Puscas
authors.forename: Detlev
authors.initials: D
authors.lastname: Erdmann
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Marcus
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005147:Facial Bones / Q000293:injuries*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012887:Skull Fractures / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D055815:Young Adult
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