Incidence of Maxillofacial Fractures in Sports
Soccer and Baseball Athletes at Risk due to Direct Body Contact
Los Angeles Angels’ shortstop Eric Aybar left the game early on Saturday, May 2, 2009 after being hit in the face by a reflected ball that bounced off of Jeter’s helmet while Jeter was sliding into second base. Aybar was covering second base and was in position to catch the ball when the injury occurred. Aybar was fortunate. His injury resulted in only a few stitches and no fracture or serious head injury.
After reviewing several research studies on maxillofacial fractures, several factors become clear. The first is that males sustain an overwhelming ratio of these types of injuries as compared to women. In Hwang, You, and Lee’s study (2009) analyzing 236 patients with sports-related multiple facial fractures, the ratio of males to females was 13.75:1. Mourouzis and Koumoura’s study (2005) on sports-related maxillofacial fractures revealed the same with a male to female ratio of 9:1.
Sport of Soccer Leads in Maxillofacial Fractures
Hwang, You, and Lee’s study (2009) Outcome Analysis of Sports-Related Multiple Facial Fractures reported soccer as the leading sport (38.1%) for facial fractures followed by baseball (16.1%) and basketball (12.7%). They also reported that nasal fractures were the most common fractures (54.2%) in all types of sports whereas orbital bone fractures (bone located below the eyes) were the most common in baseball, basketball, and ice sports.
One limitation of this study was that it was conducted in South Korea and reflected the patients that were treated at the Inha University Hospital in south Korea. Mourouzis and Koumoura’s (2005) study “Sports-related Maxillofacial Fractures: A Retrospective Study of 125 Participants” concurred with Hwang et. al’s., study with soccer being the most common sport for facial fractures. Again, the outcome of this study reflects the culture of the country in which the study was undertaken.
A study specifically looking at facial fractures sustained during sports played with a ball (Delibasi, Yamazawa, Nomura, iida, and Kogo, 2004) had a different outcome reporting the highest incidence of facial fractures in the sport of baseball (44%), followed by rugby (28%), and then soccer (18%). Their study reviewed 100 patients who were treated in Japan between 1986 and 2002. Again, cultural differences may account for the different outcome in sports.
Most Common Cause of Facial Fractures in Sports
All three studies reported that direct body contact was responsible for the majority of injuries:
- Hwang et. al., (2009) reported direct body contact (50.8%)
- Delibasi et. al., (2004) reported player to player contact (43%)
- Mourouzix and Koumoura (2005) reported that the main mechanism of injury was that of “impact against another player’s head.”
A research study (2009) by Yamamoto, Murakami, Sugiura, Ishida, Imai, Fujimoto, and Kirita lookied specifically at facial fractures during baseball and softball contradicted the above research and reported that 74% of their patients incurred facial fractures from being hit by the ball and only 20% were incurred from collisions.
The conclusion from all of these is that maxillofacial fractures occur in a variety of sports with a higher incidence in soccer and baseball (depending on the country of origin of the research). Facial injuries can occur from both player to player contact and from being hit by a ball (in the sport of baseball/softball).
Recognize and be able to Provide Emergency First Aid
Protective head gear does not seem to be an option in either sport. However, the research does lead to the conclusion that sports personnel involved in these sports need to be trained in how to recognize the signs and symptoms of maxillofacial fractures and be trained in how to provide emergency first aid in the event that an injury of this magnitude occurs.
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