The impact of osteoporosis on patients with maxillofacial trauma.

BACKGROUND Although maxillofacial injuries in the elderly population frequently result from falls and motor vehicle crashes, the association between osteoporosis and fractures of the maxillofacial region remains poorly defined. OBJECTIVE To evaluate the relationship between osteoporosis and maxillofacial trauma in the elderly. DESIGN, SETTING, AND MAIN OUTCOME MEASURES: A retrospective review of 59 patients 60 years or older treated for maxillofacial fractures at a trauma center between 1989 and 2000 was performed. The severity of osteoporosis was graded by evaluating the radiographic appearance of the vertebral bodies of each trauma patient using the Saville index. The number of maxillofacial fractures and the severity of osteoporosis in each patient was assessed to determine whether an association between osteoporosis and maxillofacial trauma exists. RESULTS Of the 59 patients evaluated, 51% were injured by falls and 46% were involved in motor vehicle crashes. Seventy-three percent of the patients had multiple facial fractures. As the severity of osteoporosis worsened, patients were more likely to sustain a greater number of maxillofacial fractures (P=.01). The mechanism of injury had no impact on the relationship between osteoporosis and the number of fractures. CONCLUSIONS Osteoporosis is an independent risk factor for the development of maxillofacial fractures. Since more than half of these patients are injured by falls, safety measures must be instituted to prevent fall-related maxillofacial injuries in the home and the community.