Rate of facial injuries in car crashes down

NEW YORK (Reuters Health) - Facial injuries sustained in car accidents are becoming less and less common, probably thanks to improvements in automobile design, an analysis of national motor vehicle crash data indicates.

But the findings also suggest that big vehicles like SUVs may actually be making the roads less safe, without offering any significant protection to their occupants.

Facial injuries are the most common type of injury sustained in a car crash, Dr. Brian T. McMullin of the Medical College of Wisconsin in Milwaukee and his colleagues note. They sought to investigate whether changes in vehicle design and restraint use influenced the incidence of these injuries by looking at 1993-2005 data from the government-run National Automotive Sampling System Crashworthiness Data System, which collects information on tow-away car crashes reported by police.

During this time period, the database included 167,391 automobile occupants who sustained at least one facial fracture, 55,150 with fractures of the skull base or frontal sinus, and 196,855 with nasal fractures.

The incidence of facial fractures declined over time, the researchers found, although the incidence of skull base and nasal fractures didn't drop significantly. But when they plotted the data by vehicle model year, the incidence of all three types of injuries fell as cars got newer.

Wearing a seatbelt sharply reduced the likelihood of sustaining a facial fracture, the researchers found, although air bags alone didn't reduce injury risk. People were more likely to have facial fractures, skull base fractures, and nasal fractures if the crash involved a side impact.

"This suggests that side impacts remain an area where current vehicle and restraint technology may be inadequate," McMullin and his team write, noting that side air bags became available only recently so it is not yet clear if they will help reduce such injuries.

The biggest risk for any of the three types of fracture was crashing into something that wasn't a car; in most cases non-moving objects such as trees and telephone poles. The researchers also found that when an accident involved a car and a van, light truck, or SUV, the occupants of the larger vehicle weren't any less likely to be injured than people riding in the smaller one.

However, when two such larger vehicles collided with one another, facial fractures and skull base injury was more common. The researchers also found that people in cars that collided with an SUV, truck or van were more likely to sustain facial or skull base injuries.

SOURCE: Archives of Facial Plastic Surgery, May/June 2009.