Affecting up to 10-15% of trauma patients, facial fractures are more than just local or aesthetic issues. A facial fracture may hint at a life-threatening brain injury, which could easily go undetected.
Affecting up to 10-15% of trauma patients, facial fractures are more than just local or aesthetic issues. A University of Helsinki doctoral thesis demonstrates that a facial fracture may warn of a serious, potentially life-threatening associated injury.
The face is critical for vital functions such as breathing, eating and vision. Facial injuries may take the form of soft tissue damage, burns, dental injuries or fractures of the facial skeleton.
"Particularly these latter fractures are known risk factors for serious associated injuries. Alarmingly, up to one in five patients with a facial fracture has a concurrent, potentially life-threatening injury," says Esa Färkkilä, Medical and Dental Specialist in Oral and Maxillofacial Surgery.
Facial injuries reveal more than expected
A facial injury may be the body's way of signalling that something much more serious is happening. The key question is whether it is identified in time.
The findings of Färkkilä's study are clear: in patients with facial fractures, especially midface or mandibular fractures, potentially life-threatening associated injuries must be actively ruled out using targeted imaging.
Färkkilä's study demonstrates that both mandibular fractures from high-energy trauma and midface fractures carry a clearly increased risk of concomitant:
- Cervical spine injury
- Blunt cerebrovascular injury
- Traumatic intracranial haemorrhage
"While these injuries are not always apparent externally, they may be life-threatening if not identified in time," states Färkkilä.
Data spanning ten years and two continents
Färkkilä analysed patient data from two major hospitals spanning a decade. The studies were conducted at Harvard University and Massachusetts General Hospital in Boston as well as at the University of Helsinki and Päijät-Häme Central Hospital in Lahti.
Nearly 4,000 patients with facial fractures were treated in Boston, and about 15% of those admitted were diagnosed with a concurrent cervical spine injury. Midface and mandibular fractures were clearly associated with an increased risk.
Findings from Finland were comparable: one in five facial fracture patients at Päijät-Häme Central Hospital was found to have an associated injury. Midface fractures were the most frequent fracture type, and falls the most common injury mechanism.
Doctoral defence
Esa Färkkilä, LicMed, LicDent, will defend his doctoral thesis entitled 'When should associated head and neck injuries be suspected in patients with craniomaxillofacial fractures?' on 6 February 2026 at 12.00 at the Faculty of Medicine, University of Helsinki. See more detailed information on the .
The thesis is also available in electronic form through the repository.
