Experimental Trauma to the Malar Eminence: Fracture Biomechanics and Injury Patterns

Abstract

OBJECTIVES: To document patterns of facial fractures after trauma to the malar eminence and to elucidate biomechanical factors relevant to the injury patterns. STUDY DESIGN AND SETTING: Studies were conducted on 14 cadaver heads. Study variables included impact velocity, contact area, impact force, and zygomatic skin thickness. Bony fractures and clinical injury patterns were documented. A fracture severity rating scale was devised and statistically correlated to the study variables using regression ANOVA analysis. RESULTS: A broad spectrum of facial fracture patterns was found. Skin thickness and surface area did not correlate with fracture severity ( P = 0.67, P = 0.83, respectively). Impact force demonstrated a trend toward significance ( P = 0.14). Velocity was most correlative with fracture severity ( P = 0.07). A critical threshold velocity (3.5 m/s) was found to correlate with the most severe fracture patterns. CONCLUSIONS: A broad spectrum of facial fracture patterns was demonstrated after experimental trauma to the malar eminence. Contact surface area and zygomatic skin thickness were not found to be significant factors in fracture severity. Velocity, rather than impact force, was most correlative with fracture severity. The most severe fracture patterns were elicited by velocities above 3.5 m/s.