Abstract
Craniomaxillofacial injuries account for a large number of emergency attendances and
a substantial proportion of the workload of acute clinicians. Although data exist
on frequency of involvement of the craniofacial bones, assessments of severity are
lacking, and scoring systems for fractures of individual bones and complex craniomaxillofacial
trauma often fail to include the frontobasal unit. To rectify this, we have devised
a validated scoring system to evaluate the severity of trauma to this region and have
merged it with a pre-existing model to create a cohesive craniofacial disruption index.
Published papers were reviewed and the frontobasal unit defined. Clinically important
anatomical regions were assigned a graduated score that depended on the severity of
disruption, and this was applied in the cases of 13 patients with known craniofacial
fractures of varying severity. Correlation with existing models was calculated and
used as a marker of validity. Our frontobasal system showed strong positive correlation
with a consensus of OMFS clinicians (r = 0.783, p < 0.01). When amalgamated with the pre-existing ZS score to create the Craniofacial
Disruption Index, it correlated strongly with all previous scoring systems (r≥0.729, p < 0.001). The index is a user-friendly, validated model that enables comparison of the
severity of complex craniofacial injuries. It has many potential uses because of its
digital, automated method of calculation.
Keywords
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Article info
Publication history
Published online: May 04, 2020
Accepted:
April 2,
2020
Identification
Copyright
© 2020 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
