Football-related maxillofacial injuries

Published:October 20, 2021DOI:


      Maxillofacial injuries sustained playing sports are becoming increasingly common, and in the UK where football is the most popular team sport, associated maxillofacial injuries are a regular occurrence. This study retrospectively examined data on patients who were referred with facial injuries sustained playing football between 2007 and 2019 (n = 265). Demographics, mechanism of injury, diagnosis, and treatment received were analysed. The mean (SD) age was 25 (11.0) years (range 3-85) and there was a strong male predominance (n = 256, 97% male). Facial fractures were diagnosed in 143 (54%) patients. The most common injury was a midface fracture and the most common mechanism of injury was a clash of heads. Patients with a facial fracture were significantly more likely to have sustained a concurrent head injury (p = 0.006). Those who were elbowed or punched were significantly more likely to have a facial fracture than a soft tissue or dentoalveolar injury (p ≤ 0.05). Players who clashed heads were significantly more likely to have a midface fracture (p ≤ 0.001). In conclusion, football-related maxillofacial injuries predominantly affect young adult males following a clash of heads. An elbow or punch to the face carries a significant risk of facial fracture and concurrent head injury. Therefore, to reduce the percentage of maxillofacial injuries seen in this sport, observed intentional contact between players, using an elbow or fist to the face in particular, must continue to carry the highest sanction.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to British Journal of Oral and Maxillofacial Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Antoun J.S.
        • Lee K.H.
        Sports-related maxillofacial fractures over an 11-year period.
        J Oral Maxillofac Surg. 2008; 66: 504-508
        • Bojino A.
        • Roccia F.
        • Giaccone E.
        • et al.
        Comprehensive analyses of maxillofacial fractures due to non-professional sports activities in Italy.
        Dent Traumatol. 2020; 36: 632-640
        • Boffano P.
        • Kommers S.C.
        • Karagozoglu K.H.
        • et al.
        Aetiology of maxillofacial fractures: a review of published studies during the last 30 years.
        Br J Oral Maxillofac Surg. 2014; 52: 901-906
        • Park H.K.
        • Park J.Y.
        • Choi N.R.
        • et al.
        Sports-related oral and maxillofacial injuries: a 5-year retrospective study, Pusan National University Dental Hospital.
        J Oral Maxillofac Surg. 2021; 79: 203.e1-203.e8
        • Elhammali N.
        • Bremerich A.
        • Rustemeyer J.
        Demographical and clinical aspects of sports-related maxillofacial and skull base fractures in hospitalized patients.
        J Oral Maxillofac Surg. 2010; 39: 857-862
        • Kim S.Y.
        • Chan C.L.
        • Hyam D.M.
        Facial fractures in football: incidence, site, and mechanism of injury.
        Br J Oral Maxillofac Surg. 2016; 54: 936-940
      1. Audickas L. Sport participation in England. Briefing paper No. CBP 8181. House of Commons Library; 2017. Available from URL: Sport participation in England - House of Commons Library ( (last accessed 6 December 2021).

        • Hill C.
        • Burford K.
        • Martin A.
        • et al.
        A one-year review of maxillofacial sports injuries treated at an accident and emergency department.
        Br J Oral Maxillofac Surg. 1998; 36: 44-47
        • Hill C.M.
        • Crosher R.F.
        • Mason D.A.
        Dental and facial injuries following sports accidents: a study of 130 patients.
        Br J Oral Maxillofac Surg. 1985; 23: 268-274
        • Maladière E.
        • Bado F.
        • Meningaud J.P.
        • et al.
        Aetiology and incidence of facial fractures sustained during sports: a prospective study of 140 patients.
        Int J Oral Maxillofac Surg. 2001; 30: 291-295
        • Papakosta V.
        • Koumoura F.
        • Mourouzis C.
        Maxillofacial injuries sustained during soccer: incidence, severity and risk factors.
        Dent Traumatol. 2008; 24: 193-196
        • Kostakis G.
        • Stathopoulos P.
        • Dias P.
        • et al.
        An epidemiologic analysis of 1,142 maxillofacial fractures and concomitant injuries.
        Oral Surg Oral Med Oral Pathol Oral Radiol. 2012; 114: S69-S73
        • Joshi U.M.
        • Ramdurg S.
        • Saikar S.
        • et al.
        Brain injuries and facial fractures: a prospective study of incidence of head injury associated with maxillofacial trauma.
        J Maxillofac Oral Surg. 2018; 17: 531-537
        • Tessier P.
        The classic reprint. Experimental study of fractures of the upper jaw. I and II. René Le Fort, M.D.
        Plast Reconstr Surg. 1972; 50: 497-506
        • Gómez Roselló E.
        • Quiles Granado A.M.
        • Artajona Garcia M.
        • et al.
        Facial fractures: classification and highlights for a useful report.
        Insights Imaging. 2020; 11: 49