Introduction: Accidents Claims Corporation received 28,901 new claims for maxillofacial fractures from January 2018 to December 2021, at an annual cost of NZ$70-80 million.[1] We have previously demonstrated interpersonal violence (IPV) is the most common cause of maxillofacial fracture referred to the Wellington Regional Plastic, Maxillofacial and Burns Unit, disproportionally affecting young Māori.[2]
Aim: To provide an update on the incidence and causes, and the potential impact of COVID-19 lockdowns, on maxillofacial fractures.
Subjects and Methods: All patients referred to the Wellington Regional Plastic, Maxillofacial and Burns Unit from January 1st 2018 to December 31st 2021 were culled from our prospective maxillofacial fracture database. Patient demographics, cause of injury, risk factors including alcohol/drug use, fracture pattern and management, were analysed.
Results: 1281 patients were identified with 963 (75.2%) males and 318 (24.8%) females. IPV, falls and sports accounted for 37.6%, 24.9% and 24.0% of all maxillofacial fracture cases, respectively, most commonly (38.7%) in the 16-30 years age group. Māori (22.0%) and NZ Europeans (55.7%) were the two largest groups, with Māori and NZ Europeans presenting primarily due to IPV and falls, respectively. During the COVID-19 lockdowns our Unit received significantly fewer referrals 4.5/10 vs 9.0/10 person-days outside of lockdown (p < 0.001). With IPV and sports less frequent (1.2 vs 3.4/10 person days and 0.41 vs 2.19/10 person days respectively). Women and those older than 60 years (1.78 vs 0.014/10 person days and 4.2 vs 1.8/10 person days, respectively) were more likely to be referred.
Conclusions: This study demonstrated that COVID-19 lockdowns led to a statistically significant increase in the incidence of maxillofacial fractures affecting females and those older than 60years, compared to outside of lockdown periods. IPV remains a major cause of maxillofacial fractures, underscoring the need for concerted prevention campaigns.