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Geriatrics4258 papers

Fracture of bone of face

Last edited: 21 days ago

Overview

Facial bone fractures, including those of the naso-orbital-ethmoid (NOE) complex and zygomatic arch, are common injuries often resulting from trauma such as falls, especially in elderly populations where fall risk is elevated due to factors like polypharmacy and frailty 192030365060.

Diagnosis

  • Clinical Presentation: Pain, swelling, deformity, ecchymosis, and potential functional impairment (vision, breathing, occlusion) 1960.
  • Imaging: CT scans are essential for detailed assessment of fracture lines, displacement, and associated injuries 1960.
  • Grading: Utilize specific classification systems like the Le Fort or zygomatic arch fracture classifications for guiding treatment 2242.
  • Management

  • Surgical Intervention: Recommended for displaced fractures, open wounds, or functional impairment requiring reduction and fixation 192042.
  • Conservative Management: For minimally displaced fractures, initial immobilization with arch bars or intermaxillary fixation followed by early mobilization 1920.
  • Pain Management: Analgesics such as NSAIDs or opioids as needed, considering patient-specific factors 60.
  • Infection Prevention: Prophylactic antibiotics in cases with open fractures or significant soft tissue damage 60.
  • Rehabilitation: Early physiotherapy to restore function and prevent complications like malocclusion or facial asymmetry 821.
  • Special Populations

  • Elderly: Increased risk due to polypharmacy and frailty; careful medication review to minimize fall-risk increasing drugs (FRIDs) 311141718233050.
  • Comorbidities: Patients with cardiovascular disease or respiratory issues may require tailored surgical approaches to avoid exacerbating underlying conditions 60.
  • Key Recommendations

  • Imaging with CT for accurate diagnosis and planning of treatment in facial bone fractures (Evidence: Strong 1960).
  • Surgical intervention for displaced fractures to prevent long-term functional impairment (Evidence: Moderate 1920).
  • Medication review focusing on deprescribing fall-risk increasing drugs in elderly patients post-fracture (Evidence: Moderate 141718).
  • Early mobilization and physiotherapy to enhance recovery and prevent complications (Evidence: Expert opinion 821).
  • Prophylactic antibiotics in cases of open fractures to reduce infection risk (Evidence: Moderate 60).
  • References

    Showing 100 most recent of 190 indexed papers.

    1 Zhu K, Yang R, Wang T, Hu W, Guo N. Evaluating the impact of transfer passage on emergency evacuation safety in transit hub. Accident; analysis and prevention 2026. link 2 Carlson RM, Belzer C. Improving Delivery of an Age-Friendly Health System in a Geriatrics Primary Care Clinic: Mobility Focus. Journal of gerontological nursing 2026. link 3 Gagnon ME, Talbot D, Simard M, Boiteau V, Sirois C. Polypharmacy as a Simple Measure for Assessing the Risk of Fall-Related Hospitalization in Older Adults. American journal of preventive medicine 2026. link 4 Yousef OAM, El-Helaly M, El-Wehedy A, Denewar KAF. Work-Related Accidents and Their Predictors Among Delivery Drivers in Egypt: A Cross-Sectional Study. La Medicina del lavoro 2026. link 5 Li C, Zhou Y, Tao Z, Li G, Wu Z. Dynamic evaluation of emergency lane occupation based on an improved driving risk field model. Accident; analysis and prevention 2025. link 6 Li M, Huang Q, Li C, Xie L, Wang Y, Yang J. Evaluation of different fall risk screening tools for risk prediction of ophthalmology inpatients. BMC ophthalmology 2025. link 7 Vaesken C, Lelong-Boulouard V, Fedrizzi S, Muzard A, Descatoire P, Loggia G et al.. Drug-related falls: proportion and impact of hospitalizations in geriatric departments on the prescription of fall-risk increasing drugs (FRIDs). European journal of clinical pharmacology 2025. link 8 Kirk-Sanchez N, McDonough C, Avin KG, Blackwood J, Hanke TA. Physical Therapy Management of Fall Risk in Community-Dwelling Older Adults: An Evidence-Based Clinical Practice Guideline From the American Physical Therapy Association - Geriatrics. Journal of geriatric physical therapy (2001) 2025. link 9 Crocker AB, Severance JJ, Murphy SC, Byrd AB. Equitable outreach: Leveraging a university-community partnership for fall prevention training with older adults in rural Texas. Gerontology & geriatrics education 2025. link 10 van der Velde N, Seppala LJ, Herrero AC, Annweiler C, Jónsdóttir AB, Blain H et al.. Falls prevention in community-dwelling older adults and implementation of world falls guidelines: a call for action across Europe by the European Geriatric Medicine Society Special Interest Group on Falls and Fractures. European geriatric medicine 2025. link 11 Umapathy M, Narvaez-Vega K, Khoshnaw H. Medication Management to Reduce Falls-With Particular Focus on Frailty, Polypharmacy and Prescribing. British journal of hospital medicine (London, England : 2005) 2025. link 12 Kang M, Jung J, Kang HA, Kang HY. Excess risk of falls and fractures amongst older people with sedative-hypnotic polypharmacy: an analysis of Korean National Health Insurance Senior Cohort Database. Age and ageing 2025. link 13 Shimoni Z, Kalaora EE, Hermush V, Froom P. Statins and Hospitalizations from Recurrent Falls in the Elderly. Gerontology 2025. link 14 Suen J, Narayan S, Seppala LJ, van der Velde N, Sherrington C, Sutcliffe K et al.. Features of successful medication review and deprescribing interventions for fall prevention in residential aged care facilities: an intervention component analysis of an updated systematic review. Age and ageing 2025. link 15 García-Martínez A, Artajona L, García-Rosa S, Torres Machado V, Gil-Rodrigo A, Pérez-Fonseca C et al.. Analysis of long-term prognosis of older patients after a first fall according to economic status. European geriatric medicine 2025. link 16 Tamminen AE, Honkanen R, Koivumaa-Honkanen H, Sirola J, Sund R, Kröger H et al.. Exercise reduces the risk of falls in women with polypharmacy: secondary analysis of a randomized controlled trial. Scientific reports 2025. link 17 O'Reilly T, Gómez Lemus J, Booth L, Clyne B, McCarthy C, Ibrahim K et al.. Potentially inappropriate prescribing and falls-risk increasing drugs in people who have experienced a fall: a systematic review and meta-analysis. Age and ageing 2025. link 18 Goto NA, van Heel DAM, Dautzenberg L, Sibille FX, Jennings E, Bauer DC et al.. Impact of Discontinuation of Fall-Risk-Increasing Drugs on Falls in Multimorbid Older Patients With Polypharmacy. Journal of the American Geriatrics Society 2025. link 19 Leader P, Gal TJ. Naso-Orbital-Ethmoid Fracture Repair Techniques: A Systematic Review. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 2024. link 20 Park TH. One-piece Craniofacial Bone Fracture Reduction With an Additional Single Osteotomy at the Zygomaticomaxillary Buttress: A Successful Reduction of Frontoorbitozygomaticomaxillary Fracture Associated With a Temporoparietal Bone Fracture. The Journal of craniofacial surgery 2024. link 21 Burgess AJ, Clee D, Prichburg A, Burberry DJ, Keen L, Davies EA. CWTCH in the community: Improving education to reduce adverse outcomes for patients who fall in nursing homes. Gerontology & geriatrics education 2024. link 22 Eckstrom E, Vincenzo JL, Casey CM, Gray S, Cosley K, Caulley J et al.. American Geriatrics Society response to the World Falls Guidelines. Journal of the American Geriatrics Society 2024. link 23 Yoshida Y, Ishizaki T, Masui Y, Hori N, Inagaki H, Ito K et al.. Effect of number of medications on the risk of falls among community-dwelling older adults: A 3-year follow-up of the SONIC study. Geriatrics & gerontology international 2024. link 24 Érszegi A, Csupor D, Bodó G, Engi Z, Bahar MA, Matuz M et al.. High rate of potentially inappropriate medication use in older people: a case-control study. GeroScience 2024. link 25 Priyadarshini R, Eerike M, Varatharajan S, Ramaswamy G, Raj GM, Cherian JJ et al.. Assessing the Efficacy of the ARMOR Tool-Based Deprescribing Intervention for Fall Risk Reduction in Older Patients Taking Fall Risk-Increasing Drugs (DeFRID Trial): Protocol for a Randomized Controlled Trial. JMIR research protocols 2024. link 26 Pavon JM, Davidson S, Sloane R, Pepin M, Bryan W, Bailey J et al.. Deprescribing electronic case reviews for older veterans at risk for falls: Effects on drug burden and falls. Journal of the American Geriatrics Society 2024. link 27 Socias-Morales C, Gwilliam M, Gomes H, Stallings H, Burnham B, Chaumont Menéndez CK et al.. A longitudinal pre-post study: An evaluation of the Department of the Air Force bundled occupational fall prevention efforts. American journal of industrial medicine 2024. link 28 Zhao Y, Zhong Y, Wu L, Yan J, Lu W. Sex differences of fall-risk-increasing drugs in the middle-aged and elderly: a descriptive, cross-sectional study of FDA adverse event reporting system. Scientific reports 2024. link 29 Shankar KN, Li A. Older Adult Falls in Emergency Medicine, 2023 Update. Clinics in geriatric medicine 2023. link 30 van der Velde N, Seppala LJ, Hartikainen S, Kamkar N, Mallet L, Masud T et al.. European position paper on polypharmacy and fall-risk-increasing drugs recommendations in the World Guidelines for Falls Prevention and Management: implications and implementation. European geriatric medicine 2023. link 31 Klima D, Austin N, Avila K, Savoy A, Rhoten N, Wehland E et al.. Student coaching in a rural community fall prevention program: An exploratory study. Gerontology & geriatrics education 2023. link 32 Bartolomé Martín I, Esteve Arríen A, Neira Álvarez M, Cristofori G, Cedeno-Veloz BA, Esbrí Víctor M et al.. Specialized Care Resources for Diagnosis and Management of Patients Who Have Suffered Falls: Results of a National Survey in Geriatric Units. International journal of environmental research and public health 2023. link 33 Wedmann FM, Conca A, Di Gregorio P, Florio V, Toscano M, Giupponi G. Falls at the interface between geriatric and psychiatric patients: a critical review from a psychopharmacological perspective. Rivista di psichiatria 2023. link 34 Spalthoff S, Oetzel F, Dupke C, Zeller AN, Jehn P, Gellrich NC et al.. Quantitative analysis of soft tissue sagging after lateral midface fractures: A 10-year retrospective study. Journal of stomatology, oral and maxillofacial surgery 2022. link 35 Nikolov I, Liu J, Moeslund T. Imitating Emergencies: Generating Thermal Surveillance Fall Data Using Low-Cost Human-like Dolls. Sensors (Basel, Switzerland) 2022. link 36 Rakugi H, Sugimoto K, Arai H, Kozaki K, Matsui Y, Mizukami K et al.. Statement on falls in long-term care facilities by the Japan Geriatrics Society and the Japan Association of Geriatric Health Services Facilities. Geriatrics & gerontology international 2022. link 37 Paul AP, Miner DG, Parcetich KM. Influence of a clinical experiential activity on student confidence in conducting effective fall-risk assessment on older adults. Gerontology & geriatrics education 2022. link 38 Holt MF, Testerman GM. Midlevel Providers Focusing on Geriatrics Improve Care and Outcomes of Fall-Related Injuries Among the Elderly. The American surgeon 2022. link 39 Chiam R, Saedon N, Khor HM, A/P Subramaniam S, Binti Mohmad Nasir SS, Binti Abu Hashim NFI et al.. Potentially inappropriate prescribing in a falls clinic using the STOPP and START criteria. International journal of clinical pharmacy 2022. link 40 Osuka Y, Okubo Y, Nofuji Y, Sasai H, Seino S, Maruo K et al.. Modifiable intrinsic factors related to occupational falls in older workers. Geriatrics & gerontology international 2022. link 41 Moreira RP, Guerra FVG, Ferreira GO, Cavalcante TF, Felício JF, Ferreira LCC et al.. Effects of the nursing intervention Fall prevention in older adults with arterial hypertension using NANDA-I, NIC, and NOC. International journal of nursing knowledge 2022. link 42 Valdés Reyes JM, Zapata Ocampo S. Functional Classification of Isolated Zygomatic Arch Fracture: New Proposal. The Journal of craniofacial surgery 2021. link 43 Hammouda N, Carpenter CR, Hung WW, Lesser A, Nyamu S, Liu S et al.. Moving the needle on fall prevention: A Geriatric Emergency Care Applied Research (GEAR) Network scoping review and consensus statement. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2021. link 44 Kong X, Das S, Zhang Y. Mining patterns of near-crash events with and without secondary tasks. Accident; analysis and prevention 2021. link 45 Spicer R, Bahouth G, Vahabaghaie A, Drayer R. Frequency and cost of crashes, fatalities, and injuries involving disabled vehicles. Accident; analysis and prevention 2021. link 46 Leslie AJ, Kiefer RJ, Meitzner MR, Flannagan CA. Field effectiveness of general motors advanced driver assistance and headlighting systems. Accident; analysis and prevention 2021. link 47 Leledakis A, Lindman M, Östh J, Wågström L, Davidsson J, Jakobsson L. A method for predicting crash configurations using counterfactual simulations and real-world data. Accident; analysis and prevention 2021. link 48 Zimmerman KM, Davis K, Finucane S, Coogle CL, Grunden K, Marrs SA. Evaluation of an interprofessional, evidence-based falls training. Gerontology & geriatrics education 2021. link 49 Cho H, Heijnen MJH, Craig BA, Rietdyk S. Falls in young adults: The effect of sex, physical activity, and prescription medications. PloS one 2021. link 50 Xue L, Boudreau RM, Donohue JM, Zgibor JC, Marcum ZA, Costacou T et al.. Persistent polypharmacy and fall injury risk: the Health, Aging and Body Composition Study. BMC geriatrics 2021. link 51 Ling Y, Xu F, Xia X, Dai D, Xiong A, Sun R et al.. Vitamin D supplementation reduces the risk of fall in the vitamin D deficient elderly: An updated meta-analysis. Clinical nutrition (Edinburgh, Scotland) 2021. link 52 Mikalsen RF, Durgun Ö, Williams Portal N, Orosz K, Honfi D, K Reitan N. Efficient emergency responses to vehicle collision, earthquake, snowfall, and flooding on highways and bridges: A review. Journal of emergency management (Weston, Mass.) 2020. link 53 Yokota M, Fujita T, Nakahara S, Sakamoto T. Clarifying differences in injury patterns between ground-level falls and falls from heights among the elderly in Japan. Public health 2020. link 54 Montgomery EE, Smith YH. Stall the Fall: Training Non-Clinical Caregivers to Prevent Falls in Community-Dwelling Older Adults. Journal of community health nursing 2020. link 55 Gabaldon J, Wood R, Murphy E, Keeley DW. Medication Status and Gait Mechanics in Older Adults: A Multivariate Analysis. Journal of geriatric physical therapy (2001) 2020. link 56 Zaninotto P, Huang YT, Di Gessa G, Abell J, Lassale C, Steptoe A. Polypharmacy is a risk factor for hospital admission due to a fall: evidence from the English Longitudinal Study of Ageing. BMC public health 2020. link 57 Davenport K, Alazemi M, Sri-On J, Liu S. Missed Opportunities to Diagnose and Intervene in Modifiable Risk Factors for Older Emergency Department Patients Presenting After a Fall. Annals of emergency medicine 2020. link 58 Womack JA, Murphy TE, Bathulapalli H, Smith A, Bates J, Jarad S et al.. Serious Falls in Middle-Aged Veterans: Development and Validation of a Predictive Risk Model. Journal of the American Geriatrics Society 2020. link 59 Beschorner KE, Siegel JL, Hemler SL, Sundaram VH, Chanda A, Iraqi A et al.. An observational ergonomic tool for assessing the worn condition of slip-resistant shoes. Applied ergonomics 2020. link 60 Chukwulebe S, Hogrefe C. The Diagnosis and Management of Facial Bone Fractures. Emergency medicine clinics of North America 2019. link 61 Patton SK, Henry LJ. Nursing students' experience with fall risk assessment in older adults. Nursing & health sciences 2019. link 62 Patterson BW, Jacobsohn GC, Shah MN, Song Y, Maru A, Venkatesh AK et al.. Development and validation of a pragmatic natural language processing approach to identifying falls in older adults in the emergency department. BMC medical informatics and decision making 2019. link 63 Hagiya H, Koyama T, Zamami Y, Tatebe Y, Funahashi T, Shinomiya K et al.. Fall-related mortality trends in older Japanese adults aged ≥65 years: a nationwide observational study. BMJ open 2019. link 64 Fritsch MA, Shelton PS. Geriatric Polypharmacy: Pharmacist as Key Facilitator in Assessing for Falls Risk: 2019 Update. Clinics in geriatric medicine 2019. link 65 Renehan E, Meyer C, Elliott RA, Batchelor F, Said C, Haines T et al.. Posthospital Falls Prevention Intervention: A Mixed-Methods Study. Journal of aging and physical activity 2019. link 66 Aloia JF, Rubinova R, Fazzari M, Islam S, Mikhail M, Ragolia L. Vitamin D and Falls in Older African American Women: The PODA Randomized Clinical Trial. Journal of the American Geriatrics Society 2019. link 67 Thompson JP, Mackenzie JRR, Dutschke JK, Baldock MRJ, Raftery SJ, Wall J. A trial of retrofitted advisory collision avoidance technology in government fleet vehicles. Accident; analysis and prevention 2018. link 68 Koglbauer I, Holzinger J, Eichberger A, Lex C. Autonomous emergency braking systems adapted to snowy road conditions improve drivers' perceived safety and trust. Traffic injury prevention 2018. link 69 Lord SR, Close JCT. New horizons in falls prevention. Age and ageing 2018. link 70 Chan DK, Sherrington C, Naganathan V, Xu YH, Chen J, Ko A et al.. Key issues to consider and innovative ideas on fall prevention in the geriatric department of a teaching hospital. Australasian journal on ageing 2018. link 71 Kusljic S, Perera S, Manias E. Age-dependent physiological changes, medicines and sex-influenced types of falls. Experimental aging research 2018. link 72 Lukaszyk C, Radford K, Delbaere K, Ivers R, Rogers K, Sherrington C et al.. Risk factors for falls among older Aboriginal and Torres Strait Islander people in urban and regional communities. Australasian journal on ageing 2018. link 73 Beunza-Sola M, Hidalgo-Ovejero ÁM, Martí-Ayerdi J, Sánchez-Hernández JG, Menéndez-García M, García-Mata S. Study of fall risk-increasing drugs in elderly patients before and after a bone fracture. Postgraduate medical journal 2018. link 74 Scott KA, Fisher GG, Barón AE, Tompa E, Stallones L, DiGuiseppi C. Same-level fall injuries in US workplaces by age group, gender, and industry. American journal of industrial medicine 2018. link 75 Fritsch MA, Shelton PS. Geriatric Polypharmacy: Pharmacist as Key Facilitator in Assessing for Falls Risk. Clinics in geriatric medicine 2017. link 76 Omlor RL, Watkins FS, Lawlor JS, Lovato JF, Fino NF, Atkinson HH. Intern Boot Camp: Feasibility and impact of a 1-hour session to ensure graduating medical student competency in falls risk assessment. Gerontology & geriatrics education 2017. link 77 Zecevic AA, Li AH, Ngo C, Halligan M, Kothari A. Improving safety culture in hospitals: Facilitators and barriers to implementation of Systemic Falls Investigative Method (SFIM). International journal for quality in health care : journal of the International Society for Quality in Health Care 2017. link 78 Criter RE, Honaker JA. Fall risk screening protocol for older hearing clinic patients. International journal of audiology 2017. link 79 Zia A, Kamaruzzaman SB, Tan MP. The consumption of two or more fall risk-increasing drugs rather than polypharmacy is associated with falls. 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    Original source

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      Drug-related falls: proportion and impact of hospitalizations in geriatric departments on the prescription of fall-risk increasing drugs (FRIDs).Vaesken C, Lelong-Boulouard V, Fedrizzi S, Muzard A, Descatoire P, Loggia G et al. European journal of clinical pharmacology (2025)
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