Researchers have proposed a new scale for describing craniofacial trauma based only on clinically reducible fractures, which researchers believe is accurate and will allow better communication among health care professionals, according to a study published in JAMA Facial Plastic Surgery.
In an effort to create a simplified scale for measuring craniofacial trauma, Garrett G.A. Casale, MD, and colleagues developed the Bony Facial Trauma Scale (BFTS) which would only include fractures that are routinely plated using open reduction internal fixation or used as clinical guides to fracture reduction and would be validated against the depth of penetration of a blunt object onto the maxillofacial skeleton.
The researchers defined 19 regions on both sides of the face where fractures occur and set the nasal bones, septum and frontal sinus as midline structures. Additionally, the scoring system includes integers regarding the type of injury sustained ranging from 0 to 3 and defined as: 0 for no fracture; 1 for nondisplaced fracture; 2 for displaced fracture; and 3 for comminuted fracture.
Ten donated cadaver heads were used to create fractures and test the system. The mean age of the donated cadaveric samples was 57.2 years (range, 41 to 87). Nine of the samples were male, one female, and the mean number of teeth present was 19 (range, 0 to 28).
To further validate the BFTS system, two evaluators scored the samples using the BFTS as well as previously established models, including the Facial Fracture Severity Scale (FFSS), the Craniofacial Disruption Score (CDS) and the ZS score. The BFTS was positively correlated with all 3 models and the correlations were statistically significant: FFSS (rs = 0.920), CDS (rs = 0.94), and ZS Score (rs = 0.902) (P < .001).
The researchers found that there was a significant correlation between facial trauma score and depth of penetration using a drop tower with impacting device (odds ratio, 4.701; 95% CI, 1.676-6.448; P = .007). The scores obtained using the BFTS, however, were not correlated with dentition or the age of the cadaveric donor.
“The BFTS fulfills a unique niche among the proposed models of describing facial trauma in that, while simplifying those models that have all been validated by their respective authors, it maintains excellent correlation with those scales,” the authors wrote. “This finding shows that the BFTS decreases complexity without sacrificing validity.” – by Talitha Bennett
Disclosure: The researchers report no relevant financial disclosures.