Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
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Epidemiology and patterns of nasal bone fracture in elderly patients in comparison to other age groups: an 8-year single-center retrospective analysis

  • Jung, Seil (Department of Plastic and Reconstructive Surgery, Inje University Sanggye Paik Hospital, Inje University School of Medicine) ;
  • Yoon, Sihyun (Department of Plastic and Reconstructive Surgery, Inje University Sanggye Paik Hospital, Inje University School of Medicine) ;
  • Kim, Youngjun (Department of Plastic and Reconstructive Surgery, Inje University Sanggye Paik Hospital, Inje University School of Medicine)
  • Received : 2022.07.27
  • Accepted : 2022.10.18
  • Published : 2022.10.20
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Abstract

Background: Nasal bone fractures are the most common type of facial bone fracture, but are under-studied in adults above 65 years of age. Therefore, we investigated the epidemiology and patterns of nasal bone fractures among older adults in comparison to different age groups. Methods: This retrospective study included 2,321 nasal bone fracture patients who underwent surgery at our hospital from January 2010 to December 2017. The patients were classified by age as preschoolers, school-age children, young and middle-aged adults, and the elderly. We performed pairwise comparisons between elderly patients and each other age group in terms of sex, cause of injury, and fracture type. Results: The 2,321 nasal bone fracture patients included 76 elderly patients (50 men [65.8%] and 26 women [34.2%]). In these patients, the two most common injury causes were falling or slipping down (n= 39; 51.3%) and road traffic accidents (n= 19; 25.0%). According to the Stranc and Robertson classification, the most common force vector was lateral, and plane 2 fractures with lateral forces predominated. Conclusion: The elderly showed similar patterns of nasal bone fractures to those observed in young and middle-aged adults, but significant differences from preschoolers (in the injury vector and plane of fracture) and from school-age children (in the sex ratio and plane of fracture). However, elderly patients presented significantly different epidemiological characteristics compared to the other three groups. Therefore, it is necessary to improve the quality of life of the elderly and prepare for the upcoming super-aged society by taking steps to reduce the incidence and severity of fractures. Possible options for doing so include strengthening individual-level safety factors and expanding the social safety net for the elderly.

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References

  1. Murray JA, Maran AG, Mackenzie IJ, Raab G. Open v closed reduction of the fractured nose. Arch Otolaryngol 1984;110:797-802. https://doi.org/10.1001/archotol.1984.00800380027008
  2. Muraoka M, Nakai Y. Twenty years of statistics and observation of facial bone fracture. Acta Otolaryngol Suppl 1998;538:261-5.
  3. Kucik CJ, Clenney T, Phelan J. Management of acute nasal fractures. Am Fam Physician 2004;70:1315-20.
  4. Friese G, Wojciehoski RF. The nose: bleeds, breaks and obstructions. Emerg Med Serv 2005;34:129-37.
  5. Hwang K, You SH, Kim SG, Lee SI. Analysis of nasal bone fractures; a six-year study of 503 patients. J Craniofac Surg 2006;17:261-4. https://doi.org/10.1097/00001665-200603000-00010
  6. Kim KS, Lee HG, Shin JH, Hwang JH, Lee SY. Trend analysis of nasal bone fracture. Arch Craniofac Surg 2018;19:270-4. https://doi.org/10.7181/acfs.2018.02264
  7. Yu H, Jeon M, Kim Y, Choi Y. Epidemiology of violence in pediatric and adolescent nasal fracture compared with adult nasal fracture: an 8-year study. Arch Craniofac Surg 2019;20:228-32. https://doi.org/10.7181/acfs.2019.00346
  8. Lee CL, Yang HJ, Hwang YJ. Comparison of the outcomes of nasal bone reduction using serial imaging. Arch Craniofac Surg 2021;22:193-8. https://doi.org/10.7181/acfs.2021.00311
  9. Kim YS, Han SH, Lee JM, Shin GJ, Choi JK, Park JM. Senior friendly hospital: a new paradigm for the hospital-based care of the elderly. Korean J Clin Geri 2017;18:8-14. https://doi.org/10.15656/kjcg.2017.18.1.8
  10. Lee HC. Population aging and Korean society. Korea J 2021;61:5-20.
  11. The World Bank. Population ages 65 and above (% of total population) [Internet]. Washington, DC: The World Bank; c2019 [cited 2022 Jun 8] Available from: https://data.worldbank.org/indicator/SP.POP.65UP.TO.ZS.
  12. Kim KW, Kim OS. Super aging in South Korea unstoppable but mitigatable: a sub-national scale population projection for best policy planning. Spat Demogr 2020;8:155-73. https://doi.org/10.1007/s40980-020-00061-8
  13. Stranc MF, Robertson GA. A classification of injuries of the nasal skeleton. Ann Plast Surg 1979;2:468-74. https://doi.org/10.1097/00000637-197906000-00004
  14. Rohrich RJ, Hollier LH Jr, Janis JE, Kim J. Rhinoplasty with advancing age. Plast Reconstr Surg 2004;114:1936-44. https://doi.org/10.1097/01.PRS.0000143308.48146.0A
  15. Toriumi DM, Rosenberger E. Rhinoplasty of the aging nose. Facial Plast Surg 2016;32:59-69. https://doi.org/10.1055/s-0035-1570126
  16. Serifoglu I, Oz II, Damar M, Buyukuysal MC, Tosun A, Tokgoz O. Relationship between the degree and direction of nasal septum deviation and nasal bone morphology. Head Face Med 2017;13:3. https://doi.org/10.1186/s13005-017-0136-2
  17. Hanba C, Svider PF, Chen FS, Carron MA, Folbe AJ, Eloy JA, et al. Race and sex differences in adult facial fracture risk. JAMA Facial Plast Surg 2016;18:441-8. https://doi.org/10.1001/jamafacial.2016.0714
  18. Kim DH, Kim KI, Park YC, Zhang LD, Lu MK, Li D. Children's experience of violence in China and Korea: a transcultural study. Child Abuse Negl 2000;24:1163-73. https://doi.org/10.1016/S0145-2134(00)00175-7
  19. Kim SH, Han DG, Shim JS, Lee YJ, Kim SE. Clinical characteristics of adolescent nasal bone fractures. Arch Craniofac Surg 2022;23:29-33. https://doi.org/10.7181/acfs.2022.00038
  20. Woollacott M, Inglin B, Manchester D. Response preparation and posture control: neuromuscular changes in the older adult. Ann N Y Acad Sci 1988;515:42-53. https://doi.org/10.1111/j.1749-6632.1988.tb32964.x
  21. Wilmut K, Purcell C. Why are older adults more at risk as pedestrians? A systematic review. Hum Factors 2021 Feb 8 [Epub]. https://doi.org/10.1177/0018720821989511.
  22. Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int 1994;4:368-81. https://doi.org/10.1007/BF01622200
  23. The Royal Australian College of General Practitioners (RACGP) and Osteoporosis Australia. Osteoporosis prevention, diagnosis and management in postmenopausal women and men over 50 years of age. 2nd ed. East Melbourne: RACGP; 2017.
  24. Sherrington C, Fairhall N, Kwok W, Wallbank G, Tiedemann A, Michaleff ZA, et al. Evidence on physical activity and falls prevention for people aged 65+ years: systematic review to inform the WHO guidelines on physical activity and sedentary behaviour. Int J Behav Nutr Phys Act 2020;17:144. https://doi.org/10.1186/s12966-020-01041-3