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Topic:Fractures

Fractures in horses refer to the disruption in the continuity of a bone, often resulting from trauma, excessive stress, or pathological conditions. These injuries can vary in severity, from simple, non-displaced fractures to complex, comminuted fractures involving multiple bone fragments. Fractures can affect any bone in a horse's body, but they are most commonly observed in the limbs due to the high mechanical loads these structures endure. Diagnosis typically involves clinical examination and imaging techniques such as radiography or ultrasound to assess the extent and nature of the fracture. Treatment strategies depend on the type and location of the fracture and may include rest, immobilization, surgical intervention, or a combination of these approaches. This page aggregates peer-reviewed research and scholarly articles focusing on the etiology, diagnosis, management, and outcomes of fractures in horses, providing insights into current veterinary practices and advancements in equine orthopedic care.
Use of Locking Compression Plate and Locking Compression T-Plate for Surgical Arthrodesis of the Carpometacarpal and Distal Tarsal Joints in 13 Horses.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    September 19, 2022   Volume 36, Issue 1 39-45 doi: 10.1055/s-0042-1756518
Lambert JL, García-López JM, Gasiorowski JC. The aim of this study was to describe the use of the locking compression plate (LCP) and locking compression T-plate (LCTP) in cases of carpometacarpal and distal tarsal arthrodesis for the treatment of osteoarthritis and small carpal or tarsal bone fractures, and to document clinical outcomes. Methods:  Case records of horses treated with carpometacarpal or distal tarsal arthrodesis via internal fixation using an LCP or LCTP between 2013 and 2021 were reviewed. All cases were evaluated retrospectively. Follow-up information was gained via phone conversation with owners and referring vete...
Equine hoof wall: Structure, properties, and bioinspired designs.
Acta biomaterialia    August 20, 2022   Volume 151 426-445 doi: 10.1016/j.actbio.2022.08.028
Lazarus BS, Luu RK, Ruiz-Pérez S, Bezerra WBA, Becerra-Santamaria K, Leung V, Durazo VHL, Jasiuk I, Barbosa JDV, Meyers MA.The horse hoof wall exhibits exceptional impact resistance and fracture control due to its unique hierarchical structure which contains tubular, lamellar, and gradient configurations. In this study, structural characterization of the hoof wall was performed revealing features previously unknown. Prominent among them are tubule bridges, which are imaged and quantified. The hydration-dependent viscoelasticity of the hoof wall is described by a simplified Maxwell-Weichert model with two characteristic relaxation times corresponding to nanoscale and mesoscale features. Creep and relaxation tests r...
Biomechanical Comparison of a Headless Compression Screw Fastener and AO Cortical Bone Screw for Fixation of a Simulated Equine Third Carpal Bone Slab Fracture.
Journal of equine veterinary science    August 7, 2022   Volume 118 104094 doi: 10.1016/j.jevs.2022.104094
Salinger A, Mochal-King C, Clinton K, Priddy LB, Elder S, Fontenot R, Eddy A, Wills R, Jaffe M.Frontal plane slab fractures account for the majority of third carpal bone (C3) fractures in racing and performance horses. Recommended treatment is stabilization with a lagged AO cortical screw. Associated complications are fragment splitting, fragment spinning, and irritation of dorsal soft tissue structures. A novel, headless, cannulated screw with interlocking threads the Headless Compression Screw Fastener (HCSF) has been developed to resist multidirectional forces and bending moments; however, it has not been applied in the horse. Simulated C3 frontal plane slab fractures were created in...
Ultrasonographic diagnosis of femoral fractures in large animals.
Journal of the American Veterinary Medical Association    July 28, 2022   Volume 260, Issue 13 1675-1682 doi: 10.2460/javma.22.02.0081
Jones SA, Whitcomb MB, Vaughan B, Goorchenko G, Busch R, Kilcoyne I, Spriet M.Femoral fractures are often catastrophic in large animals. Radiographic diagnosis is limited by patient size and feasibility, especially in ambulatory settings. Ultrasonography is widely available and may provide an alternative to radiography for definitive diagnosis. 12 large animals (6 horses, 5 cattle, and 1 elephant). Retrospective analysis of large animal patients diagnosed with femoral fracture by use of femoropelvic ultrasonography (2000 to 2019). 5 of 12 cases were ≤ 1 year of age. The remaining 7 cases were 2 to 33 years of age (median, 13 years). All patients developed severe acute...
Caecal dysfunction following standing surgical procedures.
Veterinary medicine and science    July 27, 2022   Volume 8, Issue 5 1930-1935 doi: 10.1002/vms3.882
Gough RL, McGovern KF, Bladon BM, Carmichael LA.The aim of this study is to report cases of caecal dysfunction following surgical procedures in the standing horse. The study design is retrospective. Six client-owned horses developed caecal dysfunction following a variety of surgical procedures undertaken in the standing sedated horse. Medical records were reviewed for caecal dysfunctions that had occurred in horses within 2 weeks of standing surgical procedures. Signalment, details of the original standing surgery and medications administered were recorded. Short-term outcome was obtained from clinical records. Long-term outcome was obtain...
Palmar/plantar oblique projections improve radiographic detection of fractures of the palmar/plantar processes of the equine distal phalanx. Fairburn AJ, Sherlock CE, Mair TS.Radiography is a standard diagnostic test for horses with suspected fractures of the palmar/plantar processes (PP) of the distal phalanx, however published studies evaluating the diagnostic utility for radiography are currently lacking. The objectives of this retrospective, diagnostic case-control study were to determine the sensitivity of radiographs for the detection of PP fractures, and determine the diagnostic utility of the palmar/plantar oblique projections of the PP for the identification of PP fractures compared to standard radiographic series. The medical records of horses undergoing...
Simulated Kick Injury to the Mandible in Horses: Study of Fracture Configurations and Physical Parameters of the Impact.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    July 15, 2022   Volume 35, Issue 4 255-262 doi: 10.1055/s-0042-1748878
Gfrerer L, Michel S, Fürst AE, Piskoty G, Weisse B, Montavon S, Jackson MA. The goal of this study was to generate mandibular fractures in three regions of the diastema using a metal impactor to simulate a kick from a horse and to determine the mean deceleration in the initial phase of the impact event, the maximum contact force, the impact energy necessary to create a fracture and the duration of the impact. Methods:  Thirty heads of horses aged between 5 and 20 years and euthanatized for various reasons were used. The heads were attached to a steel bar at the occiput at an axial angle of 45 degrees so that the body of the mandible was positioned horizontally ...
Catastrophic Musculoskeletal Injuries in Thoroughbred Racehorses in Uruguay, 2011-2017.
Journal of equine veterinary science    July 9, 2022   Volume 117 104074 doi: 10.1016/j.jevs.2022.104074
Bimson NH, Morrice-West AV, Wong ASM, Hitchens PL, Rocca MR, Whitton RC.Catastrophic musculoskeletal injuries (CMI) pose a major welfare concern to horses and their riders, yet limited data are available describing their occurrence in South America. Using a retrospective cohort and case-control design, the objective of the study was to determine the incidence of CMI for Thoroughbreds in training and racing, and associated horse-level risk factors in Uruguay. Seventy-seven Thoroughbreds sustained a CMI, 37 of which were age- and sex-matched to 111 control horses in the same race. Training and racing data from 2011 to 2017 were collected. Incidence of race day CMI p...
Is the Use of Bisphosphonates Putting Horses at Risk? An Osteoclast Perspective.
Animals : an open access journal from MDPI    July 3, 2022   Volume 12, Issue 13 doi: 10.3390/ani12131722
Vergara-Hernandez FB, Nielsen BD, Colbath AC.Osteoclasts are unique and vital bone cells involved in bone turnover. These cells are active throughout the individual's life and play an intricate role in growth and remodeling. However, extra-label bisphosphonate use may impair osteoclast function, which could result in skeletal microdamage and impaired healing without commonly associated pain, affecting bone remodeling, fracture healing, and growth. These effects could be heightened when administered to growing and exercising animals. Bisphosphonates (BPs) are unevenly distributed in the skeleton; blood supply and bone turnover rate determ...
An in vitro model for discovery of osteoclast specific biomarkers towards identification of racehorses at risk for catastrophic fractures.
Equine veterinary journal    June 19, 2022   Volume 55, Issue 3 534-550 doi: 10.1111/evj.13600
Malek G, Richard H, Beauchamp G, Laverty S.Focal bone microcracks with osteoclast recruitment and bone lysis, may reduce fracture resistance in racehorses. As current imaging does not detect all horses at risk for fracture, the discovery of novel serum biomarkers of bone resorption or osteoclast activity could potentially address this unmet clinical need. The biology of equine osteoclasts on their natural substrate, equine bone, has never been studied in vitro and may permit identification of specific biomarkers of their activity. Objective: (1) Establish osteoclast cultures on equine bone, (2) Measure biomarkers (tartrate resistant ac...
A review of equine tibial fractures.
Equine veterinary journal    June 15, 2022   Volume 55, Issue 2 171-181 doi: 10.1111/evj.13599
Bowers K, Weinhandl JT, Anderson DE.Equine tibial fractures are relatively infrequent in racing and non-racing sport horses, but limitations in successful treatment of tibial fractures in adult horses result in relatively high mortality compared with other musculoskeletal injuries. The aetiology of tibial fracture can be classified into two general categories: traumatic impact or fatigue failure. Tibial stress fractures, also known as fatigue fractures, are often rated as the second most common stress fracture in racing Thoroughbreds; young age, early stage in race training, and initiation of training after a period of rest are ...
Proximal sesamoid bone microdamage is localized to articular subchondral regions in Thoroughbred racehorses, with similar fracture toughness between fracture and controls.
Veterinary surgery : VS    June 7, 2022   Volume 51, Issue 6 952-962 doi: 10.1111/vsu.13816
Luedke LK, Ilevbare P, Noordwijk KJ, Palomino PM, McDonough SP, Palmer SE, Basran PS, Donnelly E, Reesink HL.To determine whether proximal sesamoid bone (PSB) microdamage and fracture toughness differ between Thoroughbred racehorses sustaining PSB fracture and controls. Methods: Cadaveric case-control. Methods: Twenty-four Thoroughbred racehorses (n = 12 PSB fracture, n = 12 control). Methods: Proximal sesamoid bones were dissected, and gross pathological changes and morphological measurements were documented. High-speed exercise history data were evaluated. Microdamage was assessed in fracture, fracture-contralateral limb (FXCL) and control PSBs using whole bone lead uranyl acetate (LUA) stainin...
Surgical management of a Salter-Harris type I proximal physeal fracture of the tibia in a foal: a case report.
BMC veterinary research    May 16, 2022   Volume 18, Issue 1 183 doi: 10.1186/s12917-022-03285-6
Mazaheri-Khameneh R, Azizi S, Davoodi F, Gooran MM.One of the traumatic fractures occurring in the hindlimb of the foals is physeal fractures of the tibia. The most common type of proximal tibial fracture in foals is reported to be Salter-Harris type II. Methods: This case report describes the history, clinical signs, radiographic findings, and surgical management of a proximal physeal fracture of the tibia due to the kick trauma in a 2-weeks-old Kurdish female foal, with signs of left pelvic limb lameness, valgus deviation with non-weight-bearing, non-mobility in stifle region and crepitation in the affected area. In this case, radiography wa...
Predicting return to racing after repair of fractures of the metacarpal/metatarsal condyles in Thoroughbred racehorses.
Veterinary surgery : VS    May 8, 2022   Volume 51, Issue 5 753-762 doi: 10.1111/vsu.13820
Young N, Corletto F, Wright I.To identify prognostic factors for return to racing after lag screw repair of condylar fractures and develop a predictive model for return to racing. Methods: Retrospective cohort study. Methods: A total of 356 horses referred to a single referral hospital in the UK with a third metacarpal/metatarsal condylar fracture between January 1999 and December 2018. Methods: Age, sex, fracture site, fracture characteristics, surgery related variables and complications were retrieved from case records. Data were divided into two sets for model training and model validation. Univariable analyses were per...
Preoperative computed tomographic evaluation of neonatal foals with rib fractures.
Veterinary surgery : VS    May 2, 2022   Volume 51, Issue 5 816-826 doi: 10.1111/vsu.13817
Garrett KS, Embertson RM, Hopper SA, Woodie JB, McQuerry KJ.To compare ultrasonographic and computed tomographic findings in neonatal foals prior to surgical repair of rib fractures as well as postoperative outcomes in foals with and without preoperative thoracic computed tomography (CT). Study design Retrospective cohort study. Sample population 43 neonatal foals undergoing surgical treatment of rib fractures between 2013 and 2021. Methods: Medical records were reviewed for age, sex, delivery method, comorbidities, presurgical anesthetic time, surgical time, number and location of fractured ribs identified with ultrasound and CT, number and location o...
Race-Level Reporting of Incidents during Two Seasons (2015/16 to 2016/17) of Thoroughbred Flat Racing in New Zealand.
Animals : an open access journal from MDPI    April 15, 2022   Volume 12, Issue 8 doi: 10.3390/ani12081033
Gibson MJ, Bolwell CF, Gee EK, Legg KA, Rogers CW.The objective of this study was to describe the incident and non-incident reports of Thoroughbred flat racing in New Zealand. Retrospective stipendiary stewards' reports of race day events during the 2015/2016 and 2016/2017 racing season were examined. The primary injury and reporting outcomes were analysed to assess the horse- and race-level risk factors associated with the occurrence of incident and non-incident reports. The number of incident and non-incident events and binomial exact 95% confidence intervals were calculated per 1000 horse starts. Most reports were for non-incidents and exa...
Arthroscopic removal of palmar intermediate carpal bone fracture fragments in four horses using a transthecal approach through the carpal flexor tendon sheath.
Veterinary surgery : VS    April 11, 2022   Volume 51, Issue 6 929-939 doi: 10.1111/vsu.13813
Hewitt-Dedman CL, O'Neill HD, Bladon BM.To describe the removal of palmar intermediate carpal bone (ICB) fracture fragments using a transthecal approach through the carpal flexor tendon sheath. Methods: Case series. Methods: Four horses with fractures of the palmar aspect of the ICB. Methods: Two horses were injured when falling and two during recovery from general anesthesia. Three horses underwent MRI to supplement conventional imaging. Three horses had concurrent fractures of the radial and/or accessory carpal bones. Conventional proximolateral carpal sheath arthroscope and instrument portals were used, supplemented with a medial...
Exercise history predicts focal differences in bone volume fraction, mineral density and microdamage in the proximal sesamoid bones of Thoroughbred racehorses.
Journal of orthopaedic research : official publication of the Orthopaedic Research Society    March 19, 2022   Volume 40, Issue 12 2831-2842 doi: 10.1002/jor.25312
Shaffer SK, Garcia TC, Stover SM, Fyhrie DP.Medial proximal sesamoid bones (PSBs) from Thoroughbred racehorses that did (Case) or did not (Control) experience unilateral biaxial PSB fracture were evaluated for bone volume fraction (BVF), apparent mineral density (AMD), tissue mineral density (TMD), and microdamage in Case fractured, Case contralateral limb intact, and Control bones. A majority of Case bones had a subchondral lesion with high microdamage density, and low BVF, AMD, and TMD. Lesion microdamage and densitometric measures were associated with training history by robust linear regression. Exercise intensity was negatively rel...
Influence of screw head diameter on ex vivo fixation of equine lateral condylar fractures with 5.5 mm cortical screws.
Veterinary surgery : VS    March 18, 2022   Volume 51, Issue 4 576-591 doi: 10.1111/vsu.13797
Constant C, Zderic I, Arens D, Pugliese B, Gehweiler D, Gueorguiev-Rüegg B, Zeiter S.To determine the influence of screw head diameter on equine condylar fracture fixation with 5.5 mm cortical screws. Methods: Ex vivo, biomechanical study, blinded, matched-pair design. Methods: Fifteen pairs of equine third metacarpal (MC3) bones. Methods: Lateral condylar fractures were simulated by parasagittal osteotomies and repaired pairwise by 2 × 5.5 mm cortical screws of 8 mm (standard) or 10 mm (modified) head diameter. Interfragmentary compression at maximum screw insertion torque was measured. The instrumented specimens were pairwise stratified for biomechanical testing u...
Multibody Computer Model of the Entire Equine Forelimb Simulates Forces Causing Catastrophic Fractures of the Carpus during a Traditional Race.
Animals : an open access journal from MDPI    March 16, 2022   Volume 12, Issue 6 737 doi: 10.3390/ani12060737
Pagliara E, Pasinato A, Valazza A, Riccio B, Cantatore F, Terzini M, Putame G, Parrilli A, Sartori M, Fini M, Zanetti EM, Bertuglia A.A catastrophic fracture of the radial carpal bone experienced by a racehorse during a Palio race was analyzed. Computational modelling of the carpal joint at the point of failure informed by live data was generated using a multibody code for dynamics simulation. The circuit design in a turn, the speed of the animal and the surface characteristics were considered in the model. A macroscopic examination of the cartilage, micro-CT and histology were performed on the radio-carpal joint of the limb that sustained the fracture. The model predicted the points of contact forces generated at the level ...
Rib fractures in adult horses as a cause of poor performance; diagnosis, treatment and outcome in 73 horses.
Equine veterinary journal    March 1, 2022   Volume 55, Issue 1 59-65 doi: 10.1111/evj.13566
Hall S, Smith R, Ramzan PHL, Head M, Robinson N, Parker R.Rib fractures in adult horses are poorly documented. Objective: To describe the presenting signs, diagnosis, treatment and outcome of horses diagnosed with rib fracture. Methods: Retrospective case series. Methods: The clinical records and diagnostic images of all adult horses diagnosed with a rib fracture at three referral centres over a 15-year period were reviewed. Results: Seventy-three horses met the inclusion criteria. Horses presented due to either resistance to ridden work and poor performance (n = 41), lameness (n = 21) or trauma (n = 7). In four horses, the presenting complaint...
Incidence of carpal fractures and risk factors for recurrent fractures after arthroscopic removal of carpal chip fracture fragments in Thoroughbred racehorses.
The Veterinary record    February 28, 2022   Volume 190, Issue 10 e1482 doi: 10.1002/vetr.1482
Mita H, Tamura N, Fukuda K, Kuroda T, Kuwano A, Sato F.We aimed to investigate the recent incidence of carpal fractures and the risk factors for recurrent ipsilateral fractures after arthroscopic removal of clinically active unilateral carpal chip fracture fragments in Thoroughbred racehorses. The findings for horses managed under the Japan Racing Association that developed carpal bone fractures between 2014 and 2018 were retrospectively reviewed. The proportion of cases that developed a recurrent carpal fracture in the originally affected joint was calculated, and the risk factors for recurrent fractures were analysed. In total, 2858 carpal fract...
An Analysis of Risk Factors for a Fracture or Luxation in Recovery From General Anesthesia in Horses: A Single Centre Study☆.
Journal of equine veterinary science    February 23, 2022   Volume 112 103914 doi: 10.1016/j.jevs.2022.103914
Bennell AJ, Wright RJH, Malalana F, Senior JM.Catastrophic fractures or luxations (FoL) sustained during recovery from general anesthesia are a significant cause of mortality during equine anesthesia. There is a lack of evidence regarding potential risk factors for a FoL occurring in the immediate anesthetic recovery period. A single center, retrospective, case-matched study was performed to identify risk factors for sustaining a catastrophic FoL during recovery from general anesthesia. Clinical data were obtained for horses which sustained a catastrophic FoL when recovering from general anesthesia from January 2011 to June 2020 in a sing...
Computed tomographic assessment of fracture characteristics and subchondral bone injury in Thoroughbred racehorses with lateral condylar fractures and their relationship to outcome.
Veterinary surgery : VS    February 14, 2022   Volume 51, Issue 3 426-437 doi: 10.1111/vsu.13770
Cianci JM, Wulster KB, Richardson DW, Stefanovski D, Ortved KF.To investigate the effects of fracture characteristics and concurrent subchondral bone pathology identified with computed tomography (CT) on the racing performance of Thoroughbred racehorses with fractures of the MC3/MT3 lateral condyle. Methods: Retrospective cohort study. Methods: Thoroughbred racehorses (n = 50) with a fracture of the MC3/MT3 lateral condyle, which had preoperative CT and internal fixation performed. Methods: Medical records were reviewed for age, sex, limb, and surgical treatment. Computed tomography scans were evaluated to determine fracture characteristics including le...
The failure mode of a mechanically loaded equine medial femoral condyle analog with a void and the impact of lag and neutral screw placement.
Veterinary surgery : VS    January 31, 2022   Volume 51, Issue 3 474-481 doi: 10.1111/vsu.13765
Moreno CR, Santschi EM, Younkin JT, Larson RL, Litsky AS.To determine the failure method of simulated equine medial femoral condyle (MFC) subchondral bone defects under compression and the influence of screw placement on failure resistance. Methods: In vitro study. Methods: Composite disks (CD) simulating the moduli of yearling bone in the MFC. Methods: Four CD conditions were tested, all with a 12.7 mm void (n = 6 per condition): intact (no void), void only, void with a 4.5 mm screw placed in neutral fashion, and void with a 4.5 mm screw placed in lag fashion. Composite disks of each condition were tested under monotonic compression to 6000...
A New Anorganic Equine Bone Substitute for Oral Surgery: Structural Characterization and Regenerative Potential.
Materials (Basel, Switzerland)    January 28, 2022   Volume 15, Issue 3 1031 doi: 10.3390/ma15031031
Addis A, Canciani E, Campagnol M, Colombo M, Frigerio C, Recupero D, Dellavia C, Morroni M.Different xenogeneic inorganic bone substitutes are currently used as bone grafting materials in oral and maxillo-facial surgery. The aim of the present study was to determine the physicochemical properties and the in vivo performance of an anorganic equine bone (AEB) substitute. AEB is manufactured by applying a process involving heating at >300 °C with the aim of removing all the antigens and the organic components. AEB was structurally characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), X-ray fluorescence (XRF), and Fourier-transformed infrared (FT-IR) spectros...
Arthroscopic guided repair of a slab fracture of the fourth carpal bone in an 8-month-old thoroughbred horse.
Journal of equine science    December 28, 2021   Volume 32, Issue 4 143-146 doi: 10.1294/jes.32.143
Miyakoshi D, Watanabe A, Ikeda H, Mizuguchi Y.An 8-month-old thoroughbred colt presented with sudden onset right forelimb lameness. A radiographic series of the right carpus was performed, and it revealed a slab fracture of the fourth carpal bone and fracture of the proximal part of the third metacarpal bone. Arthroscopically guided repair of the slab fracture of the fourth carpal bone with a 3.5 mm cortex screw and lag screw fixation of the fracture of the proximal part of the third metacarpal bone were performed. The horse started to race at 32 months old and started in 65 races over three years without any trouble associated with the r...
Detection and residence time of bisphosphonates in bone of horses. Knych HK, Janes J, Kennedy L, McKemie DS, Arthur RM, Samol MA, Uzal FA, Scollay M.Bisphosphonates are potent anti-resorptive agents that have the potential to adversely affect bone healing in equine athletes, and normal bone adaption in young racehorses. A concern exists that bisphosphonate inhibition of normal bone metabolism could lead to increased bone fractures during high-intensity exercise. We found only a single report describing concentrations of tiludronate in the bone of horses, and no studies describing clodronate. Knowledge of the residence time in bone could allow for a better understanding of the long-term effects of these compounds. Our objectives were to dev...
Fixation of a scapular body fracture in a 5 month old foal using three 4.5/5.0 mm locking compression plates.
Veterinary surgery : VS    December 5, 2021   Volume 51, Issue 2 330-334 doi: 10.1111/vsu.13749
Miyakoshi D, Higuchi T, Ikeda H, Sato M, Yoshimura S.To report a surgical technique and an outcome for the repair of a displaced, transverse scapular body fracture with locking compression plates (LCPs) in a colt. Methods: One 5 month old Thoroughbred colt. Methods: Case report. Methods: A colt sustained an unstable, comminuted, transverse fracture of the scapular body. Three 4.5/5.0 mm LCPs were used with 6.5 mm cancellous screws, 4.5 mm cortex screws, and 5.0 mm locking head screws. Implants were removed 2 months after surgery. Results: Surgical site infection was identified by purulent discharge at the distal aspect of the suture li...
Craniofacial Fractures in Equine-Related Injuries: What Should a Maxillofacial Surgeon Expect?
The Journal of craniofacial surgery    November 30, 2021   Volume 32, Issue 4 1409-1412 doi: 10.1097/SCS.0000000000007545
Puolakkainen T, Marttila E, Thorén H, Snäll J.Patients with equine-related injuries (ERI) have high rates of hospitalization and often require surgical treatment. This study aimed to clarify the injury profiles of patients sustaining ERI-related craniofacial fractures and their relationship with other severe head and neck injuries.This retrospective study included all patients with craniofacial fractures admitted to a tertiary trauma center during 2013 to 2018. Out of 3256 patients, a total of 39 patients were included in the study (1.2%). Demographic and clinically relevant variables were reported and statistically evaluated.Males repres...