Abstract
IntroductionAs fractures of the supraorbital region are far less common than midfacial or orbital fractures, a study was initiated to investigate whether fist blows could lead to fractures similar to those often seen in the midface.MethodsA detailed skull model and an impactor resembling a fist were created and a fist blow to the supraorbital region was simulated. A transient finite element analysis was carried out to calculate von Mises stresses, peak force, and impact time.ResultsWithin the contact zone of skull and impactor critical stress values could be seen which lay at the lower yield border for potential fractures. A second much lower stress zone was depicted in the anterior-medial orbital roof.ConclusionsIn this simulation a fist punch, which could generate distinct fractures in the midface and naso-ethmoid-orbital region, would only reach the limits of a small fracture in the supraorbital region. The reason is seen in the strong bony architecture. Much higher forces are needed to create severe trauma in the upper face which is supported by clinical findings. Finite element analysis is the method of choice to investigate the impact of trauma on the human skeleton.
Highlights
As fractures of the supraorbital region are far less common than midfacial or orbital fractures, a study was initiated to investigate whether fist blows could lead to fractures similar to those often seen in the midface
As trauma of the supraorbital region may lead to vision threatening orbital blow-in fractures, it was of interest to investigate whether impacts that are a main cause for zygomatic, infraorbital and orbital wall fractures could cause similar dislocation patterns in the supraorbital arch
Future studies could show if this conception could be appropriate. This investigation showed that the supraorbital region can withstand higher forces than the midface due to the different bony architecture
Summary
As fractures of the supraorbital region are far less common than midfacial or orbital fractures, a study was initiated to investigate whether fist blows could lead to fractures similar to those often seen in the midface. Fractures in the supraorbital region represent only a small group within craniomaxillofacial trauma [1,2,3] and are related to high-impact trauma or complex fractures of the skull and midface. As trauma of the supraorbital region may lead to vision threatening orbital blow-in fractures, it was of interest to investigate whether impacts (i.e. fist punches) that are a main cause for zygomatic, infraorbital and orbital wall fractures could cause similar dislocation patterns in the supraorbital arch. The supraorbital arch forms the superior enclosure of the orbit and shows an interesting different architecture Biomechanical investigations utilizing the finite element analysis (FEA) have been proven efficient in the mandible and midface [4,5,6,7] and were chosen for this investigation.
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