Fac­ing the ugly truth


Hutt Hos­pi­tal is ze­ro­ing in on the lead­ing causes of fa­cial frac­tures - and it doesn’t make for pretty read­ing.

Vi­o­lence ac­counted for al­most 40 per cent of the 1535 max­illo­fa­cial frac­ture cases re­ferred to the hos­pi­tal’s Plas­tic, Max­illo­fa­cial and Burns Unit in the five years to 2017.

Skull cracks and breaks, frac­tures to the face, eye sock­ets, check bones, up­per and lower jaw were among the in­juries treated by the unit.

The study’s se­nior au­thor, Dr Swee Tan, said the find­ings were a ‘‘dis­turb­ing out­come’’ and called for the is­sue to be swiftly ad­dressed.

‘‘We ur­gently re­quire more ef­fec­tive pub­lic health strate­gies to com­bat the prob­lem as this type of in­jury is es­sen­tially pre­ventable.

‘‘We know a large pro­por­tion are re­lated to al­co­hol con­sump­tion and, prob­a­bly, the study un­der­es­ti­mated the pro­por­tion.

‘‘Al­co­hol is a large part of this and we need to do some­thing about the avail­abil­ity of al­co­hol ... it is not ac­cept­able,’’ Tan said.

The find­ings were be­ing pre­sented at the Royal Aus­tralasian Col­lege of Sur­geons’ an­nual sci­en­tific congress in Syd­ney on Tues­day.

Ac­ci­dent Com­pen­sa­tion Cor- po­ra­tion (ACC) paid $51.5 mil­lion for treat­ment and en­ti­tle­ments for these types of in­juries from 2015 to 2017.

But that fig­ure was likely to be the tip of the ice­berg, as it didn’t in­clude emer­gency treat­ment at the coun­try’s pub­lic hos­pi­tals.

While al­co­hol was not a part of the in­ci­dent, Tan spent five hours pierc­ing to­gether the face of vol­un­teer fire­man Peter Fisher af­ter a bru­tal beat­ing in Mart­in­bor­ough in Oc­to­ber 2012.

Fisher, who suf­fered ex­ten­sive fa­cial frac­tures, bro­ken eye sock­ets and had three teeth knocked out, spent 78 days in hos­pi­tal and had to learn to walk again af­ter suf­fer­ing a brain in­jury and stroke.

ACC fig­ures show that more than half-a-mil­lion-dol­lars was spent on cov­er­ing treat­ment and en­ti­tle­ments for fa­cial frac­ture and dis­lo­ca­tions from Lower Hutt and Up­per Hutt city claimants be­tween 2015 and 2017.

A fur­ther $1.95m was spent on these types of claims in Welling­ton City and a fur­ther $142,376 in Porirua City.

In to­tal, $51.5m was spent na­tion­ally cov­er­ing 15,755 claims for these in­juries over the three-year pe­riod.

Pre­vi­ously, in­juries from road crashes were the most com­mon cause of fa­cial frac­tures, but this study showed num­bers had dra­mat­i­cally de­clined and only ac­counted for about 6 per cent of cases.

This was be­ing cred­ited to bet­ter pub­lic health strate­gies and ed­u­ca­tion pro­grammes, as well as re­cent leg­is­la­tion changes.

‘‘It is very sig­nif­i­cant that road traf­fic ac­ci­dents were the lead­ing cause of max­illo­fa­cial frac­tures be­fore the in­tro­duc­tion

‘‘That is a great suc­cess, in our view ... as a so­ci­ety, we must com­mit sim­i­lar ef­forts to deal with in­ter­per­sonal vi­o­lence,’’ Tan said.

Falls, mainly by el­derly pa­tients, were the sec­ond-most com­mon cause of fa­cial frac­tures seen by the unit, fol­lowed by sport­ing in­juries which both rep­re­sented about a quar­ter of the over­all to­tal.

Tan be­lieved the Hutt find­ings were an ac­cu­rate re­flec­tion of the state of play at New Zealand hos­pi­tals.

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