Craniomaxillofacial fractures during recreational baseball and softball

Purpose: Baseball and softball are leading causes of sports-related facial trauma in the United States. We review our institutional experience (Strong Memorial Hospital, Rochester, NY) with these injuries and discuss measures to reduce their incidence. Patients and Methods: We review our institution's experience with facial fractures sustained during the course of a softball or baseball game over a 12-year period. A total of 38 patients were identified and medical records analyzed for patient demographics, type of impact, and fracture location. Results: The male-to-female ratio was 3.2:1; mean age was 24.2 years, with 17 (45%) of the injuries occurring in the pediatric population. The majority of the injuries were caused by direct impact with the ball (68%), while player-player collisions (18%) and impact from a swung bat (13%) were responsible for the remaining injuries. There were a total of 39 fractures; 18 fractures (46%) involved the midface (level 2), skull (level 1) fractures accounted for 12 (31%), while 9 (23%) were mandibular (level 3) fractures. Conclusion: With 68% of the injuries resulting from a ball impact, we endorse the recommendations of the Consumer Product Safety Commission for the use of low-impact National Operating Committee on Standards for Athletic Equipment-approved baseballs and softballs for youth and recreational leagues. (C) 2004 American Association of Oral and Maxillofacial Surgeons.