Epidemiology of Craniomaxillofacial Trauma in Chile: A Systematic Review and 24-Year Nationwide Interrupted Time-Series Analysis.

Craniomaxillofacial trauma (CMFt) poses a significant burden, yet in many countries the evidence base is fragmented across single-center hospital series without specialized registry. Using Chile as a case study, we demonstrate a dual-synthesis approach to construct a national CMFt profile. Six databases were searched through February 2026 (PROSPERO: CRD420261290860). Two reviewers independently screened studies. Risk of bias was assessed with the JBI critical appraisal tool. Fracture-site proportions were pooled via random-effects meta-analysis and synthesized using GRADE. DEIS trauma discharges (2001-2024) were analyzed with negative binomial interrupted time-series. Nineteen studies were included. CMFt represented 2.6-6.1% of emergency consultations. CMFt admissions were 54.2/1000 trauma discharges; this rate dropped during 2020-2021 and rebounded post-2022. Pooled fracture-site distributions were highest for mandibular (45.3%) and zygomatic (24.2%) fractures. CMFt disproportionately affected males across both hospital series and national discharge data. According to DEIS, low-energy accidental injuries were the predominant etiology, followed by transport-related high-energy injuries and interpersonal violence, contrasting with hospital series where interpersonal violence predominated among adult surgical cohorts. Fracture admissions had longer length of stay (LOS) than soft-tissue CMFt (+0.94 days), with mean LOS ranging from 2.08 (nasal) to 8.35 days (multiple skull/facial fractures). These findings support prioritizing surgical preparedness and training in common fracture patterns, while strengthening trauma surveillance, referral pathways, and service planning in health systems without dedicated CMFt registries.

Duke Scholars

Author Elda L Fisher Surgery, Plastic, Maxillofacial, and Oral Surgery