{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:07:17Z","timestamp":1786122437526,"version":"build-2736575974"},"reference-count":27,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Craniomaxillofac. Trauma Reconstr.","CMTR"],"abstract":"<jats:p>Background: The coronavirus disease 2019 (COVID-19) pandemic altered nasal fracture epidemiology, with fewer outdoor injuries and more domestic accidents. This study compared intra-pandemic and post-pandemic nasal fracture patterns and their prevention implications. Materials and Methods: This retrospective study included patients treated for nasal fractures during February 2020\u2013January 2021 (intra-pandemic) and February 2023\u2013January 2024 (post-pandemic). The post-pandemic cohort was identified using the same eligibility criteria, variable definitions, coding framework, and electronic-record retrieval procedure as the previously published intra-pandemic cohort. The predefined objective was a direct comparison of these two matched periods; no pre-pandemic control group was included. Results: A total of 290 patients were analyzed (184 post-pandemic and 106 intra-pandemic). In exploratory unadjusted comparisons, sports accidents occurred in 29\/184 (15.8%) post-pandemic versus 7\/106 (6.6%) intra-pandemic cases (p = 0.023), road traffic incidents in 31\/184 (16.8%) versus 7\/106 (6.6%) (p = 0.041), interpersonal violence in 60\/184 (32.6%) versus 20\/106 (18.9%) (p = 0.009), and alcohol-related events in 37\/184 (20.1%) versus 7\/106 (6.6%) (p = 0.009). Falls, virus- or flu-associated syncope, and accidents at home were more frequent intra-pandemic. Because multiple comparisons were performed, findings with p-values near 0.05 should be regarded as nominal and hypothesis-generating. The unadjusted mean hospital stay was shorter post-pandemic; however, the study period was not independently associated with length of stay after adjustment. The post-pandemic period showed a borderline, non-significant association with violence-related fractures (odds ratio 1.76, 95% confidence interval 0.99\u20133.12; p = 0.051). Conclusion: The observed changes are compatible with a return of social, recreational, and traffic-related trauma patterns, although the absence of a pre-pandemic control group and the exploratory nature of subgroup analyses limit causal interpretation. Differences in hospital stay appear to be more closely related to patient-level characteristics than to the study period itself.<\/jats:p>","DOI":"10.3390\/cmtr19030034","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T10:12:01Z","timestamp":1786097521000},"page":"34","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Lockdown to Knockdown: The Return of Violence and Sport in Post-COVID Nasal Fractures"],"prefix":"10.3390","volume":"19","author":[{"given":"Anna","family":"Aydin","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Lesserstra\u00dfe 180, 22049 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawik","family":"Revend","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Army Hospital Berlin, Scharnhorststra\u00dfe 13, 10115 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doha","family":"Revend","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Army Hospital Berlin, Scharnhorststra\u00dfe 13, 10115 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9481-5256","authenticated-orcid":false,"given":"Thomas","family":"Beikler","sequence":"additional","affiliation":[{"name":"Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Martinistra\u00dfe 52, 20251 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Schuck","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Lesserstra\u00dfe 180, 22049 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manfred","family":"Giese","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Lesserstra\u00dfe 180, 22049 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1287-9775","authenticated-orcid":false,"given":"Florian","family":"Dudde","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Army Hospital Hamburg, Lesserstra\u00dfe 180, 22049 Hamburg, Germany"},{"name":"Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Martinistra\u00dfe 52, 20251 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"ref_1","unstructured":"Alvi, S., and Patel, B.C. (2026, June 13). Nasal Fracture Reduction, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK538299\/."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Filip, R., Gheorghita Puscaselu, R., Anchidin-Norocel, L., Dimian, M., and Savage, W.K. (2022). Global Challenges to Public Health Care Systems during the COVID-19 Pandemic: A Review of Pandemic Measures and Problems. J. Pers. Med., 12.","DOI":"10.3390\/jpm12081295"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"100289","DOI":"10.1016\/j.adoms.2022.100289","article-title":"Impact of COVID-19 lockdown on incidence of maxillofacial fractures: A retrospective analysis","volume":"6","author":"Boom","year":"2022","journal-title":"Adv. Oral Maxillofac. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Alves, V.P., Souto-Souza, D., Fernandes, I.A., Falci, S.G.M., and de Souza, G.M. (2025). Impact of the COVID-19 pandemic on the prevalence of the fractures and etiology of orofacial trauma: A systematic review and meta-analysis. BMC Oral Health, 25.","DOI":"10.1186\/s12903-025-06009-y"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"23259671231205317","DOI":"10.1177\/23259671231205317","article-title":"Effect of the COVID-19 Pandemic on Injuries Related to Individual and Team Sports: An Analysis of the NEISS Database Between 2017 and 2021","volume":"11","author":"Leipman","year":"2023","journal-title":"Orthop. J. Sports Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1007\/s10006-024-01286-3","article-title":"Changing of nasal fracture patterns in maxillofacial trauma consultation-impact of the COVID-19 pandemic","volume":"28","author":"Dudde","year":"2024","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_7","first-page":"s00441801313","article-title":"Video Clinics for Nasal Bone Injuries in COVID Times\u2014Is it a Valid Tool for Routine Practice?","volume":"29","author":"Narang","year":"2025","journal-title":"Int. Arch. Otorhinolaryngol."},{"key":"ref_8","unstructured":"Klinginsmith, M., Hohman, M.H., and Katrib, Z. (2026, June 13). Nasal Septal Fracture, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK555912\/."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1177\/0194599813487493","article-title":"Cosmetic rhinoseptoplasty in acute nasal bone fracture","volume":"149","author":"Kim","year":"2013","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1089\/fpsam.2020.0643","article-title":"Epidemiology of Nasal Bone Fractures","volume":"24","author":"Dong","year":"2022","journal-title":"Facial Plast. Surg. Aesthet. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"S1019","DOI":"10.4103\/jpbs.jpbs_347_21","article-title":"Study of Patterns of Maxillofacial Injuries: An Institution-based Observational Study","volume":"13","author":"Kalathil","year":"2021","journal-title":"J. Pharm. Bioallied Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"675","DOI":"10.14744\/tjtes.2025.84443","article-title":"Etiological factors of maxillofacial traumas in forensic cases: A four-year retrospective study","volume":"31","author":"Sabak","year":"2025","journal-title":"Ulus. Travma Acil Cerrahi Derg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e302","DOI":"10.1055\/s-0042-1757427","article-title":"The Impact of the COVID-19 Pandemic on Injury Patterns in Inpatient and Outpatient Orthopaedic Trauma","volume":"8","author":"Gatt","year":"2022","journal-title":"Surg. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"7296","DOI":"10.1177\/08862605221143194","article-title":"The Effect of the COVID-19 Pandemic on Domestic Violence in Germany: A Comparison of Three Representative Population Surveys","volume":"38","author":"Kliem","year":"2023","journal-title":"J. Interpers. Violence"},{"key":"ref_15","first-page":"e223","article-title":"Impact of the coronavirus pandemic on maxillofacial trauma: A retrospective study in southern Spain","volume":"27","year":"2022","journal-title":"Med. Oral Patol. Oral Cir. Bucal"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s10006-022-01041-6","article-title":"The changing face of maxillofacial trauma during the 2020 COVID-19 lockdowns in Melbourne, Australia","volume":"27","author":"Nhongo","year":"2023","journal-title":"Oral Maxillofac. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2895","DOI":"10.1007\/s00068-024-02594-9","article-title":"Continuously increasing e-scooter accidents and their possible prevention in a large European city","volume":"50","author":"Frank","year":"2024","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1007\/s00402-024-05209-5","article-title":"E-scooter accidents-epidemiology and injury patterns: 3-year results from a level 1 trauma center in Germany","volume":"144","author":"Linhart","year":"2024","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_19","first-page":"11","article-title":"What happened after the repeal of social distancing laws? The impact on facial trauma presentations","volume":"7","author":"Hoffman","year":"2024","journal-title":"Aust. J. Otolaryngol."},{"key":"ref_20","first-page":"452","article-title":"Impact of the COVID-19 pandemic on the incidence and characteristics of craniomaxillofacial fractures in Central Europe: A multi-center study","volume":"52","author":"Lorenz","year":"2024","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"6789","DOI":"10.1038\/s41598-024-63890-3","article-title":"Long-term impact of the COVID-19 pandemic on oral and maxillofacial trauma: An interrupted time series analysis","volume":"14","author":"Tatsumi","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s00068-025-02957-w","article-title":"Frequency and patterns of CMF emergency cases during and after COVID-19","volume":"51","author":"Thoenissen","year":"2025","journal-title":"Eur. J. Trauma Emerg. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1002\/cre2.308","article-title":"Effects of alcohol consumption on maxillofacial fractures in simple falls","volume":"6","author":"Hino","year":"2020","journal-title":"Clin. Exp. Dent. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.1016\/j.ijom.2020.01.016","article-title":"The effect of alcohol on facial Trauma outcomes: An analysis of the National Trauma Data Bank","volume":"49","author":"Paw","year":"2020","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Rees, E.M., Nightingale, E.S., Jafari, Y., Waterlow, N.R., Clifford, S., Pearson, C.A.B., Group, C.W., Jombart, T., Procter, S.R., and Knight, G.M. (2020). COVID-19 length of hospital stay: A systematic review and data synthesis. BMC Med., 18.","DOI":"10.1186\/s12916-020-01726-3"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1017\/S1049023X21000285","article-title":"COVID-19 Changed the Injury Patterns of Hospitalized Patients","volume":"36","author":"Rozenfeld","year":"2021","journal-title":"Prehosp. Disaster Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1177\/00034894211042446","article-title":"Sport and Recreational Causes of Nasal Bone Fractures","volume":"131","author":"Xiao","year":"2022","journal-title":"Ann. Otol. Rhinol. Laryngol."}],"container-title":["Craniomaxillofacial Trauma &amp; Reconstruction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1943-3883\/19\/3\/34\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T10:27:55Z","timestamp":1786098475000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1943-3883\/19\/3\/34"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,7]]},"references-count":27,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["cmtr19030034"],"URL":"https:\/\/doi.org\/10.3390\/cmtr19030034","relation":{},"ISSN":["1943-3883"],"issn-type":[{"value":"1943-3883","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,7]]}}}