{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:38:14Z","timestamp":1793317094773,"version":"4.5.0"},"reference-count":49,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T00:00:00Z","timestamp":1722211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Open Access Publishing Fund of Philipps-Universit\u00e4t Marburg"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Maxillofacial trauma (MFT) caused by falls, interpersonal violence or traffic accidents leading to fractures of different facial regions, including the midface and the mandible, are common clinical conditions requiring open reduction and internal fixation. The aim of this study was to analyze the incidence and time trends in MFT-associated surgeries regarding different facial regions in the German healthcare system over time. Materials and methods: Nationwide data regarding the national diagnosis-related group (DRG) inpatient billing system was received from the German Federal Statistical Office for the years 2005\u20132022. We estimated the age\u2013gender standardized incidence of MFT-associated procedures classified by the Operation and Procedure Classification System (OPS) and evaluated age- and gender-adjusted time trends using Poisson regression analysis. Results: The total standardized incidence rate of MFT-associated procedures in the observational period 2005\u20132022 was 25.1 (\u264013.3; \u264237.5) per 100,000 person-years within a slight significant annual decrease of 0.5%. A significant increase in the incidence of MFT-related procedures within the observational period was found in older adults from 60 to 79 years (+55.1%; \u2640+54.8%; \u2642+56.3%) and elderly patients over 80 years (+66.7%; \u2640+59.1%; \u2642+85.1%). Other significant trends are decreases in MFT-related procedures performed in children from 0\u201314 years (\u221228.1%; \u2640\u221230.3%; \u2642\u221227.3%) and young adults between 15 and 35 years (\u221220.4%; \u2640\u22127.3%; \u2642\u221222.5%). Conclusions: MFT-associated surgery is a persisting challenge in the German healthcare system. There is an ongoing transition in MFT-associated surgeries from younger to older patients beyond the scope of demographic change, highlighting the increasing importance of interdisciplinary treatment of patients with pre-existing conditions in maxillofacial surgery. Implementation of injury prevention measures might be beneficial in this population.<\/jats:p>","DOI":"10.3390\/jcm13154438","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T16:37:17Z","timestamp":1722271037000},"page":"4438","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Epidemiologic Trends in Maxillofacial Trauma Surgery in Germany\u2014Insights from the National DRG Database 2005\u20132022"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1777-6409","authenticated-orcid":false,"given":"Axel","family":"Meisgeier","sequence":"first","affiliation":[{"name":"Department of Oral and Craniomaxillofacial Surgery, UKGM GmbH, University Hospital Marburg and Faculty of Medicine, Philipps University, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Pienkohs","sequence":"additional","affiliation":[{"name":"Department of Oral and Craniomaxillofacial Surgery, UKGM GmbH, University Hospital Marburg and Faculty of Medicine, Philipps University, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"D\u00fcrrschnabel","sequence":"additional","affiliation":[{"name":"Department of Oral and Craniomaxillofacial Surgery, UKGM GmbH, University Hospital Marburg and Faculty of Medicine, Philipps University, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Moosdorf","sequence":"additional","affiliation":[{"name":"Center for Orthopaedics and Trauma Surgery, UKGM GmbH, University Hospital Marburg and Faculty of Medicine, Philipps University, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5865-0020","authenticated-orcid":false,"given":"Andreas","family":"Neff","sequence":"additional","affiliation":[{"name":"Department of Oral and Craniomaxillofacial Surgery, UKGM GmbH, University Hospital Marburg and Faculty of Medicine, Philipps University, 35043 Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1948","DOI":"10.1016\/j.jcms.2015.06.028","article-title":"Etiology and injury patterns of maxillofacial fractures from the years 2010 to 2013 in Mecklenburg-Western Pomerania, Germany: A retrospective study of 409 patients","volume":"43","author":"Schneider","year":"2015","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1007\/s10006-021-01003-4","article-title":"Quality of life following maxillofacial trauma in the elderly: A multicenter, prospective study","volume":"26","author":"Boffano","year":"2022","journal-title":"Oral. Maxillofac. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Zhang, Z.X., Xie, L., and Li, Z. (2024). Global, regional, and national burdens of facial fractures: A systematic analysis of the global burden of Disease 2019. BMC Oral Health, 24.","DOI":"10.1186\/s12903-024-04048-5"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3120","DOI":"10.1002\/lary.31299","article-title":"Trends in Management and Cost Burden of Facial Fractures: A 14-Year Analysis","volume":"134","author":"Weitzman","year":"2024","journal-title":"Laryngoscope"},{"key":"ref_5","first-page":"904","article-title":"Evaluation of Mandibular Fractures in a German Nationwide Trauma Center Between 2015 and 2017","volume":"21","author":"Abel","year":"2021","journal-title":"J. Maxillofac. Oral Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"18291","DOI":"10.1038\/s41598-021-97858-4","article-title":"Long-term evaluation of treatment protocols for isolated midfacial fractures in a German nation-wide craniomaxillofacial trauma center 2007\u20132017","volume":"11","author":"Bonitz","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/S0278-2391(85)80049-5","article-title":"An analysis of 2,067 cases of zygomatico-orbital fracture","volume":"43","author":"Ellis","year":"1985","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1054\/ijom.2001.0056","article-title":"Retrospective analysis of 1502 patients with facial fractures","volume":"30","author":"Iida","year":"2001","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1007\/s12285-023-00458-6","article-title":"Primary treatment of midface fractures","volume":"17","author":"Lentge","year":"2024","journal-title":"Die MKG-Chir."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12285-023-00462-w","article-title":"Traumatology of the midface and the skull base","volume":"17","author":"Tavassol","year":"2024","journal-title":"Die MKG-Chir."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s12285-023-00437-x","article-title":"Traumatology of the mandible","volume":"16","author":"Schneider","year":"2023","journal-title":"Die MKG-Chir."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/s12285-023-00420-6","article-title":"Use of patient-specific implants\u2014An overview and current developments From individual indications in specialized centers to clinical routine","volume":"16","author":"Ferrari","year":"2023","journal-title":"Die MKG-Chir."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1097\/00005373-198906000-00018","article-title":"Patterns of maxillofacial injuries in restrained and unrestrained motor vehicle crash victims","volume":"29","author":"Reath","year":"1989","journal-title":"J. Trauma"},{"key":"ref_14","first-page":"39","article-title":"Timing of definitive management of severe orbital and midfacial injuries","volume":"36","author":"Schettler","year":"1991","journal-title":"Fortschritte Kiefer Gesichtschir"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/j.1600-9657.2004.00262.x","article-title":"Have the causes of maxillofacial fractures changed over the last 16 years in Finland? An epidemiological study of 725 fractures","volume":"21","author":"Kontio","year":"2005","journal-title":"Dent. Traumatol."},{"key":"ref_16","first-page":"261","article-title":"Twenty years of statistics and observation of facial bone fracture","volume":"538","author":"Muraoka","year":"1998","journal-title":"Acta Otolaryngol. Suppl."},{"key":"ref_17","first-page":"U1529","article-title":"Maxillofacial fractures at Waikato Hospital, New Zealand: 1989 to 2000","volume":"118","author":"Buchanan","year":"2005","journal-title":"N. Z. Med. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1046\/j.1440-1622.2000.01836.x","article-title":"Changing Patterns of Severe Craniomaxillofacial Trauma in Auckland over Eight Years","volume":"70","author":"Adams","year":"2001","journal-title":"Aust. N. Z. J. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/S0901-5027(05)80469-2","article-title":"Maxillofacial and associated injuries in severely traumatized patients: Implications of a regional survey","volume":"24","author":"Down","year":"1995","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1001\/archotol.1989.01860310064024","article-title":"The changing picture of facial fractures. 5-Year review","volume":"115","author":"Beck","year":"1989","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2613","DOI":"10.1016\/j.joms.2011.02.057","article-title":"Epidemiology of facial fracture injuries","volume":"69","author":"Allareddy","year":"2011","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s40902-018-0168-y","article-title":"Fracture patterns and causes in the craniofacial region: An 8-year review of 2076 patients","volume":"40","author":"Jin","year":"2018","journal-title":"Maxillofac. Plast. Reconstr. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1055\/s-0032-1322535","article-title":"Global trends in maxillofacial fractures","volume":"5","author":"Lee","year":"2012","journal-title":"Craniomaxillofacial Trauma Reconstr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1016\/j.joms.2013.11.018","article-title":"Trends in maxillofacial trauma: A comparison of two cohorts of patients at a single institution 20 years apart","volume":"72","author":"Martinez","year":"2014","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e10693","DOI":"10.7717\/peerj.10693","article-title":"Trends in the incidence, prevalence and years lived with disability of facial fracture at global, regional and national levels from 1990 to 2017","volume":"9","author":"Wu","year":"2021","journal-title":"PeerJ"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Juncar, M., Tent, P.A., Juncar, R.I., Harangus, A., and Mircea, R. (2021). An epidemiological analysis of maxillofacial fractures: A 10-year cross-sectional cohort retrospective study of 1007 patients. BMC Oral Health, 21.","DOI":"10.1186\/s12903-021-01503-5"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.jcms.2014.10.011","article-title":"European Maxillofacial Trauma (EURMAT) project: A multicentre and prospective study","volume":"43","author":"Boffano","year":"2015","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"S69","DOI":"10.1016\/j.tripleo.2011.08.029","article-title":"An epidemiologic analysis of 1,142 maxillofacial fractures and concomitant injuries","volume":"114","author":"Kostakis","year":"2012","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1111\/j.1600-9657.2011.00996.x","article-title":"Pattern of maxillofacial fractures at a tertiary hospital in northern India: A 4-year retrospective study of 718 patients","volume":"27","author":"Gandhi","year":"2011","journal-title":"Dent. Traumatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1054\/ijom.2002.0208","article-title":"Serious facial fractures in New Zealand from 1979 to 1998","volume":"31","author":"Kieser","year":"2002","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1097\/SCS.0000000000001299","article-title":"Changing trends in adult facial trauma epidemiology","volume":"26","author":"VandeGriend","year":"2015","journal-title":"J. Craniofacial Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.jcms.2013.05.005","article-title":"Epidemiological analysis of maxillofacial fractures treated at a university hospital, Xinjiang, China: A 5-year retrospective study","volume":"42","author":"Mijiti","year":"2014","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1016\/j.jcms.2011.11.004","article-title":"The pattern of the maxillofacial fractures\u2014A multicentre retrospective study","volume":"40","author":"Hegde","year":"2012","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1055\/s-0031-1293520","article-title":"Craniomaxillofacial trauma: Synopsis of 14,654 cases with 35,129 injuries in 15 years","volume":"5","author":"Kraft","year":"2012","journal-title":"Craniomaxillofacial Trauma Reconstr."},{"key":"ref_35","unstructured":"BSI (2024, June 17). Consumption of Alcoholic Beverages in Germany 2003\u20132022 (in Liters). Available online: https:\/\/www.statista.com\/statistics\/266167\/consumption-of-alcoholic-beverages-in-germany\/."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"42","DOI":"10.4103\/0970-0358.63959","article-title":"Analysis of facial bone fractures: An 11-year study of 2,094 patients","volume":"43","author":"Hwang","year":"2010","journal-title":"Indian J. Plast. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.jcms.2007.01.005","article-title":"Maxillofacial fractures in Southern Bulgaria\u2014A retrospective study of 1706 cases","volume":"35","author":"Bakardjiev","year":"2007","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_38","first-page":"188","article-title":"Trends in the aetiology of facial fractures in the south of Ireland (1975\u20131993)","volume":"89","author":"Carroll","year":"1996","journal-title":"Ir. J. Med. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/S0901-5027(05)80756-8","article-title":"Maxillofacial fractures in a Norwegian district","volume":"21","author":"Torgersen","year":"1992","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_40","unstructured":"(2023, August 20). Destatis. Traffic Accident Fatalities down 10.6% in 2020. Available online: https:\/\/www.destatis.de\/EN\/Press\/2021\/02\/PE21_084_46.html."},{"key":"ref_41","unstructured":"Evers, C. (2024, June 11). Seat Belts, Child Seats, Helmets and Protective Clothing. Available online: https:\/\/www.bast.de\/DE\/Publikationen\/DaFa\/2022-2021\/2021-01.html."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/edt.12904","article-title":"Changing trends in maxillofacial injuries among paediatric, adult and elderly populations: A 22-year statistical analysis of 3424 patients in a tertiary care centre in Northwest Italy","volume":"40","author":"Gugliotta","year":"2024","journal-title":"Dent. Traumatol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.ijom.2010.01.017","article-title":"Jaw fractures diagnosed and treated at Malmo University Hospital: A comparison of three decades","volume":"39","author":"Hallmer","year":"2010","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1016\/j.joms.2019.10.023","article-title":"Falls Due to Loss of Consciousness are Associated With Maxillofacial Fracture Severity","volume":"78","author":"Ito","year":"2020","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e5","DOI":"10.5037\/jomr.2014.5405","article-title":"Maxillofacial Fractures due to Falls: Does Fall Modality Determine the Pattern of Injury?","volume":"5","author":"Roccia","year":"2014","journal-title":"J. Oral Maxillofac. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/S0749-0690(02)00003-4","article-title":"Falls in cognitive impairment and dementia","volume":"18","author":"Shaw","year":"2002","journal-title":"Clin. Geriatr. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/S0266-4356(03)00256-0","article-title":"Falls in elderly people that result in facial injuries","volume":"42","author":"Wade","year":"2004","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_48","first-page":"7","article-title":"Health status of the old and very old people in Germany: Results of the Gesundheit 65+ study","volume":"8","author":"Gaertner","year":"2023","journal-title":"J. Health Monit."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1007\/s12603-020-1500-7","article-title":"Impact of Social Isolation Due to COVID-19 on Health in Older People: Mental and Physical Effects and Recommendations","volume":"24","author":"Ganz","year":"2020","journal-title":"J. Nutr. Health Aging"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/15\/4438\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:25:54Z","timestamp":1760109954000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/15\/4438"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,29]]},"references-count":49,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["jcm13154438"],"URL":"https:\/\/doi.org\/10.3390\/jcm13154438","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,29]]}}}