Maxillofacial fractures associated with electric scooter trauma: a cohort study from a national level I trauma center.

PURPOSE: Electric scooters (e-scooters) have become a widely used mode of urban transportation, but their increasing popularity has been accompanied by a rise in trauma-related emergency department visits. Craniofacial injuries represent a particularly relevant subset due to the exposed riding position and the limited use of protective equipment. This study analyzed the epidemiological characteristics, fracture patterns, associated injuries, and treatment requirements of patients presenting with facial fractures after e-scooter accidents. METHODS: A retrospective observational study was conducted at a tertiary university hospital between January 2020 and December 2024. Adult patients presenting to the emergency department with facial fractures directly related to e-scooter accidents were included. Demographic variables, helmet use, alcohol and drug involvement, fracture distribution, associated systemic injuries, and treatment modalities were assessed. RESULTS: A total of 42 patients with facial fractures were identified. Mean age was 29.4 years, and 76.2% were male. Helmet status was documented in 10/42 patients (23.8%); among documented cases, 3/10 (30.0%) reported helmet use. Alcohol status was documented in 14/42 patients (33.3%); among documented cases, 10/14 (71.4%) were positive. Drug status was documented in 15/42 patients (35.7%); among documented cases, 8/15 (53.3%) were positive. More than 80 facial fractures were recorded, predominantly involving the midface. Orbital fractures were the most common injury pattern, followed by mandibular and maxillary fractures. Intracranial lesions were documented in 10/42 patients (23.8%), most commonly traumatic subarachnoid hemorrhage (8/42, 19.0%). Six patients (14.3%) required surgical treatment. Hospital admission was necessary in 38.1% of cases, including two intensive care unit admissions. CONCLUSION: E-scooter-related trauma is an increasingly relevant cause of craniofacial injury, predominantly affecting young adult males. Among cases with available documentation, alcohol positivity and absence of helmet use were frequent. Given the substantial missingness in these variables, these findings should be interpreted cautiously. Although most fractures were managed conservatively, the rate of associated intracranial injury highlights the need for preventive strategies, stricter safety measures, and careful emergency department assessment.