Medico-legal consequences of dog attacks: A retrospective analysis of disability, permanent facial scarring, and psychiatric outcomes.

BACKGROUND: Dog attacks represent a significant public health and medico-legal problem that may result in long-term physical, psychological, and functional consequences. While the acute clinical effects of dog bites have been widely investigated, evidence regarding permanent impairment, facial scarring, and psychiatric sequelae requiring forensic evaluation remains limited. OBJECTIVE: This study aimed to evaluate the demographic characteristics, injury patterns, disability outcomes, permanent facial scarring, and psychiatric sequelae of dog attack victims referred for medico-legal assessment. METHODS: A retrospective study was conducted on 168 dog attack victims referred to the Specialized Boards of the Council of Forensic Medicine of Türkiye between 2015 and 2025. Demographic characteristics, attack-related variables, injury patterns, fracture status, permanent facial scarring, psychiatric diagnoses, and disability rates were analyzed. Associations between injury characteristics and medico-legal outcomes were assessed using appropriate statistical methods. RESULTS: Males accounted for 61.9% of cases, and 79.8% of victims were adults aged 18-64 years. Facial injuries were significantly more common among pediatric victims than adults (44.1% vs. 15.7%, p < 0.001). Permanent facial scarring was identified in 20.2% of cases and was significantly more frequent among children (35.3% vs. 16.4%, p < 0.001). Fractures were present in 36.3% of victims and were associated with significantly higher disability rates (11.43% vs. 3.48%, p < 0.001). Disability rates increased progressively with injury depth, reaching the highest levels in neurovascular injuries (17.73%, p < 0.001). Post-traumatic stress disorder was diagnosed in 18.5% of cases. Chasing-related attacks were associated with deeper injury patterns than bite-related attacks (p < 0.001). CONCLUSIONS: Dog attacks may result in substantial medico-legal consequences, including permanent facial scarring, psychiatric sequelae, and long-term disability. Pediatric victims appear particularly vulnerable to facial injuries and permanent scarring. Fracture presence and injury depth were important determinants of disability outcomes. These findings may contribute to more standardized forensic documentation, disability assessment, and medico-legal evaluation of dog attack victims.