Clinical impact and economic burden of electric scooter-related facial fractures in Barcelona.

PURPOSE: The landscape of facial trauma has evolved with the integration of micromobility devices into urban environments. This study aimed to characterize the clinical profile of electric scooter (e-scooter) accidents compared with traditional etiologies (traffic, assaults, falls) and evaluate the economic burden imposed on the public health system. METHODS: A cohort of 119 patients who underwent surgery for facial fractures at a Spanish tertiary hospital between 2020 and 2024 was analyzed. To accurately assess economic impact, a specific subgroup of 51 "pure facial fractures"-those with isolated injuries-was utilized for cost analysis. RESULTS: E-scooter users (10.1% of the total cohort) were significantly younger (mean age 27.9 years, p = 0.044), had shorter hospital stays (7.7 days, p = 0.007), and lower ICU requirements (16.7%) than the traditional group. Adverse outcomes accounted for 29.4% of cases overall, with a significantly higher rate in the e-scooter group compared to other etiologies (58.3% vs. 26.2%; p = 0.039). The median cost for an e-scooter injury was €8,092; though higher than other causes, this was not statistically significant (p = 0.33). CONCLUSION: E-scooters generate complex facial injuries with clinical severity and complication rates comparable to high-energy trauma. The high economic cost and reconstructive complexity, suggest a need for stricter safety regulations, such as mandatory full-face helmets.