Hit by a Pitch

Steven H. Dayan, MD, FACS

by Steven H. Dayan, MD, FACS | February 1, 2000 @ 02:00PM
Medically Reviewed by Steven Dayan

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Steven DayanFacial injuries occurring while participating in sports related activities can have devastating functional and cosmetic consequences to individuals, especially young children.

In a recent scientific study reviewing sports related facial fractures it was discovered that the two most common sporting events associated with facial fractures were baseball and softball. Because of baseball's 6 million participants, it is not surprising that there is a high incidence of facial injuries. However, it is astonishing to note that softball is the single leading sporting activity responsible for facial fractures and has three times the amount of facial fractures than that found in baseball. The majority of these fractures are occurring to the nose. These findings likely reflect the greater recreational appeal of softball. However, an additional factor occurs when the increased mass and volume of a softball strikes the face, resulting in more significant injuries to the facial and nasal bones.

The nose, as the leading structure on the face, is the most commonly fractured facial bone. Unfortunately, most nasal fractures are overlooked or neglected leading to a progressive blockage of nasal breathing and a crooked nasal deformity. Children in particular may suffer internal damage with minimal external symptoms. If an internal nasal septal injury is not properly identified and treated, it can lead to an infection, a possible abscess, and even complete nasal collapse. Although frequently obtained, an X-ray of the nose offers limited or no clinical value on the treatment of the nasal injury. A concerned patient's efforts are better served seeking out the evaluation of an experienced and competent nasal physician. Most nasal injuries are benign and of no consequence. However, in the event of a nasal or septal fracture, early attention is key to avoiding future problems. The best way to avoid injury is through prevention. Today, a facial guard mask that can be securely attached to a baseball helmet. Little league organizations that mandate the use of this equipment report a decrease incidence of facial injuries.1 In fact, the little leaguers accept the face guard and appreciate "its look."

The Consumer Product Safety Commission has determined that batting helmets equipped with these clear face guards may prevent, reduce or lessen the severity of 3,900 facial injuries per year.1 By protecting the developing pediatric face, the potential benefits far outweigh the perceived inconveniences and associated costs. Communities sponsoring organized baseball and softball leagues should consider adopting a protective face mask gear policy.

Dr. Dayan has no financial interest in protective facial equipment.

  1. U.S. Consumer Product Safety Commission. Release study of protective equipment for baseball #96-140. June 1996.

Originally published in the February 2000 issue of HealthCare Times

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