Introduction : King’s College Hospital, a major trauma centre in South East London, covers a diverse population. We compare the aetiology of facial fractures we see to that of the rest of the UK.

Methods : A retrospective search of the A + E database (Symphony) for three months in 2011 was performed; all patients with facial fractures were included. Data extracted included detailed aetiology and patient demographics.

Results : In total 126 patients with facial fractures were identified. 64% of injuries (81 patients) were caused by assault; significantly higher than national data. 64% of these had mandibular fractures; 25% orbital fractures. A quarter had alcohol prior to the assault; 4% had used drugs. Only 4% were documented as being related to mugging. There were various mechanisms of assault. Punched only 63% (51 patients). Punched and kicked 16% (13 patients). Punched and weapon used 6% (5 patients). Kicked only 1% (1 patient). Head-butted only 3% (2 patients). Un-known 11% (9 patients). Fell or pushed to floor 12% (10 patients). Total involving weapons 14% (11 patients). Weapons included traffic cone, bottle, SCART cable falls accounted for 16% of patients, aged between 22 and 97 years; 100% of 22–39 year olds had consumed alcohol ± drugs. 35% sustained fractured orbits; 50% fractured mandibles. RTAs accounted for 7% of patients. 70% of patients sustained orbital fractures, none had mandibular fractures.

Conclusion : Assaults account for the majority of patients with facial fractures seen at King’s College Hospital. Alcohol also appears to be a significant factor, particularly in falls and assaults.