Emerging Trends in Facial Trauma: The Rising Burden of E-Scooter and E-Bike Injuries and their Surgical Outcomes

Facial fracture surgery aims to restore function and facial form while minimizing morbidity; however, late complications may still arise. With the growing use of electric scooters and e-bikes, the epidemiology of facial trauma has shifted, requiring updated characterization. This retrospective cohort study included all patients who underwent operative repair of facial fractures at a tertiary maxillofacial trauma center between 2017 and 2022. Demographic features, mechanism of injury, fracture pattern, treatment modality, and 6-month postoperative outcomes were analyzed. A total of 254 surgically managed patients were included (mean age 30.9±14.4 years; 56.7% male). Micro-mobility trauma accounted for 50.8% of cases and was associated predominantly with mandibular and condylar fractures, frequently managed with closed treatment or combined IMF-based approaches. In contrast, other mechanisms more commonly resulted in midfacial fractures treated with ORIF. Intraoperative and early postoperative complications were rare (0.8% each), whereas late complications occurred in 5.1% of patients, most frequently temporomandibular dysfunction, malocclusion, neurosensory disturbance, or infection. Concomitant soft-tissue injury was significantly associated with late complications (P=0.042), and late complications were more frequent following ORIF-only procedures, though this did not reach statistical significance (P=0.06). These findings indicate that while contemporary surgical management of facial fractures is generally safe, late complications remain clinically meaningful. Micro-mobility trauma has emerged as a dominant mechanism shaping fracture distribution and treatment selection, though not overall complication rates. Patients with soft-tissue injury and those undergoing ORIF may benefit from closer postoperative surveillance.