Interpersonal Violence-Related Facial Fractures: 12-Year Trends and Surgical Outcomes in a Southern European Level-I Trauma Centre

Background and Objectives: Interpersonal violence (IPV) has overtaken road traffic collisions as a leading cause of facial fractures, yet regional data from Southern Europe are limited. Materials and Methods: We retrospectively reviewed all adults (≥18 y) treated between 1 January 2011 and 31 December 2022 for radiologically confirmed IPV-related facial fractures. Recorded variables were demographics, AO-CMF (Arbeitsgemeinschaft für Osteosynthesefragen—Craniomaxillofacial) fracture site, Facial Injury Severity Score (FISS), presence of facial soft-tissue wounds, treatment modality, and length of stay; associations between variables were explored. Results: A total of 224 victims were identified; 94% were men (median age 26 y, IQR 22–34). The mandible was the most frequently involved bone (42%), followed by the orbit (25%); 14% sustained fractures at multiple sites. Facial soft-tissue wounds occurred in 9% of cases, three-quarters of which were associated with mandibular injury (p = 0.005). The median FISS was 2 and was higher in males, patients > 34 y, those with multiple fractures, and those with wounds (all p < 0.05). FISS showed a weak positive correlation with hospital stay (r = 0.23), which averaged 4.1 ± 1.6 days. Open reduction and internal fixation were required in 78% of patients, most often 24–72 h after admission. Annual IPV-related admissions remained stable throughout the 12-year period. Conclusions: IPV in this region consistently injures young men, with the mandible and orbit most at risk. FISS is a practical bedside indicator of resource use. The unchanging incidence—likely underestimated because isolated nasal fractures and minor injuries are often managed outside maxillofacial services or never reported—highlights the urgency of targeted prevention programs, routine screening, and streamlined multidisciplinary pathways.