Do Mandatory Face Shields Reduce the Number of Craniomaxillofacial Injuries in the National Hockey League?

Labe, Brandon¹, Dazen, Cody M¹, Rose, Matthew J¹, Lee, Kevin², Heinle, Jeremy T³
Faculty / Advisor: Ford, Brian P^1
1University of Pennsylvania School of Dental Medicine, Department of Oral & Maxillofacial Surgery/Pharmacology
²Columbia University, Department of Oral & Maxillofacial Surgery/Pharmacology
³Philadelphia College of Osteopathic Medicine

Introduction

The purpose of this study was to analyze the effectiveness of the National Hockey League's (NHL) mandatory visor policy on the number and type of craniomaxillofacial (CMF) injuries.

Methods

A cross-sectional study was designed using the 2 databases: the NHL Injury Viz and the Pro Sports Transactions. CMF injuries and player characteristics from the NHL's 2009-2010 through the 2016-2017 seasons were obtained. The study outcomes of games missed and number of injuries were compared before and after the implementation of the league rule.

Results

A total of 149 CMF injuries were included in the final sample. Following the mandatory visor rule, there were significant decreases in the total number of CMF injuries per season (14.3 vs 30.7, P = .01) and the number of upper face injuries per season (7.0 vs 16.7, P = .04). Although there was no difference in the ratio of upper facial injuries before and after the rule change, players who wore a face shield did have a lower proportion of upper face injuries among all CMF injuries sustained (42.9 vs 64.6%, P < .01). Ultimately, neither face shield use (P = .49) nor implementing a mandatory face shield rule (P = .62) changed the number of games missed when injury did occur.

Conclusion

Upper facial injuries were observed to be less common among players wearing face shields. After the NHL mandated face shields, there were significant decreases in the mean number of CMF and upper facial injuries per season. Face shields did not appear to influence the severity or downtime from injury that were sustained.