Maxillofacial Injuries in an Eastern Nepal Tertiary Hospital.

BACKGROUND: Maxillofacial injury is a major health problem, and injury patterns vary in different societies. The purpose of the present study was to evaluate the pattern of maxillofacial injuries presenting to BPKIHS. METHODS: Patients with age >15 years presenting with maxillofacial injuries from May, 2019 to April, 2020 were included in this cross-sectional descriptive study. Demographic profile, etiology, delay in presentation, pattern of soft tissue/ bony/ dental injuries, treatment modality were recorded and analyzed using Microsoft excel. RESULTS: Within one year study period 190 patients with age group >15 years presented with facial injuries. There were 164 male (86.32%) and 26 female (13.68 %) patients (M:F=6.3: 1) with mean age of 34.96 years. Road Traffic Accident (RTA) (61.58%) was the most common etiology. Majority of the patients reported to hospital within 2-6 hrs of injury. Other associated injuries was present in 36.32 % of patients with orthopedic injury (60.87%) being common. Soft tissue injuries were seen in 80.53% patients, of which 49.02% were associated with facial fractures. Mandible fractures were seen in 56.19% of hard tissue injuries, of which 40.68% had multiple fractures followed by 28.81% with parasymphysis fracture. Within 37.14% patients with midface fractures, zygoma fracture (33.33%) was the commonest. Intervention was done in 80.95 % patients, with ORIF (72.38 %) being the commonest. Dentoalveolar injuries was seen in 22.63 % patients, of which 48.19% were associated with facial fractures. CONCLUSIONS: Our observations show that motor vehicle accidents were the most frequent cause of maxillofacial injury.

Epidemiology and Etiology of Facial Injuries in Children.

Pediatric Trauma results in over 8 million emergency department visits and 11,000 deaths annually. Unintentional injuries continue to be the leader in morbidity and mortality in pediatric and adolescent populations in the United States. More than 10% of all visits to pediatric emergency rooms (ER) present with craniofacial injuries. The most common etiologies for facial injuries in children and adolescence are motor vehicle accidents, assault, accidental injuries, sports injuries, nonaccidental injuries (eg, child abuse) and penetrating injuries. In the United States, head trauma secondary to abuse is the leading cause of mortality among non-accidental trauma in this population.

Urban drinking and driving: comparison of electric scooter and bicycle related accidents in facial fracture patients

Background: In recent years, electric scooters (e-scooter) have emerged as an alternative mode of urban transport due to their availability and effortless use. However, e-scooter-related trauma and injuries, especially to the head, have received wide media coverage and raised public concern about their safety. We aim to determine and compare clinically relevant variables, incidence, and severity between bicycle and e-scooter-related facial fractures and potential protective measures for injury prevention. Material and methods: This retrospective study comprised all patients admitted to a tertiary trauma center with bicycle or e-scooter-related facial fractures between January 2019 and October 2020. Patient- and injury-related variables, including demographics, injury mechanisms, helmet use, influence of alcohol, types of facial injuries, types of other injuries, given treatment, and hospital stay, were collected, analysed, and compared between bicycle and e-scooter injuries. Results: Altogether 169 patients with facial fractures, 124 bicycle-related injuries (73.4%) and 45 e-scooter-related injuries (26.6%) were included. Alcohol involvement was significantly higher in e-scooter patients (88.9%) than in bicycle patients (31.5%) (p<0.001). Driving under the influence of alcohol was associated with driving without a helmet in both groups (p<0.001). In multivariate analyses, e-scooter accidents were 18 times more likely to occur under the influence of alcohol (OR 17.85, p<0.001) and were more likely to involve collision with a stationary object (OR 3.81, p=0.028). E-scooter patients were significantly younger (OR 0.95, p<0.001) and had significantly more cranial fractures (OR 10.15, p=0.014) than bicycle patients. (AU)

Facial Fracture Patterns and Severity of Associated Injuries After Motorcycle Accidents.

BACKGROUND: Motorcycle injuries remain a significant cause of motor vehicle-related morbidity and mortality in Taiwan. Besides, the facial region is a commonly fractured site under motorcycle accidents. To date, there are no trauma mechanism-based studies of facial fractures. AIM AND OBJECTIVES: This study aims to determine the facial fracture patterns, the severity of head trauma, and associated injuries by different motorcycle-related trauma mechanisms enabling a greater understanding of its distribution and magnitude. METHODS: This is a retrospective descriptive analysis conducted over a 2-year period at Linkou Chang Gung Memorial Hospital. We focused on the population of maxillofacial injury caused by motorcycle accidents. We divided the patient cohort into 3 main trauma mechanisms: single-motorcycle collision (SM group), motorcycle-to-motorcycle collision (MM group), motorcycle-to-vehicle collision (MV group). Data, including demographics, age, fracture patterns of facial bones, and other associated injuries, were collected. RESULTS: A total of 881 cases were identified that involved facial fractures. Most patients were male (71%), young adult (mean age, 32.49 years), and the most common fracture region is the midfacial fracture (79.5%, 700 victims). Among the 3 groups, the MM group was less likely to sustain severe injuries by trauma score system, less head injury and mortality rate. The MV group and SM group have similar mortality rates but different fracture pattern tendencies. Lower facial fractures were more likely in the MV group, but midface fractures in the SM group. Associated injuries were higher in the MV group. CONCLUSIONS: Our study presents the different trends of fracture patterns and injury under 3 main mechanisms of motorcycle casualties. We document all these data in the hope of providing insights into trauma doctors dealing with motorcycle accidents.

Relationship between the use and types of helmets with facial injuries - a prospective study.

INTRODUCTION: many studies have demonstrated the benefits of helmet to prevent and reduce severity of injuries in motorcyclists. OBJECTIVE: the aim of the present study was to evaluate a possible relationship between the use of different types of helmets and the occurrence of facial injuries among victims of motorcycle accidents, seen at Hospital da Restauração, Recife/PE, Brazil. MATERIALS AND METHODS: demographic and trauma data were collected from hospitalized motorcycle accident victims with facial injuries from December 2020 to July 2021. Pearsons chi-square test was used to assess association between two categorical variables using a margin of error of 5%. RESULTS: among the participants, the average age was 33.46 years. The age group between 18 and 29 years was the most prevalent. Most participants were male. 60.0% of motorcyclists used helmets at the time of the accident and of this percentage 37.6% used fixed full-face helmet, 16.5% open-face helmet and the other 5.9% articulated full-face helmet. 62.7% of participants had facial fractures. Among the fractures, those of the zygomatic-orbital complex were the most common fracture and were significantly associated with the use of helmets, especially with open-face helmet. CONCLUSIONS: the use of helmets was associated with a lower number of facial fractures among patients who were victims of motorcycle accidents. Fracture of the zygomatic-orbital complex was related to the absence of a helmet at the time of the accident, as well as the use of open-face helmets.

Facial Fractures and Their Relation to Head and Cervical Spine Injuries in Hospitalized Bicyclists.

Bicyclists are vulnerable road users. The authors aimed to characterise facial fractures and their association with head and neck injuries in bicyclists admitted to a Scandinavian Level 1 trauma center with a catchment area of ~3 million inhabitants. Data from bicycle-related injuries in the period 2005 to 2016 were extracted from the Oslo University Hospital trauma registry. Variables included were age; sex; date of injury; abbreviated injury scale (AIS) codes for facial skeletal, head and neck injuries; and surgical procedure codes for treatment of facial fractures. Anatomical injury was classified according to AIS98. A total of 1543 patients with bicycle-related injuries were included. The median age was 40 years (quartiles 53, 25), and 1126 (73%) were men. Overall, 652 fractures were registered in 339 patients. Facial fractures were observed in all age groups; however, the proportion rose with increasing age. Bicyclists who suffered from facial fractures more often had a concomitant head injury (AIS head >1) than bicyclists without facial fractures (74% vs. 47%), and the odds ratio for facial fracture(s) in the orbit, maxilla and zygoma were significantly increased in patients with AIS head >1 compared to patients with AIS head=1. In addition, 17% of patients with facial fractures had a concomitant cervical spine injury versus 12% of patients without facial fractures. This results showed that facial fractures were common among injured bicyclists and associated with both head and cervical spine injury. Thus, a neurological evaluation of these patients are mandatory, and a multidisciplinary team including maxillofacial and neurosurgical competence is required to care for these patients.

Urban drinking and driving: comparison of electric scooter and bicycle related accidents in facial fracture patients.

BACKGROUND: In recent years, electric scooters (e-scooter) have emerged as an alternative mode of urban transport due to their availability and effortless use. However, e-scooter-related trauma and injuries, especially to the head, have received wide media coverage and raised public concern about their safety. We aim to determine and compare clinically relevant variables, incidence, and severity between bicycle and e-scooter-related facial fractures and potential protective measures for injury prevention. MATERIAL AND METHODS: This retrospective study comprised all patients admitted to a tertiary trauma center with bicycle or e-scooter-related facial fractures between January 2019 and October 2020. Patient- and injury-related variables, including demographics, injury mechanisms, helmet use, influence of alcohol, types of facial injuries, types of other injuries, given treatment, and hospital stay, were collected, analysed, and compared between bicycle and e-scooter injuries. RESULTS: Altogether 169 patients with facial fractures, 124 bicycle-related injuries (73.4%) and 45 e-scooter-related injuries (26.6%) were included. Alcohol involvement was significantly higher in e-scooter patients (88.9%) than in bicycle patients (31.5%) (p<0.001). Driving under the influence of alcohol was associated with driving without a helmet in both groups (p<0.001). In multivariate analyses, e-scooter accidents were 18 times more likely to occur under the influence of alcohol (OR 17.85, p<0.001) and were more likely to involve collision with a stationary object (OR 3.81, p=0.028). E-scooter patients were significantly younger (OR 0.95, p<0.001) and had significantly more cranial fractures (OR 10.15, p=0.014) than bicycle patients. CONCLUSIONS: Compared with patients in bicycle accidents, facial fracture patients injured in e-scooter accidents are younger, are more likely under the influence of alcohol, and sustain more severe craniofacial skeleton fractures. Our results for both groups of patients advocate stricter adherence to helmet and road safety legislation as well as public education for injury prevention.

Driving Under the Influence of Alcohol among Road Traffic Accident Patients Presenting to a Tertiary Care Centre.

Introduction: Driving under the influence is one of the most significant risk factors for road traffic accidents, leading to severe and multiple orthopaedic injuries. The aim of this study was to find out the prevalence of driving under the influence of alcohol among road traffic accident patients presenting to a tertiary care centre. Methods: A descriptive cross-sectional study was conducted on patients involved in road traffic accidents presenting to a tertiary care centre. Data from 10 January 2020 to 9 December 2021 were collected between 22 July 2023 to 22 August 2023 from the hospital records after receiving ethical approval from the Institutional Review Committee. Patients who had road traffic accidents and were diagnosed with fractures were included in the study. Patients with incomplete hospital records were excluded from the study. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 2,519 patients, 307 (12.19%) (10.91-13.47, 95% Confidence Interval) were driving under the influence of alcohol when involved in a road traffic accident. Out of 307 patients, 305 (99.35%) accidents involved two-wheelers. A total of 118 (38.44%) patients suffered soft tissue injuries, while 47 (15.31%) sustained head injuries, and 28 (9.12%) sustained facial injuries. Conclusions: The prevalence of driving under the influence of alcohol among road traffic accident patients presenting to a tertiary care centre was similar to other studies done in similar settings. Keywords: accidents; alcohol consumption; bone; Nepal; trauma.

Epidemiology of maxillofacial injuries during monsoon and non-monsoon season in India: a data-based retrospective study from a tertiary care dental teaching hospital.

Background: Maxillofacial Injury (MFI) is a major public health concern that is multifactorial in etiology-road traffic accidents (RTAs), falls and violence. RTAs are the major cause of maxillofacial injuries (MFIs) in countries like India. Recent studies have shown that maxillofacial fractures (MFF) constitute a significant proportion of facial injuries seen in hospitals (56.5%). The incidence of maxillofacial fractures can vary depending on several factors, including age, gender, and environmental factors. Of particular concern is the impact of seasonal variations, such as the monsoon season, which lead to high incidence of maxillofacial fractures due to hazardous conditions. Methods: A retrospective review of medical records was done in a tertiary-care dental teaching hospital was done. Results: Data of 200 subjects including 154 males (77%) and 46 females (23%) with a mean age of 35.38 ± 16.541 years; age range: 1 - 80 years was analyzed. A total of 200 MFI's were recorded between 2021 and 2022. Soft tissue injuries were reported in 37.5% of the cases in non-monsoon season and 42.3% of the cases during the monsoon season. Dentoalveolar fractures were reported in 6.2% of the cases during the non-monsoon seasons and 7.7% during the monsoon season. In this study, mandible was the most fractured bone (n=104,52%) followed by zygomatic complex (n=50, 25%). The frequently observed pattern among mandibular fracture was condyle 8.3% during the non-monsoon season and 2.9% during the monsoon season). Conclusions: The results of the study indicate that mandibular fractures are most commonly seen in maxillofacial fractures, followed by fractures of the zygomatic complex. The study also reveals a higher incidence of soft tissue injuries and dentoalveolar fractures during the monsoon season. Further research is warranted to explore the factors that contribute to the seasonal variation in maxillofacial fractures for effective interventions to reduce their occurrence.

Profile of Hospitalizations of Children and Adolescents Victims of Transport Accidents: A Retrospective Study

Abstract Objective: To present the profile of hospitalizations due to transport accidents in individuals aged 0-19 years in a reference hospital for urgent and emergency traumatology care. Material and Methods: This retrospective study is grounded on analyzing medical records of children and adolescents hospitalized due to transport accidents in 2016 and 2017. The bivariate analyses included Chi-square and Fischer's exact tests and binary logistic regression, with a 5% significance level. Results: Four hundred and seventy-five (43.7%) of the 1,088 medical records investigated corresponded to transport accidents, and accidents involving motorcycles were the most frequent (68.3%), affecting adolescents (81.3%), while children were more involved in accidents as pedestrians (57.1%). Advancing age increases the likelihood of the outcome, with a significant association in the multivariate analysis (p<0.001). The mandible was most frequently affected in maxillofacial fractures. Conclusion: Transport accidents predominantly affect male adolescents, involving motorcycles, and the lower limbs are the most affected. The mandible was the most affected bone in maxillofacial fractures.

The Impact of Traffic Law Enforcement Regulations on the Incidence and Severity of Maxillofacial Injuries.

Objectives: This study aimed to assess the effectiveness of the new traffic law enforcement regulations (TLERs) on the incidence and severity of maxillofacial injuries in Oman, as road traffic accidents (RTAs) are the main cause of facial injuries in Oman. Methods: A retrospective longitudinal analytic study was conducted at three tertiary care hospitals in Muscat, Oman. All patients with RTA-related maxillofacial injuries during a five-year period from January 2005 to December 2009 (before the new TLERs) and the five-year period from January 2015 to December 2019 (after the new TLERs) were included in the study. Results: A total of 1,127 patients were included in the study. Of these, 646 (57.3%) patients sustained RTA-related maxillofacial injuries before the implementation of the new TLERs compared to 481 (42.7%) after the introduction of TLERs. No significant gender-based difference was found between the two study periods. The incidence of injury before the implementation of the new TLERs was 22.7 per 100,000 population, which then reduced significantly to 11 per 100,000 after the TLERs were implemented. Overall, the mean facial injury severity score reduced significantly, from 3.2 to 2.3, after the implementation of the new TLERs. Conclusions: The findings of this study indicate that the newly introduced TLERs have resulted in a reduction in the incidence and severity of RTA-related maxillofacial injuries. Continuous improvement and reinforcement of TLERs will further help reduce the burden of these injuries to society in general and health services in particular.

Electric scooter related injuries in Calgary emergency departments.

OBJECTIVES: Electric scooters (e-scooters) have contributed to a rise in injury burden and emergency department (ED) utilization since their local introduction 3 years ago. This study is a novel collaboration between the City of Calgary's Department of Transportation and emergency medicine researchers to better understand the nature and frequencies of e-scooter injuries. It quantifies the incidence and characteristics of e-scooter related injuries treated in Calgary EDs/urgent care centres (UCCs). METHODS: Administrative data from electronic medical records of all patients presenting to Adult Emergency Departments and one Urgent Care Centre in Calgary with an e-scooter related injury between July 8, 2019, and Oct 1, 2019, and May 22, 2020, and September 30, 2020 were collected. Additional data were obtained from paper EMS reports. Descriptive statistics were used to characterize injury-specific variables and comparisons were drawn between ED visits for other transportation modalities. RESULTS: 1272 ED/urgent care visits were attributed to an e-scooter related incident. The majority of incidents occurred between 20:00 and 24:00 (47%). Most injuries occurred to the lower limb (54.8%), followed by facial injuries (42.9%). The overwhelming majority of injuries happened to the e-scooter drivers (97.6%). E-scooter injuries made up approximately 15% of all trauma presentations to Calgary area adult EDs during the e-scooter season and 1 in 1400 e-scooter rides resulted in a visit to an ED/UCC. CONCLUSIONS: Traumatic ED visits related to e-scooter use represent an increasing burden of preventable injuries. This study identified specific characteristics to focus future education and public policy efforts on.

RéSUMé: OBJECTIFS: Les scooters électriques (e-scooters) ont contribué à une augmentation du fardeau des blessures et de l'utilisation des services d'urgence (SU) depuis leur introduction locale il y a trois ans. Cette étude est une nouvelle collaboration entre le Département des transports de la Ville de Calgary et des chercheurs en médecine d'urgence afin de mieux comprendre la nature et la fréquence des blessures causées par le scooter électrique. Il quantifie l'incidence et les caractéristiques des blessures liées aux scooters électriques traitées dans les services d'urgence/soins d'urgence de Calgary. MéTHODES: Données administratives provenant des dossiers médicaux électroniques de tous les patients se présentant aux services d'urgence pour adultes et à un centre de soins d'urgence de Calgary avec une blessure liée à un scooter électrique entre le 8 juillet 2019 et le 1er octobre 2019 et entre le 22 mai 2020 et le 30 septembre 2020. Des données supplémentaires ont été obtenues à partir des rapports papier des SMU. Des statistiques descriptives ont été utilisées pour caractériser les variables spécifiques aux blessures et des comparaisons ont été établies entre les visites aux urgences pour les autres modes de transport. RéSULTATS: 1 272 visites aux urgences ou aux soins d'urgence ont été attribuées à un incident lié à un scooter électrique. La majorité des incidents se sont produits entre 20 h 00 et 24 h 00 (47 %). La plupart des blessures se sont produites au niveau des membres inférieurs (54,8 %), suivies des blessures au visage (42,9 %). La grande majorité des blessures sont survenues chez les conducteurs de scooters électriques (97,6 %). Les blessures liées aux scooters électriques représentent environ 3,5 % de toutes les présentations de traumatismes dans les services d'urgence pour adultes de la région de Calgary et 1 sur 1 400 trajets en scooter électrique a entraîné l'admission dans un service d'urgence. CONCLUSIONS: Les visites aux urgences traumatiques liées à l'utilisation des scooters électriques représentent une charge croissante de blessures évitables. Cette étude a identifié des caractéristiques spécifiques sur lesquelles il convient de concentrer les efforts futurs en matière d'éducation et de politique publique.

Patterns of craniomaxillofacial trauma among helmeted cyclists.

BACKGROUND/AIM: The head and face are prone to injury in bicycle accidents and helmets are proven to be helpful in decreasing injuries to some extent. The aim of this study was to determine whether certain craniomaxillofacial regions are at increased risk of injury (fracture) during bicycle accidents among helmeted cyclists. MATERIALS AND METHODS: This retrospective cohort study was conducted using data from the National Electronic Injury Surveillance System (NEISS). Data concerning craniomaxillofacial injuries as a result of cycling accidents between 2019 and 2020 were reviewed. The primary predictor variables were the craniomaxillofacial region and a craniofacial bone. The co-variates included patient characteristics (age, gender, race) and injury characteristics (location, season). The primary outcome variable was a fracture. Logistic regression was used to determine any independent risk factors for a fracture. RESULTS: Five hundred patients reported helmet use at the time of injury. Fractures of the face region were 75 times (p < .01) more likely than the head region. No particular craniofacial bone was at greater risk of fracture relative to the maxilla. Adults (OR 24.0, p < .01) and seniors (OR 38.6, p < .01) were each at greater risk for fracture relative to children. CONCLUSIONS: The facial region was at increased risk of fracture relative to the head during a bicycle accident. Adults and seniors were at increased risk of suffering craniofacial fractures relative to children.

Manejo de las fracturas maxilofaciales y sus complicaciones / Management of maxillofacial fractures and its complications

RESUMEN Antecedentes: el trauma maxilofacial corresponde a toda lesión traumática del macizo facial. Actualmente representa uno de los problemas de salud más importantes en el mundo. Nuestro objetivo es realizar un análisis de nuestra experiencia en las intervenciones realizadas en pacientes internados y sus complicaciones. Material y métodos: se realizó un estudio descriptivo, retrospectivo y observacional de 205 pacientes con fracturas maxilofaciales desde el año 2011 hasta el año 2019. Resultados: el 81,46% fueron hombres (n: 167) y el rango etario más afectado osciló entre los 21 y 30 años con el 38,54% (n:79). El accidente de tránsito 56,1% (n:115) fue el mecanismo de trauma más frecuente. Los tipos de fracturas faciales fueron: panfaciales 12,2% (n: 25), tercio superior 1,46% (n:3), tercio medio 72,2% (n:148) y tercio inferior 14,15% (n:29). Dentro del tercio superior, el 66,67% (n:2) fueron fracturas del seno frontal asociadas al hueso frontal, en el tercio medio las combinadas en un 54,73% (n:81) y en el tercio inferior, las complejas en el 34,48% (n:10). Fueron intervenidos 199 pacientes (97,07%). Solo el 11,56% (n:23) presentó alguna complicación. No se observaron complicaciones graves. Discusión: según nuestra serie, la mayoría de los pacientes fueron hombres jóvenes; la causa más frecuente, el accidente de tránsito, y el tercio medio, el más afectado, resultados estos similares a los de otros estudios publicados. El tratamiento quirúrgico fue principalmente reducción abierta y fijación con material de osteosíntesis de titanio, un procedimiento seguro y fiable, que permite restablecer la funcionalidad previa al traumatismo, con un índice muy bajo de complicaciones posoperatorias.

ABSTRACT Background: Maxillofacial trauma corresponds to all traumatic injuries affecting the facial bones. Nowadays, it represents one of the main healthcare issues worldwide. The aim of this study is to analyze our experience in the interventions performed in hospitalized and their complications. Material and methods: We performed a retrospective and observational study of 205 patients with maxillofacial fractures from 2011 to 2019. Results: 81.46% were men (n = 167) and 38.54% (n = 79) of the patients were between 21 and 30 years of age. Traffic collision was the most common mechanism of trauma (56,1%, n = 115). The types of facial fractures were panfacial (12.2%; n = 25), of the upper-third (1.43%; n = 3), of the middle-third (72.2%; n = 148) and of the lower third (14.15%; n = 29). In the upper third of the face frontal sinus fractures associated with the frontal bone were the most common (66.67%; n =2); in the middle-third combined fractures were most prevalent (54.73%; n = 81) while complex fractures were most frequent in the lower third (34,48%; n = 10). One-hundred and ninety-one patients were operated on (97.07%). Complications occurred in only 11.56% (n = 23) and were not serious. Discusion: In our series, most patients were young men, traffic collisions were the most common cause of trauma, and the middle third of the face was the most affected region. These results are similar to our publications. Surgical management, mostly by open reduction and fixation with titanium-based osteosynthesis material, is an effective, safe and reliable procedure, which allows the restoration of pre-trauma function, with very low rate of postoperative complications.

E-scooter-related craniomaxillofacial injuries compared with bicycle-related injuries - A retrospective study.

The aim of the study was to compare incidences and types of injury incurred between e-scooter crashes and bicycle crashes. This retrospective study included all victims of e-scooter crashes who were treated in the department of oral and maxillofacial surgery during a 12-months interval.A comparison was made with a cohort of patients who underwent bicycle crashes. Study parameters included type of fracture, soft tissue and dental affection, necessity of inpatient or outpatient treatment, the use of helmets, and the time of admission. In total, 400 patients were included. Of these 40 had suffered a crash on an e-scooter and 360 on a bicycle. Descriptive statistics showed a low helmet-wearing rate among cyclists (16.1% of recorded cases), with no helmet wearing recorded among e-scooter users. E-scooter-related crashes showed a higher rate of facial soft-tissue injuries (77.5%, p = 0.049) than among cyclists (61.7%), as well as a higher rate of dental injuries (27.5%, p = 0.017) compared with the bicycle cohort (13.3%). Facial fractures were also more common in the e-scooter cohort (45% vs 25.8%, p = 0.010). Admission was typically at the weekend - in the afternoon for the bicycle cohort and in the evening and at night for the e-scooter cohort. As a consequence of the fact that e-scooter riders seem to have an increased risk of facial injuries, it seems that an awareness campaign might be necessary to encourage helmet usage and to persuade intoxicated persons to use public transportation instead.

[Epidemiological and tomodensitometric aspects of post-traumatic maxillofacial fractures in Mopti, Mali]. / Profil épidémiologique et tomodensitométrique des fractures maxillo-faciales post-traumatiques à Mopti au Mali.

Introduction: facial injuries are a public health problem, both physically and psychologically, characterized by a variety of injuries and sometimes by severe esthetic or functional sequelae. The purpose of this study was to describe the epidemiological and tomodensitometric aspects of maxillofacial fractures in Mopti. Methods: we conducted a cross-sectional and descriptive study in the Department of Radiology of the Mopti Hospital from January 2019 to December 2019. All patients who had undergone maxillofacial CT scan for a trauma with fracture confirmed by CT scan during this period were included. The variables analyzed were age, sex, etiology and the types of fractures observed on CT scan. Data recording and analysis were carried out using SPSS version 20 and Excel 2013. Results: of a total of 120 patients, the mean age was 26.43 years with a standard deviation of 14.547. Men predominated (75%; n= 90). Road accidents were the leading cause of fractures (50%; n = 60). Occlusofacial fractures accounted for 38.33% (n= 46). Lefort II was the most common fracture (22.50%; n= 27). Conclusion: this study allowed us to identify the population groups most affected by maxillofacial fractures in the Mopti region: adolescents and young adults. Tomodensitometric results were dominated by occlusofacial fractures, in particular Lefort type II fractures.

Perfil epidemiológico dos pacientes submetidos à cirurgia para tratamento de fratura de face em um hospital universitário / Epidemiological profile of patients undergoing surgery to treat facial fractures in a university hospital

Introdução: Trauma facial apresenta relevância estética, social e econômica. Conhecer sua epidemiologia permite formular medidas de prevenção, educação e sistematização de atendimento. Métodos: Triagem, através do sistema de informação hospitalar, buscando pacientes que necessitaram de cirurgia para fratura de face entre abril de 2015 e abril de 2020. Foram, então, coletados dados epidemiológicos. Resultados: Foram selecionados 141 pacientes. A média de idade foi 34 anos, com maioria do sexo masculino (85%). A etiologia predominante foi acidente com veículo automotor e a fratura cirúrgica mais prevalente foi a de órbita (67%). A mediana de tempo entre o trauma e a cirurgia foi de 18 dias. Sessenta pacientes apresentaram lesões associadas à fratura de face, com destaque para as ortopédicas e neurológicas. Conclusão: A etiologia mais comum de fraturas faciais cirúrgicas foi acidente de trânsito, sendo o sexo masculino mais afetado. As fraturas de órbita foram as mais tratadas cirurgicamente.

Introduction: Facial trauma presents aesthetic, social and economic relevance. Knowing its epidemiology makes it possible to formulate measures for prevention, education and systematization of care. Methods: Research through the hospital information system, looking for patients who needed to undergo surgery for face fracture between April 2015 and April 2020. Epidemiological data were then collected. Results: 141 patients were selected. The average age was 34 years, with most males (85%). The predominant etiology was motor vehicle accidents, and the most prevalent surgical fracture was orbit (67%). The median time between trauma and surgery was 18 days. Sixty patients had injuries associated with facial fractures, especially orthopedic and neurological injuries. Conclusion: The most common etiology of surgical facial fractures was a traffic accident, predominantly among men. Orbit fractures were the most surgically treated.

Pattern of oral and maxillofacial trauma and associated factors: An 8-year prospective study.

BACKGROUND/AIMS: Oral and maxillofacial trauma (OMFT) is a public health problem due to its high occurrence and demand for resources for its management and the financial and social impact of OMFT victims on the health system. The aim of this study was to conduct an 8-year prospective analysis of OMFT cases from an emergency service. MATERIALS AND METHODS: A hospital-based 8-year prospective study on OMFT and associated factors was performed on data from December 2011 to December 2019. Data regarding sociodemographic (gender, age, and skin color) and socio-economic profiles (educational level, family income, and occupation), OMFT profile (etiology, OMFT type, and treatment), associated factors [alcohol consumption and personal protective equipment (PPE) use], OMFT occurrence (injury day and hour), length of hospital stay, and cost were collected. Descriptive and inferential analyses of data were performed. RESULTS: Most OMFT cases involved men with low schooling and family income, resulting from traffic accidents. OMFT severity was associated with longer hospital stay, higher hospital costs and nonuse of PPE, midface fractures (mainly orbital-zygomatic fractures), closed reduction, and open reduction/internal fixation. Traffic accidents were the main cause of longer hospital stays for victims aged 41-60 years with better socio-economic status compared with cases that had higher hospital costs. In general, higher hospital costs were associated with victims of violence under 40 years of age, with low schooling and farmers. Alcohol consumption and non-use of PPE also contributed to increasing the length of hospital stay. CONCLUSION: Oral and maxillofacial trauma severity was associated with longer hospital stay and higher hospital costs. Associated factors such as alcohol consumption and non-use of PPE contributed to increase the length of hospital stay and OMFT severity.

Basilar, skull and facial fractures in 2nd row occupants by crash type with a focus on side and rear impacts.

OBJECTIVE: Field data was analyzed to assess the risk of basilar, skull and facial fractures in 2nd row occupants by crash type. The study determined the rate of fractures in seriously injured (MAIS 3 + F) occupants to establish priorities for 2nd row occupant safety. METHODS: Field accident data on seriously injured (MAIS 3+) occupants was determined using 1993-2015 NASS-CDS and 2017-19 CISS by crash type identified with damage area variables for non-ejected occupants in the 2nd row. Occupants with serious head and face injuries (AIS 3+) were subdivided by fractures to the skull, basilar skull and face. Moderate-to serious (AIS 2+) orbit fractures were included. The rate of injury was determined. Individual electronic cases were analyzed for occupants with basilar fracture in rear and side impacts. RESULTS: The proportion of 2nd row occupants with AIS 3+ head and face injury was highest at 73.7% in rear impacts followed by side impacts at 54.2% for those with MAIS 3 + F injury. Basilar fractures (AIS 3+) occurred in 53.9% of 2nd row occupants with skull fracture in rear impacts but only 20.3% in side impacts. Overall, basilar fractures occurred in 10.8% of 2nd row occupants with serious injury (MAIS 3 + F) in rear impacts and 2.7% in side impacts. The frequency of AIS 3+ facial fractures was highest in side impacts (40.2%) and lowest (7.6%) in rear impacts. CONCLUSIONS: While basilar skull fractures are rare in 2nd row occupants, at 0.083% in rear and 0.044% in side impacts, they represent 53.9% of 2nd row occupants with a skull fracture and serious injury in rear impacts and 20.3% in side impacts. The mechanism of injury is different in rear and side impacts, but frequently involves multi-impact crashes, severe impacts, intrusion into the seating area and head impact on hard surfaces.

Characteristics of crashes and injuries on delivery motorcycles: A retrospective cohort study.

Objectives: The food delivery market is growing rapidly. As most delivery riders use motorcycles, motorcycle crashes will increase along with the growing delivery market size. This study aimed at examining the proportions of motorcycle crashes and characteristics of injuries incurred while using motorcycles for occupational purposes.Methods: This retrospective analysis included motorcycle crash patients aged 16 years or older, who were treated in 23 emergency rooms in Korea, between 2014 and 2018. Patients were divided into two groups: delivery riders (delivery group) and others (nondelivery group). Crash and injury characteristics were compared between the two groups. In addition, trends of patients in the delivery group were compared from 2014 to 2018.Results: This study examined 26,982 motorcycle crash patients, including 3894 (14.43%) patients in the delivery group and 23,088 (85.57%) in the nondelivery group. The number of patients in the delivery group increased drastically from 583 in 2014 to 1029 in 2018, whereas the number of patients in the nondelivery group did not considerably increase (4411 in 2014 and 4462 in 2018). The delivery group had a higher proportion of crashes caused by collisions with cars or other motorcycles (p < 0.001); however, injury severity was lower. The delivery group had a lower proportion of head and face injuries but a higher proportion of extremity injuries. Furthermore, 39.9% of all crashes in this group occurred between 17:00 and 21:00. Over time, there were neither any changes in the injury severities, nor any changes in the characteristics of the delivery group, with the exception of increases in both the proportion of motorist insurance and the proportion of wearing a helmet.Conclusions: The results indicated differences in characteristics between delivery motorcycle crashes and other motorcycle crashes. Although delivery motorcycle crash severity was low compared to other motorcycle crashes, the number of patients increased significantly. Therefore, to prevent crashes, it is necessary to improve the working environment. In addition, to prevent the extremity injuries of delivery riders, the policy of wearing extremity protective gears should be considered.