Characteristics of injuries related to traffic crashes in Israel before and during the COVID-19 pandemic.

OBJECTIVES: This study explored differences in patient characteristics, injury characteristics, treatment modalities, and treatment outcomes among patients who presented to the Emergency Department (ED) following traffic crashes during the COVID-19 period (from March 15, 2020 to March 15, 2022) in comparison to the previous corresponding period between 2017 and 2019. METHODS: The study is a retrospective chart review study. The study included a random sample of 610 patients who presented to the ED of a major hospital located in northern-central Israel following traffic crashes: 305 patients who presented during the COVID-19 period (from March 15, 2020 to March 15, 2022) and 305 patients who presented during the previous corresponding period (from March 15, 2017 to March 15, 2019). Socio-demographic data, data regarding the traffic crashes, and medical data of the patients were collected from their medical records, and the data were compared. RESULTS: In the context of the COVID-19 period, a notable surge in the percentage of cyclist victims was evident, marking an increase from 7.5% to 19% compared to the corresponding period. Conversely, the incidence of pedestrian victims during the COVID-19 period dropped to 19.7%, in contrast to 30.8% in the corresponding period. Notably, patients involved in pedestrian crashes amid the COVID-19 period exhibited a shorter hospital stay (M = 2.8 days, SD = 3.3) compared to the corresponding period (M = 4.3 days, SD = 7.1) [t = 1.8 (df = 141), p < 0.05]. However, a higher fatality rate was observed among these patients during the COVID-19 period compared to the corresponding period (6.7% vs. 0%) [χ2 = 6.4 (df = 1), p < 0.05]. CONCLUSIONS: The study reveals significant changes in traffic crashes characteristics during the pandemic period, including a notable increase in cyclist victims and a decrease in pedestrian incidents. These shifts may be attributed to factors such as changes in transportation patterns, increased use of bicycles for essential travel. Despite these changes, the proportion of severe crashes remained relatively consistent. These findings underscore the importance of understanding the underlying causes behind these shifts and highlight the ongoing need for public education and awareness initiatives to promote traffic safety, particularly for vulnerable road users, during pandemic periods.

Insurance cost and injury characteristics of anterior cruciate ligament injuries in sub-elite football: A population analysis involving 3 years of Australian insurance data.

OBJECTIVES: To investigate the injury characteristics and insurance cost of anterior cruciate ligament injuries in sub-elite football players in New South Wales, Australia. DESIGN: Descriptive epidemiological study. METHODS: Three years of insurance records (2018-2020) was used to describe anterior cruciate ligament injury costs and characteristics. Concomitant injuries and the mechanism of injury were determined by analysing the injury descriptions. Claim characteristics and costs are presented by age group (junior = 7-17 years, senior = 18-34 years, and veteran = 35 + years) and sex. Categorical data (including age-groups and sex) are presented as counts and percentages and analysed using a Chi squared or Fisher's exact test. Cost data are reported as means ±â€¯standard deviation with 95 % confidence intervals. RESULTS: Over the course of three football seasons (2018-2020), 786 anterior cruciate ligament injuries were reported to the injury insurance company. The total insurance cost was AU$3,614,742 with direct injury insurance costs accounting for 36.3 % of the total costs. The mean indirect insurance costs were six-fold higher than direct insurance costs (AU$11,458 vs AU$1914). Isolated injuries had an average cost of $4466 whilst concomitant injuries had an average cost of $4951. Surgical costs are excluded from direct cost calculations. The peak injury count occurred in the first month of all three football seasons, immediately after the pre-season. CONCLUSIONS: Anterior cruciate ligament injuries represent a substantial economic burden to the insurer and individual. The cost data provided can be used for future economic and modelling studies.

Injury Incidence and Its Characteristics in Korean Youth and Collegiate Taekwondo Sparring Athletes: A Retrospective Study.

This study aimed to identify the incidence of injury and its characteristics in Korean youth and collegiate Taekwondo athletes during 2021 and to provide a suggestion regarding injury incidence. A total of 183 athletes (95 youth and 88 collegiate athletes) who were registered with the Korea Taekwondo Association (KTA) participated. The research was based on the injury questionnaire developed by the International Olympic Committee (IOC). The questionnaire consists of a total of seven items, including four items related to demographic characteristics and three items related to injuries (locations of injury, types of injury, and causes of injury). A frequency analysis was performed to identify the injury characteristics. Additionally, the injury incidence rate (IIR) was calculated based on 1000 athletic exposures (AEs) during 2021. The IIRs for one recent year (2021) showed 4.43/1000 AEs and 3.13/1000 AEs in youth and collegiate Taekwondo athletes, respectively. The frequency analysis showed that finger (youth: 17.3%, collegiate: 14.6%), contusion (youth: 25.3%, collegiate: 23.8%), and contact with other athletes (youth: 57.6%, collegiate: 54.4%) ranked the highest in terms of the locations of injury, types of injury, and causes of injury, respectively. A continuing injury tracking system can play a key role in accumulating big data for identifying risk factors and developing interventions to reduce injury in Taekwondo sparring.

Injury epidemiology in Chinese undergraduate classical dance students: A 14-week prospective study.

OBJECTIVES: The aim of this study was to investigate the injury prevalence, incidence rate, injury proportions, and characteristics of injuries in Chinese undergraduate classical dance students by using the modified Oslo Sports Trauma Research Centre Questionnaire on Health Problems. DESIGN: Prospective study. SETTING: Online survey. PARTICIPANTS: 63 Chinese classical undergraduate students (female: 40, male: 23; median age: 20 years, range: 17-20 years) completed the survey. MAIN OUTCOME MEASURES: The injury prevalence (proportions) and incidence rate were calculated. The characteristics (severity, locations, injury type) of injuries were investigated. RESULTS: During the 14-weeks, 84% students reported injury occurrence more than one time. The injury incidence rate was 3.28 injuries per 1000h across 14-weeks. Weekly proportion for all injuries ranged from 38.2% to 61.9% and substantial injuries ranged from 7.5% to 22.7%. The lower back was the most frequently injured body location (38.9%), followed by the knee (17.3%) and the ankle (12.9%). In all reported injuries, overuse injury was the most prevalent type (78.9%, 95% CI: 73.2%-81.1%). CONCLUSIONS: Chinese classical dance students are at a relatively high risk for injuries. Injury prevention programs in Chinese classical dance students should focus on the lower back and lower extremity.

Characteristics and Risk Factors for Electric Scooter-Related Crashes and Injury Crashes among Scooter Riders: A Two-Phase Survey Study.

Electric scooters (or e-scooters) are among the most popular micromobility options that have experienced an enormous expansion in urban transportation systems across the world in recent years. Along with the increased usage of e-scooters, the increasing number of e-scooter-related injuries has also become an emerging global public health concern. However, little is known regarding the risk factors for e-scooter-related crashes and injury crashes. This study consisted of a two-phase survey questionnaire administered to a cohort of e-scooter riders (n = 210), which obtained exposure information on riders' demographics, riding behaviors (including infrastructure selection), helmet use, and other crash-related factors. The risk ratios of riders' self-reported involvement in an e-scooter-related crash (i.e., any crash versus no crash) and injury crash (i.e., injury crash versus non-injury crash) were estimated across exposure subcategories using the Negative Binomial regression approach. Males and frequent users of e-scooters were associated with an increased risk of e-scooter-related crashes of any type. For the e-scooter-related injury crashes, more frequently riding on bike lanes (i.e., greater than 25% of the time), either protected or unprotected, was identified as a protective factor. E-scooter-related injury crashes were more likely to occur among females, who reported riding on sidewalks and non-paved surfaces more frequently. The study may help inform public policy regarding e-scooter legislation and prioritize efforts to establish suitable road infrastructure for improved e-scooter riding safety.

Management of lumbar spondylolysis in the adolescent athlete: a review of over 200 cases.

BACKGROUND: Spondylolysis is a defect of the pars interarticularis of vertebrae, most commonly seen at L5 and L4. The etiology of spondylolysis and isthmic spondylolisthesis is generally considered to be a result of repetitive mechanical stress to the weak portion of the vertebrae. A higher incidence of spondylolysis is observed in young athletes. Symptomatic spondylolysis can be successfully treated conservatively, but there is currently a limited consensus on treatment modalities and a lack of large-scale clinical trials. PURPOSE: The purpose of the present study was to investigate the optimal treatment algorithm for symptomatic spondylolysis in adolescent athletes and evaluate the functional outcomes of those undergoing the nonoperative treatment. STUDY DESIGN: A retrospective review. PATIENT SAMPLE: Two hundred one adolescent patients ranging from age 10 to 19 involved in athletics OUTCOME MEASURES: Injury characteristics (age, mechanism, time), sports played, bone stimulator use, bony healing at 3 months on computed tomography (CT) scans, return to sports, corticosteroid injection use. METHODS: Two hundred one adolescent athlete patients (62 females and 139 males) diagnosed with spondylolysis between 2007 and 2019 were retrospectively reviewed. Diagnosis was based on plain radiography followed by magnetic resonance imaging. All patients were treated conservatively with cessation of sports activity, thoracolumbosacral orthosis, and external bone stimulator for three months after diagnosis. CT scans were obtained for the 3-month follow-up visits to assess bony healing. Subsequently the patients received 6 weeks of rehabilitation focused on core strengthening. Symptomatic patients after the treatment were referred for steroid injections and continued with the rehabilitation protocol. RESULTS: The most common age of injury was 15 years old, following a strong normal distribution. The most commonly played sport was football, followed by baseball/softball. The primary mechanism of injury was weight training closely followed by a football injury. The first quarter of the calendar year had the highest incidence of injuries with the most injuries occurring in March and the least occurring in December. One hundred fifty-two athletes reported using bone stimulators as prescribed, and these patients showed a significantly higher rate of bony healing on follow-up CT scans than those who did not use bone stimulators. One hundred ninety-seven patients (98%) returned to sports or similar level of activities. Thirty-seven patients (18%) received facet or epidural steroid injections due to continued pain and one patient underwent a surgical procedure. Follow-up CT scans showed 49.8% bony healing. CONCLUSIONS: Conservative treatment of spondylolysis in adolescent athletes with cessation of sports, thoracolumbosacral orthosis, and bone stimulator followed by rehabilitation was associated with excellent outcomes in terms of return to sports.

Psychosocial reintegration following traumatic spinal cord injury in South Africa: The influence of employment, injury characteristics and living situation.

OBJECTIVES: To determine the influence of employment, injury characteristics and living situation on psychosocial reintegration in individuals who sustained a traumatic spinal cord injury (TSCI) in South Africa. DESIGN: A cross-sectional exploratory survey. SETTINGS: Communities of the Cape Metropolitan Area, South Africa. PARTICIPANTS: A total of 108 community- dwelling adults, between ages of 19 and 71 years, who have sustained a TSCI more than 1- year ago. OUTCOME MEASURES: : The Sydney psychosocial reintegration scale (SPRS-2). RESULTS: The SPRS-2 and domains mean (SD) scores were: (1) Overall SPRS-2 of 27.87(13.4); (2) Occupational activity of 8.62 (4.8); (3) Interpersonal relationships of 9.80 (5.1); and (4) Living skills of 9.45 (4.9). Multivariate regression analysis resulted in two significant independent variables, namely employment and living situation. Employment alone explained 24.3% of the variance in the overall psychosocial model, 25.6% in the occupational activity model, while employment together with living situation explained 24.2% of the variance in the living skills model, with those employed reporting better psychosocial reintegration and those living in informal dwellings reporting poorer psychosocial reintegration. CONCLUSION: Employment and living situation strongly influenced psychosocial reintegration following a TSCI, indicating the important role of socio-economic status for psychosocial adaptation after injury. As employment plays a significant mediating role, and living in informal dwellings negatively affect psychosocial reintegration following a TSCI, rehabilitation stakeholders and policy makers need to continue lobbying for social and political change that support employment opportunities and provide accessible housing for persons with TSCI.

Quality of life after traumatic spinal cord injury in a developing context: the influence of contextual factors and injury characteristics.

PURPOSE: To identify contextual factors and injury characteristics influencing the quality of life (QoL) among individuals who sustained a traumatic spinal cord injury (TSCI) in South Africa. MATERIALS AND METHODS: We carried out a cross-sectional survey to examined the influence of contextual factors and injury characteristics on quality of life among 108 conveniently selected community-dwelling adults between the ages of 19 and 71 years old, who sustained a TSCI more than 1 year post-injury. RESULTS: Multivariate regression analysis resulted in three significant independent variables (gender, employment, and time living with the injury) that explained 38.1% of the variance in the model, of which being employed and living with a TSCI between 11 and 15 years were the strongest factors influencing the overall and each domain of quality of life. CONCLUSION: Our results highlight that employment plays an important role in QoL for individuals who sustained a TSCI. They also suggest that increased time since the injury is most likely to provide individuals an opportunity to develop efficient coping strategies, allowing for greater overall adjustment and life satisfaction, leading to a better quality of life.IMPLICATIONS FOR REHABILITATIONSince the time of the injury was found to be improved QoL, there is a need to improve the health care system of Individuals with SCI.As the employment is a significant factor positively influencing QoL, vocational rehabilitation programs should be included during the rehabilitation processes.Rehabilitation stakeholders need to continue lobbying for social and political changes that support expanded employment options for individuals who sustained a TSCI in order to improve their quality of life.

Características de lesões em atletas adolescentes de basquete / Characteristics of injuries in adolescent basketball athletes

INTRODUÇÃO: O basquetebol é um esporte de contato físico que envolve movimentos complexos como pular, girar e mudar de direção, que frequentemente causam lesões. OBJETIVOS: Este estudo tem como objetivo compreender as características das lesões em atletas adolescentes de basquete. MÉTODOS: Este estudo usa um método descritivo com uma abordagem de estudo transversal, usando um questionário baseado na web (Formulários Google) que consiste em perguntas fechadas para examinar a história, tipos, fatores e tratamentos das lesões sofridas pelos adolescentes atletas de basquete do Centro de Treinamento Esportivo de Estudantes (Pusat Pelatihan Olahraga Pelajar ou PPOP) do DKI Jakarta. Os sujeitos são 14 atletas do sexo masculino e feminino, com idade média de 15,9 ± 1,1 anos, altura média de 172,29 ± 9,33 centímetros e peso médio de 65,71 ± 10,06 quilogramas. O instrumento de pesquisa é um questionário distribuído online na forma de Formulários Google. Um teste de validade foi realizado no questionário usando Aikens. Os dados dos resultados do questionário foram analisados por meio de uma análise percentual das respostas a cada questão. RESULTADOS: Os resultados revelaram que 76% dos atletas sofreram lesões em membros inferiores, sendo a lesão mais frequente na articulação do tornozelo (45%). Além disso, os atletas também afirmaram que as entorses / torções são o tipo de lesão mais experiente (42%). Os treinamentos ocorreram quando 79% dos atletas experimentaram as lesões, enquanto os outros 21% as vivenciaram durante as partidas. CONCLUSÕES: Os resultados deste estudo não podem generalizar os achados, pois envolveu apenas 14 participantes, o que também é uma limitação deste estudo, mas esses achados relatam que a maior lesão que ocorre durante o exercício é a articulação do tornozelo, por isso os autores sugerem fazer um aquecimento adequado. Antes de iniciar uma sessão de treinamento ou durante uma sessão de treinamento competitivo, prevenir lesões é a melhor abordagem para os atletas reduzirem sua ocorrência.

INTRODUCTION: Basketball is a physical contact sport that involves complex movements such as jumping, spinning, and changing directions, all of which frequently cause injuries. OBJECTIVES: This study aims to understand the characteristics of injuries on adolescent basketball athletes. METHODS: This study uses a descriptive method with a cross-sectional study approach using a web-based questionnaire (Google Forms) consisting of close-ended questions to examine the history, types, factors, and treatments of the injuries experienced by the adolescent basketball athletes at the Student Sports Training Center (Pusat Pelatihan Olahraga Pelajar or PPOP) of DKI Jakarta. The subjects are 14 male and female athletes with an average age of 15.9±1.1 years old, an average height of 172.29±9.33 centimeters, and an average weight of 65.71±10.06 kilogram. The research instrument is a questionnaire distributed online in the form of Google Forms. A validity test was conducted on the questionnaire using Aikens. Data Questionnaire result data were analyzed using a percentage analysis on the answers to each question in the questionnaire. RESULTS: The results revealed that 76% of the athletes experienced injuries in the lower limb, with the most frequent injury in the ankle joint (45%). Furthermore, the athletes also stated that sprains/twists are the most experienced type of injury (42%). The training sessions were when 79% of the athletes experienced their injuries, whereas the other 21% experienced them during the matches. CONCLUSIONS: The results of this study cannot generalize the findings because it only involved 14 participants, which is also a limitation of this study, but these findings report that the greater injury that occurs during exercise is the ankle joint, so the authors suggest doing an adequate warm-up. Before starting a training session or during a competitive training session, preventing i

Epidemiology of injuries in senior men's field hockey: A two-season prospective observational injury surveillance study.

Determining the rate and severity of injuries incurred through sport is accepted as the primary step towards designing, implementing and evaluating injury prevention programmes. The aim of this study was to determine the injury incidence rate and characteristics of male field hockey athletes participating in the Irish Hockey League. Athletes from eight field hockey teams were assigned to an online reporting system, where they logged injuries as they were incurred. Injuries were defined as any physical complaint. Coaches and physiotherapists were contacted weekly to corroborateinjuries. Overall 323 injuries were reported across 34,449 exposure hours, giving rise to an incidence rate of 9.4/1000 h. On average, athletes sustained one injury over the course of two seasons. Muscle strains, pain and contusions were the most common types of injury, while the hamstring, knee and hip/groin were the most frequently reported locations. While 66.9% of injuries occurred through non-contact mechanisms, contact injuries were also common. Injury recurrences accounted for 16.1% of injuries. In conclusion, the incidence of injury in field hockey is high, occurring from a variety of mechanisms. Future injury prevention strategies should prioritise injuries to the hamstring, knee and ankle, and be specific to particular playing positions.

Injury Causes and Severity in Pediatric Traumatic Brain Injury Patients Admitted to the Ward or Intensive Care Unit: A Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study.

Background: Traumatic brain injury (TBI) is the leading cause of death and disability in children. It includes a range of different pathologies that differ considerably from adult TBI. Analyzing and understanding injury patterns of pediatric TBI is essential to establishing new preventive efforts as well as to improve clinical management. Methods: The multi-center, prospectively collected CENTER-TBI core and registry databases were screened and patients were included when younger than 18 years at enrollment and admitted to the regular ward (admission stratum) or intensive care unit (ICU stratum) following TBI. Patient demographics, injury causes, clinical findings, brain CT imaging details, and outcome (GOSE at 6 months follow-up) were retrieved and analyzed. Injury characteristics were compared between patients admitted to the regular ward and ICU and multivariate analysis of factors predicting an unfavorable outcome (GOSE 1-4) was performed. Results from the core study were compared to the registry dataset which includes larger patient numbers but no follow-up data. Results: Two hundred and twenty seven patients in the core dataset and 687 patients in the registry dataset were included in this study. In the core dataset, road-traffic incidents were the most common cause of injury overall and in the ICU stratum, while incidental falls were most common in the admission stratum. Brain injury was considered serious to severe in the majority of patients and concurrent injuries in other body parts were very common. Intracranial abnormalities were detected in 60% of initial brain CTs. Intra- and extracranial surgical interventions were performed in one-fifth of patients. The overall mortality rate was 3% and the rate of unfavorable outcome 10%, with those numbers being considerably higher among ICU patients. GCS and the occurrence of secondary insults could be identified as independent predictors for an unfavorable outcome. Injury characteristics from the core study could be confirmed in the registry dataset. Conclusion: Our study displays the most common injury causes and characteristics of pediatric TBI patients that are treated in the regular ward or ICU in Europe. Road-traffic incidents were especially common in ICU patients, indicating that preventive efforts could be effective in decreasing the incidence of severe TBI in children.

Costs resulting from nonprofessional soccer injuries in Switzerland: A detailed analysis.

BACKGROUND: Soccer injuries constitute an important public health problem and cause a high economic burden. Nevertheless, comprehensive data regarding injury costs in nonprofessional soccer are missing. The aim of this study was to determine which groups of nonprofessional soccer athletes, injury types, and injury situations caused high injury costs. METHODS: A cross-sectional, retrospective telephone survey was carried out with a random sample of persons who had sustained a soccer injury between July 2013 and June 2014 and who had reported this accident to the Swiss National Accident Insurance Fund (Suva). One year after the corresponding accident, every injury was linked to its costs and to the answers obtained in the interview about injury setting, injury characteristics, and injury causes. Finally, the costs of 702 injuries were analyzed. RESULTS: The average cost of an injury in nonprofessional soccer amounted to €4030 (bias-corrected and accelerated 95% confidence interval (BCa 95%CI): 3427-4719). Persons aged 30 years and older experienced 35% of soccer injuries but accounted for 49% of all costs. A total of 58% of all costs were the result of injuries that occurred during amateur games. In particular, game injuries sustained by players in separate leagues for players aged 30+/40+ years led to high average costs of €8190 (BCa 95%CI: 5036-11,645). Knee injuries accounted for 25% of all injuries and were responsible for 53% of all costs. Although contact and foul play did not lead to above-average costs, twisting or turning situations were highly cost relevant, leading to an average sum of €7710 (BCa 95%CI: 5376-10,466) per injury. CONCLUSION: Nonprofessional soccer players aged 30 years and older and particularly players in 30+/40+ leagues had above-average injury costs. Furthermore, the prevention of knee injuries, noncontact and nonfoul play injuries, and injuries caused by twisting and turning should be of highest priority in decreasing health care costs.

Epidemiology of physical activity-related injuries in Chinese university students.

Knowledge gaps of the physical activity-related injury (PARI) problem among general undergraduates exist. We conducted a study in four universities, where 1421 students graded 1-3 were interviewed face-to-face during April and May after their completion of the baseline survey in March and April 2017, aiming to describe the incidence and characteristics of PARI. PARI experience and physical activity (PA) participation in the past 12 months were collected. Injury incidence density (IID) and risk, and injury characteristics were evaluated for the overall sample and by gender. Pearson chi-square or Fisher's exact tests and independent-sample t tests were used to test between-group differences. We found that 486 PARIs were reported totally by 289 participants, with an overall IID of 0.57 per 1000 hours of exposure (males: 1.07, females: 0.45) and an injury risk of 0.34 injuries/student/y (males: 0.52; females: 0.28). Higher IIDs were found in roller skating, football, and basketball. The majority of injuries occurred outdoors and involved the lower extremities, with sprain and strain being the primary injury types. Moreover, most injuries were new, acute, and happened in non-contact situations. Of all injuries, 52.1% required medical attention and 64.6% resulted in inactivity of one or more days. Some significant differences were observed between males and females. Our study indicates that PARI is a public health concern among Chinese university students, which can provide direction for targeted prophylactic interventions to underpin the sex-specific injury mechanism to reduce PARI.

Analysis of Injury Incidences in Male Professional Adult and Elite Youth Soccer Players: A Systematic Review.

CONTEXT: The incidence of injury for elite youth and professional adult soccer players is an important concern, but the risk factors for these groups are different. OBJECTIVE: To summarize and compare the injury incidences and injury characteristics of male professional adult and elite youth soccer players. DATA SOURCES: We searched MEDLINE and Web of Science using the search terms elite, international, European, soccer, football, injury, injuries, epidemiology, incidence, prevalence, not female, not American football, and not rugby. We also used the search terms professional for studies on professional adult soccer players and high-level, soccer academy, youth, adolescent, and young for studies on elite youth soccer players. STUDY SELECTION: Eligible studies were published in English, had a prospective cohort design, and had a minimum study period of 6 months. To ensure that injury data were assessed in relationship to the athlete's individual exposure, we included only studies that reported on injuries and documented exposure volume. DATA EXTRACTION: Two independent reviewers applied the selection criteria and assessed the quality of the studies. DATA SYNTHESIS: A total of 676 studies were retrieved from the literature search. Eighteen articles met the inclusion criteria: 6 for elite youth and 12 for professional adult soccer players. CONCLUSIONS: Injury rates were higher for matches than for training for both youth and adult players. Youth players had a higher incidence of training injuries than professionals. Efforts must be made to reduce the overall injury rate in matches. Therefore, preventive interventions, such as adequately enforcing rules and focusing on fair play, must be analyzed and developed to reduce match-related injury incidences. Reducing training injuries should be a particular focus for youth soccer players.

Burden of maxillofacial trauma at level 1 trauma center.

There is an upward trend in facial injuries following changes in population pattern, increasing industrialization and urbanization, hence maxillofacial trauma is becoming a burden and a leading medical problem in emergency rooms worldwide. This study was performed to evaluate the pattern of maxillofacial fractures, associated injuries, and treatment used at Jai Prakash Narayan Apex Trauma Center (JPNATC), All India Institute of Medical Sciences (AIIMS), New Delhi, India, between January 2007 and June 2010. The study provides basis for establishment of trauma as major etiology of maxillofacial injuries and planning for preventive strategies. A retrospective study of patients seen and treated at JPNATC, AIIMS, New Delhi, between January 2007 and June 2010 was performed. Data extracted from patient records included etiology, age, sex, types and sites of fractures, treatment modality, and concomitant injuries. There were 795 fractures of the maxillofacial skeleton and 86 concomitant injuries from 542 patients. Road traffic accident (RTA) (56.8%) was the most common etiologic factor, followed by falls (22.3%) and fights (18.5%). The age range was from 3 to 75 years (mean, 34.7 years) with a peak incidence in the third decade with a male-to-female ratio of 3.7:1. The most common location of maxillofacial fractures was the mandible 615 (77%) and middle third 180 (23%). With regard to mandibular fractures, the body (29.6%) was the most common site, followed by the angle (24.4%), ramus (19.5%), dentoalveolar (14.6%), symphysis (11.0%), condyle (0.8%) while in the middle third, the nasal bone (36.7%) was the most common, followed by zygomatic bone (27.8), Lefort II (14.4), Lefort I (7.8%), dentoalveolar (10.0%), and Lefort III (3.3%). Majority of the patients were treated by open reduction and internal fixation (70.6). Concomitant injuries were 84 (10.8%) with orthopedic injuries accounting for the majority (63.9%). Head injury was associated in 16.3% of cases. RTA was the major etiologic factor of maxillofacial injuries in our setting and the young adult males were the main victims. Henceforth, establishment of regionalized, efficient, and focused trauma centers in various parts of the country particularly for acute trauma should be emphasized. Also, the laws regarding the precautions such as seat belts, speed limits, and traffic rules must be observed strictly to reduce the incidence of RTA.

An assessment of etiological spectrum and injury characteristics among maxillofacial trauma patients of Government dental college and Research Institute, Bangalore.

BACKGROUND: Maxillofacial injuries pose a therapeutic challenge to trauma, maxillofacial and plastic surgeons practicing in developing countries. This was a retrospective study carried out to determine the incidence, etiology, injury characteristics of maxillofacial injuries reported at our centre. PATIENTS AND METHODS: The data for this study were obtained from the medical records of 689 cases reported to our centre during the period from 2006-2009. Records of patients who were either treated in the emergency room as outpatients or the Department of Oral and Maxillofacial Surgery as inpatients were analyzed and were subjected to statistical analysis using statistical package for social sciences (SPSS) for Windows version 17.0. Data was summarized in form of proportions and frequency tables for categorical variables and was subjected to Chi-Square test. RESULTS: Out of 689 patients, 75.9% were male and 24.1% were female. 42.5% of the patients were in the age group of 21 to 30 years. Road traffic accidents accounted for the majority (74.3%) of cases of maxillofacial trauma. Mandible was seen as the most commonly fractured bone (50.3%) and 53.8% head and neck injuries were most common among the associated injuries. CONCLUSION: Road traffic accidents were clearly the most prevalent etiological factor for maxillofacial trauma. Measures on prevention of road traffic crashes should be strongly emphasized in order to reduce the occurrence of these injuries.

Civilian craniocerebral gunshot injuries in a developing country: presentation, injury characteristics, prognostic indicators, and complications.

BACKGROUND: Civilian craniocerebral gunshot injuries (CGIs) are rare but increasing in incidence in the developing world and there is scare literature on presentation, injury characteristics, prognostic indicators, and complications of brain trauma due to projectiles. METHODS: A retrospective review of 51 civilian patients with CGI who presented to the Aga Khan University Hospital between 1998 and 2011 was carried out. Presentation, injury characteristics, and complications were analyzed with emphasis on outcomes and prognostic indicators. RESULTS: There were 43 male and 8 female patients with an average age of 28.92 (±12.33) years. Twenty-three patients had a Glasgow Coma Scale (GCS) score of 13-15, 6 patients had a GCS score of 9-12, and 22 patients had a GCS score of 3-8 on admission. The overall mortality rate was 22% (n = 11). The most common postoperative neurologic deficits were motor deficits (19 patients) followed by aphasias (11 patients). On univariate analysis, admission GCS score and bi- or multilobar injuries were found to be highly predictive of neurologic outcome. There was no difference in outcomes between penetrating and perforating injuries. We also failed to find a statistically significant correlation between ventricular injury and outcomes in our patients. CONCLUSION: Admission GCS and number of lobes involved are highly prognostic of outcome. Patients with a GCS score ≥9 and unilobar injury on computed tomographic scans may benefit the most from surgical management.

Epidemiological trends of spine trauma: an Australian level 1 trauma centre study.

Knowledge of current epidemiology and spine trauma trends assists in public resource allocation, fine-tuning of primary prevention methods, and benchmarking purposes. Data on all patients with traumatic spine injuries admitted to the Alfred Hospital, Melbourne between May 1, 2009, and January 1, 2011, were collected from the Alfred Trauma Registry, Alfred Health medical database, and Victorian Orthopaedic Trauma Outcomes Registry. Epidemiological trends were analyzed as a general cohort, with comparison cohorts of nonsurvivors versus survivors and elderly versus nonelderly. Linear regression analysis was utilized to demonstrate trends with statistical significance. There were 965 patients with traumatic spine injuries with 2,333 spine trauma levels. The general cohort showed a trimodal age distribution, male-to-female ratio of 2:2, motor vehicle accidents as the primary spine trauma mechanism, 47.7% patients with severe polytrauma as graded using the Injury Severity Score (ISS), 17.3% with traumatic brain injury (TBI), the majority of patients with one spine injury level, 7% neurological deficit rate, 12.8% spine trauma operative rate, and 5.2% mortality rate. Variables with statistical significance trending toward mortality were the elderly, motor vehicle occupants, severe ISS, TBI, C1-2 dissociations, and American Spinal Injury Association (ASIA) A, B, and C neurological grades. Variables with statistical significance trending toward the elderly were females; low falls; one spine injury level; type 2 odontoid fractures; subaxial cervical spine distraction injuries; ASIA A, B, and C neurological grades; and patients without neurological deficits. Of the general cohort, 50.3% of spine trauma survivors were discharged home, and 48.1% were discharged to rehabilitation facilities. This study provides baseline spine trauma epidemiological data. The trimodal age distribution of patients with traumatic spine injuries calls for further studies and intervention targeted toward the 46- to 55-year age group as this group represents the main providers of financial and social security. The study's unique feature of delineating variables with statistical significance trending toward both mortality and the elderly also provides useful data to guide future research studies, benchmarking, public health policy, and efficient resource allocation for the management of spine trauma.