Silent severe aortic regurgitation due to blunt chest trauma: ignore it at your peril-a case report.

Background: Blunt chest trauma (BCT) presenting to the emergency department is common and may cause life-threatening cardiac complications. Whilst complications causing haemodynamic instability are generally detected promptly, others may present late with long-term consequences. We describe a rare, serious complication of BCT presenting five years after a road traffic accident (RTA). Case summary: A 23-year-old man was incidentally found to have a murmur. Past history was notable only for BCT with rib fracture sustained in a RTA 5 years prior. Examination revealed a hyperdynamic pulse, loud decrescendo diastolic murmur, and Duroziez's sign over the femoral arteries. Echocardiography showed severe valvular aortic regurgitation (AR) from a hole in the left coronary cusp and holodiastolic flow reversal in the descending aorta. The left ventricle (LV) showed marked dilatation in diastole, mild dilatation in systole, and preserved systolic function. The aorta was normal. Severe AR was attributed to his previous BCT, with AR causing subsequent LV dilatation. He underwent aortic valve replacement (AVR) with rapid recovery. He remains well, and his echo shows a well-functioning AVR with normalization of LV dimensions. Discussion: Aortic regurgitation following BCT is rare but well-recognized, most often resulting from RTAs. Only a third of cases are diagnosed acutely. In others, lack of haemodynamic instability means that emergency echocardiography is not routinely performed, such that this may go unrecognized with long-term consequences. Clinicians should be aware of possible valve damage following BCT. Prompt echocardiography should be routinely performed for all BCT at initial presentation, even without haemodynamic instability.

Co-location analysis of pedestrian accident attributes for Ankara.

Even though accidents with pedestrians are more likely to have a severe or fatal outcome, most research concentrates on the vehicle part of the accidents. To make better policies and infrastructure decisions it is crucial to understand how and why such accidents happen. In this article, 2.588 pedestrian accidents from the year 2018 that resulted in injury or death in the city of Ankara, Türkiye are considered, and different attributes are analyzed co-location-wise. Three types of analysis will be undertaken for these accidents: temporal, natural environment, and pedestrian characteristics. The season of the year, weekend-weekday, and time of day will be explored for the temporal analysis. Visibility (daylight, twilight, and darkness) and rain are the natural surroundings of interest. The analyzed pedestrian characteristics are age group, gender, clothing colour, and nationality. Generally, the accident properties are evenly distributed and mostly the higher co-locations occur with themselves. Three important results stand out in this study. Firstly, the type of precaution appropriate to different time periods of the day should be applied, taking into account the locations that have the strongest co-location with themselves. Secondly, a seasonal approach should be adopted in determining places where pedestrian safety needs to be increased in the city. Lastly, pedestrian safety measures targeting especially both '0-14 and 65 + age groups' and 'foreign citizenship' should be prioritized in the identified locations. The results show that the co-location methodology is a good fit for analyzing pedestrian accidents and a wider use of this methodology for other accident types and in general might be beneficial.

Pricing weekly motor insurance drivers' with behavioral and contextual telematics data.

Telematics boxes integrated into vehicles are instrumental in capturing driving data encompassing behavioral and contextual information, including speed, distance travelled by road type, and time of day. These data can be amalgamated with drivers' individual attributes and reported accident occurrences to their respective insurance providers. Our study analyzes a substantial sample size of 19,214 individual drivers over a span of 55 weeks, covering a cumulative distance of 181.4 million kilometers driven. Utilizing this dataset, we develop predictive models for weekly accident frequency. As anticipated based on prior research with yearly data, our findings affirm that behavioral traits, such as instances of excessive speed, and contextual data pertaining to road type and time of day significantly aid in ratemaking design. The predictive models enable the creation of driving scores and personalized warnings, presenting a potential to enhance traffic safety by alerting drivers to perilous conditions. Our discussion delves into the construction of multiplicative scores derived from Poisson regression, contrasting them with additive scores resulting from a linear probability model approach, which offer greater communicability. Furthermore, we demonstrate that the inclusion of lagged behavioral and contextual factors not only enhances prediction accuracy but also lays the foundation for a diverse range of usage-based insurance schemes for weekly payments.

Household cost of road traffic accident-related injuries: A case study of St. Joseph Hospital, Koforidua in Ghana.

Road traffic accidents (RTAs) are a prominent contributor to both mortality and morbidity, particularly affecting individuals aged 5-29 years. Road traffic Injuries impose substantial physical and economic burden on individuals, households, and governments, particularly in African nations. Thus, our study focuses on assessing the economic cost of road traffic accidents within the context of St. Joseph Hospital, Koforidua. A cross-sectional survey was conducted at the Emergency Unit of the St. Joseph Hospital with a sample size of 291 patients. A patient perspective was used in costing the management of RTAs. Data was descriptively analyzed with Microsoft Excel with means and standard deviations estimated for direct, indirect, and intangible costs to the patient. Total direct and indirect cost of road traffic accidents were approximately GHS1,973,801.28 (US$164,483.44) and GHS520,309.46 (US$43,359.12) respectively which represents 79.1 % and 20.9 % of the total cost. The annual average economic cost for all cases was GHS8,570.83 (US$714.24). Intangible costs were also found to be high, with 54.2 % patients rating their RTA burden to be between mild to moderate, 10.8 % as moderate to severe and 1.4 % as severe. RTA cost burden is huge for all households. Uninsured patients bear significantly higher costs than insured patients. Intangible costs were also high, prompting the need to provide psychological care to RTA victims and their families. Concerted efforts should be directed at strict enforcement, training, improvement of road infrastructure and legislation to reduce or curb road traffic accidents in LMICs.

Management of Congenital Radioulnar Synostosis Fracture Following Road Traffic Accident: A Rare Case Report.

Introduction: Congenital radioulnar synostosis (CRUS) is a rare condition characterized by the fusion of the radius and ulna bones in the forearm, resulting in limited forearm rotational movement. Case Report: We present a unique case of a 26-year-old male who suffered a forearm injury following a road traffic accident. Initial evaluation revealed a malformed proximal radius and distal radioulnar joint, and the presence of radioulnar synostosis, along with a fracture at the junction of the radius and ulna. Open reduction internal fixation was performed, followed by structured rehabilitation. At 6-month follow-up, significant improvement in forearm motion was observed, enabling the patient to perform daily activities independently. Conclusion: This case underscores the importance of comprehensive evaluation in traumatic injuries and understanding the anatomy and function of the forearm complex. It also highlights the efficacy of surgical intervention and rehabilitation in restoring function and quality of life for patients with this rare condition. This report contributes to the limited literature on managing fractures in the context of CRUS and emphasizes the need for further research in this area.

Assessing the risks arising from a trailer connected behind a passenger car.

Article pays attention to the impact of using the trailer on driving performances of a studied vehicle combination.The research was performed via extensive experimental measurements. A new methodology of determining a technical condition of the trailer' brakes was proposed and verified, which can be also applied during the regular technical inspection. Various load distributions in the trailer caused the centre of gravity's position of the vehicle was changed, which may increase the risk of skidding or disconnection of the trailer from the towing vehicle. Also, the vehicle's ability to accelerate and decelerate decreased considerably due to the loading up. There were assessed the braking characteristics of the combination of vehicles as well, depending on the technical condition of the trailer's brakes. The importance of this article lies in the quantification of selected factors on road safety in relation to driving with a combination of vehicles.

Survival status and its predictors among adult victims of road traffic accident admitted to public hospitals of Bahir Bar City, Amhara regional state, Northwest, Ethiopia, 2023: multi center retrospective follow-up study.

INTRODUCTION: Road traffic accident is the most common cause of death in adults worldwide. Road traffic accident-related deaths increased from time to time in low- and middle-income countries including Ethiopia; however, there is limited evidence about Survival status and its predictors among adult victims of road traffic accidents admitted to Hospitals in Ethiopia specifically in the study area. Thus, this study aimed to assess Survival status and its predictors among adult victims of road traffic accident admitted to Hospitals. METHODS: An institutional-based retrospective follow-up study was conducted from July 01/2019 to June 30/2022. A total of 402 samples were chosen using simple random sampling. Data was collected by a prepared checklist from the victims' chart and entered into Epi-Data version 4.6 software and then exported to STATA version 14.1 for analysis. Kaplan-Meier failure function and log-rank test were computed. The assumption was checked by Schoenfeld residual test. All variables in bivariable analysis, p-value < 0.25 were entered into multivariable cox-regression model. Adjusted Hazard Ratio with 95% Confidence Interval was reported to declare the strength of association and statistical significance p-value of < 0.05. Model fitness was checked by using Cox-Snell residual. Data was presented by text, table, and graph. RESULT: The median survival time was 504 h. From all, 63(15.6%) deaths, 57% of deaths occurred between 24 and 168 h of follow-up with an overall incidence of 15.34deaths per10, 000 victims-hours observation. According to the Kaplan-Meier failure curve together with the log-rank test, the incidence density rate of death among victims who had a complication during admission was71.86per10,000victims-hour observation (95%, CI:53.66-96.25), which is different from those who did not have complication 5.17per10,000person-hour observation (95%, CI:3.26-8.21). The incidence density rate of death among victims who had low level of arterial oxygen saturation (SPO2 < 95%) during admission was 82.87per10, 000 victims-hour observation (95%, CI: 63.15-108.75), which is different from those who had arterial oxygen saturation ≥ 95% 3.16per10, 000victims -hour observation (95%, CI: 1.75-5.71) Develop complication (AHR = 3.1,95% CI:1.44-6.70), systolic blood pressure measurement value ≤ 89 mmHg (AHR = 2.4,95% CI:1.10-5.19), not admitted intensive care unit (AHR = 0.46,95% CI:0.022-0.97), Glasgow Coma Scale score ≤ 8 (AHR = 2.9,95% CI:1.07-7.75), Glasgow Coma Scale score 9-12(AHR = 3.8,95% CI:1.61-8.97) and, level of arterial oxygen saturation ≤ 95% (AHR = 6.5,95% CI:2.38-17.64) were predictors of outcome variable. CONCLUSION AND RECOMMENDATIONS: The median survival time was short. Complication, low systolic blood pressure measurement value, low Glasgow Coma Scale score, not admit to intensive care unit and low level of arterial oxygen saturation were significant predictors of the outcome variable. So that healthcare providers better give special attention and care to those victims admitted to Hospitals. A further prospective study is recommended.

Can there be a genetic marker for Post-Traumatic Stress Disorder outside the Diagnostic Interview within the Scope of Forensic Psychiatry? / Travma Sonrasi Stres Bozuklugunun Adli Psikiyatri Kapsaminda Tani Görüsmesi Disinda Genetik Belirteci Olabilir mi?

OBJECTIVE: This study was conducted to investigate the role of two candidate polymorphisms to improve the diagnosis of Post-Traumatic StressDisorder (PTSD) in forensic psychiatry settings. METHODS: Individuals who applied to our unit with PTSD symptoms following a traffic accident were included. The control group consisted of people who had experienced a similar accident without any symptoms. Sociodemographic data-form, Hamilton Depression Rating Scale and Anxiety Sensitivity Index-3 (ASI 3) were applied to the patients and controls, and the frequencies of the rs8042149 polymorphic allele of the RORA gene and the rs717947 polymorphic allele (4p15) were investigated. RESULTS: A total of 103 people were included (54 case, 49 control). The rates of polymorphisms were not different between the groups. Higher education levels were associated with lower PTSD incidence while higher scores in the Social Subscale of ASI strongly predicted the occurrence of PTSD. CONCLUSION: The polymorphisms assessed did not help to differentiate the groups in the current sample. The potential of the Social Subscale of ASI-3 in predicting the occurrence of PTSD following a trauma should be evaluated in a longitudinal design.

Predictors of driving risk in patients with obstructive sleep apnea syndrome treated by continuous positive airway pressure: a French multicenter prospective cohort.

STUDY OBJECTIVES: To investigate the predictors of persistent driving risk related to sleepiness in patients with obstructive sleep apnea syndrome treated by continuous positive airway pressure. METHODS: Longitudinal analysis of a prospective national database including 5,308 patients with obstructive sleep apnea syndrome and an indication of continuous positive airway pressure. Near-misses related to sleepiness, accidents related to sleepiness, and sleepiness at the wheel were assessed before initiation and after ≥ 90 days of treatment. Multivariable associations with the cumulative incidence of near-misses and accidents under treatment were calculated using Cox models adjusted for age, sex, obesity, sleep duration, sleepiness at the wheel, accidents/near-misses history, depressive symptoms, residual apnea-hypopnea index, and adherence to treatment. RESULTS: Residual sleepiness at the wheel under treatment was associated with eight-fold higher incidence of near-misses related to sleepiness (HR=8.63 [6.08-12.2]) and five-fold higher incidence of accidents related to sleepiness (HR=5.24 [2.81-9.78]). Adherence ≤4h/night was also a significant predictor of persistent driving risk (HR=1.74 [1.12-2.71] for near-misses and HR=3.20 [1.37-7.49] for accidents). CONCLUSIONS: Residual sleepiness at the wheel and treatment-adherence ≤4h/night are easy-to assess markers to detect persistent driving risk during the follow-up evaluations of patients under treatment. Health professionals, but also policy makers, should be aware of the crucial importance to systematically evaluate these elements during the follow-up evaluations of the patients with obstructive sleep apnea syndrome treated by continuous positive airway pressure to better evaluate their driving risk.

The association between road traffic accidents and visual functions: A systematic review and meta-analysis.

BACKGROUND:  Poor visual functions have been reported to be related to the occurrence of road traffic accidents. AIM:  To review the association between visual function and road traffic accidents (RTAs) from published relevant empirical studies. SETTING:  Worldwide. METHODS:  A random effects (RE) model meta-analysis was conducted using STATA 18. Statistical tests conducted include meta-summary statistics, RE meta-analysis (forest plot), meta-regression (relationship between mean age and effect sizes), funnel plots, Egger's and Begg's tests for publication bias and small study effects. RESULTS:  A total of 17 relevant studies, which were either cross-sectional or observational by design, were included in the meta-analysis. Reported effect sizes were within computed confidence intervals (CI) at 95%. The computed Q test of homogeneity was 61.94. The overall mean effect size of 1.43 (95% CI of 0.985-1.883) was statistically significant at a 5% level (Z = 6.26; p  0.001). The I-squared = 62.17% (p = 0.00) confirmed moderate heterogeneity and the Q-value of 61.94 (p = 0.00) rejected the null hypothesis that the effect size was the same in all the studies. The funnel plot showed that the remaining majority of 13 studies were within the funnel plot on the right-hand side of the line of no effect. CONCLUSION:  These results provide evidence of associations between visual functions and RTAs, and highlight the need for targeted interventions and further research to address the challenges associated with impaired visual functions and road safety.Contributions: The study contributes to the understanding of the implications of visual functions for road safety.

A Case Report on a Syndesmotic Ankle Injury Treated With Arthrex TightRope.

Syndesmotic ankle injuries, often referred to as "high ankle sprains," pose intricate challenges in orthopedic practice, particularly among athletes engaged in high-impact sports. Conventional treatments have encompassed conservative approaches and the use of syndesmotic screws, each beset by inherent limitations. The Arthrex TightRope system has emerged as a pioneering alternative, heralded for its capacity to facilitate physiologic micromotion, eliminate the necessity for hardware removal, and expedite early rehabilitation. This case report delineates the management of a 29-year-old male professional soccer player who suffered a trimalleolar ankle fracture compounded by a severe syndesmotic injury subsequent to a road traffic accident. The patient underwent a comprehensive treatment involving open reduction and internal fixation (ORIF) of all three malleoli, complemented by syndesmotic stabilization employing the Arthrex TightRope system. Post-operative care encompassed a regimen of gradual weight-bearing and methodical rehabilitation. At the one-year follow-up, the patient demonstrated excellent ankle joint function devoid of pain or complications related to hardware, underscoring the efficacy of managing syndesmotic and malleolar fractures successfully. This case underscores the potential advantages of integrating traditional ORIF techniques with contemporary syndesmotic fixation strategies like the TightRope system for complex ankle fractures, advocating for further research to refine their optimal utilization in clinical settings.

A postmortem study of demographics and severity of thoracoabdominal injuries among patients attending a teaching hospital in northeast India.

Introduction: The global estimate reflects 4.4 million injury-related deaths every year and the thoracoabdominal region is frequently injured since it is a wide area. Methods: An autopsy-based cross-sectional study was conducted using a convenient sampling technique for three years. A Chi-square test was conducted for categorical variables. A P value of less than 0.01 was considered statistically significant. Results: Out of 80 cadavers, the male:female ratio was 1:0.31. The commonest age group was 20-29 years. Victims of road traffic accidents were 54 (67.5%) followed by falls from height 10 (12.5%). External thoracic injuries were commoner than internal and vice versa in abdominal injuries. Liver injuries were major in number. Combined thoracic-abdominal and associated injuries were observed in 67 (83.75%) victims. The commonest cause of death was craniocerebral injury combined with hemorrhagic shock (36.25%). Eighteen (22.5%) victims died on the spot having an Injury Severity Score (ISS) of 73.37 followed by a survival time of 1-7 days in 17 (21.25%) cases. A significant correlation was found between ISS and survival period. Conclusion: All thoracic and abdominal injuries represent a possible increase in morbidity and mortality; hence, working toward their prevention and timely intervention is necessary.

Mapping the relationship between traffic accidents, road network configuration, and urban land use.

Understanding the nature of traffic accidents in relation to urban access networks is crucial for building safer and more resilient cities. This paper examines the issue of traffic accidents through the lenses of urban configurational theory and urban land use. Three data layers were used in the study, including space syntax analysis conducted in Depthmap X, geotagged traffic accidents collected by the police department, and geotagged land-use data. The method involved superimposing these data layers and exploring potential correlations using a geographic information system (GIS). The findings indicate significant correlations between the spatial frequency of traffic accidents and the choice measure (at 2500 m), local integration, and active land use. The findings of this study can help inform planners and policymakers about the best location to implement safety measures to reduce the risk of traffic accidents in urban access networks.

Obstructive shock induced by internal thoracic artery injury with traumatic sternal fracture.

Internal thoracic artery (ITA) injuries associated with sternal fractures can lead to shock. Several studies have documented injuries resulting in hemorrhagic shock, yet there is limited reporting on obstructive shock. Opinions differ regarding which is superior between transcatheter arterial embolization (TAE) and open thoracotomy. We report the case of an 80-year-old female patient presented with blunt chest trauma when driving. Her vital signs were normal. However, ultrasonography revealed a hypoechoic anterior mediastinal lesion. Her blood pressure decreased immediately before undergoing a computed tomography (CT) scan. The CT scan showed a sternal fracture, anterior mediastinal extravasation, and dilation of the inferior vena cava. TAE was performed on both internal thoracic arteries, and the patient was transferred to a hospital where an open thoracotomy could be performed. The patient was treated conservatively and discharged without sequelae. Obstructive shock caused by an ITA injury with a sternal fracture can be successfully treated using TAE.

Which is the role of driver- or passengers-sex on the severity of road crashes?

Aim: The aim of the study is to quantify the main ways in which the sex of the driver/occupant of a passenger car affects the severity of road crashes. Methods: All 171 230 cars occupied by the driver and one or more passengers included in the Spanish Register of Victims of Road Crashes from 2014 to 2020 were included. We designed two cohort studies: In the first one, we estimated the Incidence Rate Ratios (IRR) between the sex of the drivers and the occurrence of any death and/or severe injuries among their passengers. In the second one we estimated the conditioned IRR between the sex of the occupants of the same car and their risk of death and/or severe injuries. We used fixed Poisson models to obtain IRR estimates, crude and adjusted by individual- environment- and vehicle-related variables. Results: A consistent inverse relationship between driver's female sex and passenger's severity was found, (IRR 0.72, 95 % CI 0.68-0.77), stronger for single crashes (IRR 0.67, 95 % CI 0.60-0.65). The magnitude decreased after adjusting for vehicle- and environment-related variables (IRR 0.82, 95 % CI 0.73-0.92). In the second study, the risk of death or hospitalization was higher for occupants of female sex (IRR 1.23, 95 % CI 1.17-1.30). Conclusions: The risk of death or severe injuries among passengers of cars involved in single crashes is lower for female drivers, probably due to safer driving. On the contrary, in similar crashes, the risk of injuries leading to hospitalization is higher for females.

Effectiveness and Safety of Pharmacopuncture on Inpatients with Tension Headache Caused by Traffic Accidents: A Pragmatic Randomized Controlled Trial.

Background: This study investigated the effectiveness and safety of pharmacopuncture for pain relief and functional improvement in patients with traffic accident (TA)-induced acute tension headaches. Methods: The study employed a parallel, single-centered, pragmatic, randomized controlled trial design. Eighty patients complaining of acute tension headaches were randomized into the integrative Korean medicine treatment (IKM treatment) group and the pharmacopuncture group on suboccipital muscles (suboccipital muscles pharmacopuncture + IKM treatment), with 40 participants assigned to each group. The patients in the pharmacopuncture group underwent pharmacopuncture as an add-on therapy, consisting of three sessions. Both groups were reassessed 2 months post-intervention. To assess the outcomes, the Numeric Rating Scale (NRS) for Headache, NRS for Neck Pain, Headache Disability Index, Headache Impact Test-6, EuroQol 5-Dimension, and Patient Global Impression of Change were used. Results: The improvement in the outcomes of the pharmacopuncture group was significantly greater than that of the comparison group on day 4 of hospitalization in terms of pain (difference in NRS of headache -2.59, 95% CI -3.06 to -2.12; NRS of Neck pain -1.05, 95% CI -1.50 to -0.59) and function (difference in HDI -24.78, 95% CI, -31.79 to -17.76; HIT-6 -6.13, 95% CI, -9.47 to -2.78). Additionally, in 2 months of follow-up, the recovery rate of headache was significantly higher in the pharmacopuncture group than in the comparison group. Conclusions: The pharmacopuncture group demonstrated superior outcomes in symptom improvement than the comparison group did, providing insights into novel and useful applications of pharmacopuncture in the clinical practice of Korean medicine.

Near miss road traffic accidents and associated factors among truck drivers in Gamo zone, southern Ethiopia by using a contributory factors interaction model.

Background: Road traffic accidents (RTAs) are among the leading causes of injuries, fatalities, and the resulting increase in financial burdens worldwide. Every year, RTAs cause numerous serious injuries and fatalities in Ethiopia. it is important to understand how prevalent near-miss crash accidents are, and which by definition could have injured the victim but did not result in an actual accident. The determinants of these near-misses are essential in road crash accident reduction strategies. In spite of the fact that near-miss accidents are much more common than actual losses or injuries, very little research has been conducted on them. Thus, this study was intended to assess the near-miss accidents and associated factors among truckers in Gamo zone, southern Ethiopia. Methodology: The community-based cross-sectional study was employed from May 12 to July 10,2022, using a structured interviewer-administered questionnaire. A simple random sampling technique was used to select participants. The data were analyzed using the statistical package for social sciences. A binary and multivariate logistic regression model was used to identify the determinants of near-miss accidents. A statistical significance level was set at p < 0.05. Results: About 72.5% of truckers had experienced near-miss road traffic accidents. The majority of the near-miss accidents were caused by speeding, followed by driving on the wrong side of the road and skidding, 65 (22.6%), 39 (13.5%), and 38 (13.2%), respectively. Driving frequency per week, location of accidents, condition of the road, sleeping status, and weather conditions were significantly associated with near-miss accidents. Conclusion: The prevalence of near-miss accidents is high in the Gamo zone. Being a younger and less educated driver, high driving frequency per week, driving on major roads and junctions, foggy weather, and inadequate sleep all contribute to the occurrence of accidents. Road safety measures that could address these identified factors are required to mitigate potential RTAs.

Epidemiology of Oral and Maxillofacial Traumatic Injuries Among the Patients Reporting to the Dental Institute of Western Maharashtra Region, India.

Objective: To analyze the distribution, etiology, and patterns of oral and maxillofacial trauma among the subjects reporting to a dental institute in the Western Maharashtra region of India. Methods: This retrospective study was conducted by manually collecting data from the medical records of subjects who reported to the dental institute with a history of trauma from 1st January 2018 to 31st December 2022. All the injured subjects with complete clinical and radiographical records of maxillofacial injuries were included. The demographic data, etiology & site of trauma, and associated injuries were analyzed. Data were tabulated into four age groups (< 20 years, 21-40 years, 41-60 years, and > 60 years). Five etiological factors, i.e. road traffic accidents (RTA), stumble & falls, violence, animal attack, and strike by an object, were further evaluated based on age and gender. Maxillofacial injuries were classified into seven types: maxillary fractures (subcategorized), mandibular fractures (subcategorized), zygomaticomaxillary complex (ZMC) fractures, nasal, frontal, orbital, and naso-orbito-ethmoidal fractures. Data were tabulated and analyzed. Results: A total of 437 subjects were included, consisting of 84.2% males and 15.8% females, with the highest incidence of trauma between 21-40 years. Road traffic accident was the main reason for maxillofacial injuries (50.3%), followed by falls (26.5%), and violence (19.9%). ZMC fractures accounted for 55.4% (242 fractures), followed by mandibular fractures (42.3%). Conclusion: RTA is the main factor responsible for maxillofacial injuries in this part of Maharashtra among subjects of both genders. Education and motivation regarding road safety measures are the two factors that need to be focused on to reduce the incidence of maxillofacial injuries.

Comparative Study of Computerized Tomography Imaging of Facial Trauma Using 2D and 3D Reconstruction Scans.

Background The article intends to compare the efficacy of detecting fractures of facial bones in terms of the number of fractures detected, single or multiple involvement, displaced or undisplaced, segmental involvement, and comminuted or non-comminuted using 2D computerized tomography (CT) versus 3DCT for planning optimum treatment. Methodology One hundred patients with suspected facial bone fractures sustained either by assault, road traffic accident, or self-fall on arrival to casualty were examined clinically. Subsequently, palpation was done to detect facial bone fractures. On suspicion, they were subjected to a CT scan of the face in both coronal and axial views. The results were interpreted in the form of bones involved and detection of fractures of the same on both 2D and 3D scans. The acquired images of fractures obtained by 2D scan were reconstructed using software to obtain virtual images of the same by 3D scan to help further delineate which fractures or combination of them are better appreciated on both scans.  Result Out of 100 patients, 52 had maxilla fractures, which were better delineated by 3D scans. The detection of zygomatic arch fractures was almost equal on both scans. Mandibular and orbital fractures were better delineated by 3D scans. Conclusion To conclude, we believe that in maxillofacial trauma, 3DCT provides better information than 2DCT, especially with regard to the delineation of fractures and the involvement of single or multiple bones, as it gives a real-time picture of the same. This helps in planning the management of patients, whether surgical intervention is required or can be managed conservatively.