Pattern of Facial Laceration at Tertiary Care Centre in Eastern Nepal: A Descriptive Cross-sectional Study.

INTRODUCTION: Facial lacerations are a source of concern as these can be life threatening at times due to extensive haemorrhage and also leave lifelong scars. The objective of this study was to find out the pattern of facial lacerations in the Nepalese population visiting a tertiary care centre in eastern Nepal. METHODS: A descriptive cross-sectional study was conducted among the maxillofacial trauma patients visiting the Emergency department and department of Dental Surgery at a tertiary care centre from 1 October 2022 to 30 September 2023. Ethical approval was taken from the Institutional Review Committee . All patients attending the Dental outpatient department and Emergency department for the management of facial laceration in the study period were included in the study. RESULTS: Out of 236 patients, there were 199 (84.32%) male and 37 (15.67%) female patients. The most common age group was of 21-30 years 88 (37.29%) and Road Traffic Accidents 183 (77.54%) was the main aetiology. Facial lacerations and maxillofacial fractures both were seen in 98 (41.53%) patients. There were a total of 358 facial laceration sites among 236 patients and chin region 76 (21.22%) was the most common followed by forehead region 54 (15.08%). CONCLUSIONS: Facial lacerations were mostly seen in males, younger adults and road traffic accidents were the main aetiology for these injuries. Facial lacerations showed predominant T-shaped distribution with chin being the most common site.

Comprehensive examination of etiological factors and clinical manifestations of maxillofacial traumas in forensic cases: A five-year retrospective study.

BACKGROUND: Maxillofacial injuries, due to their diverse etiological causes, are often considered a component of multi-trauma and constitute a significant portion of trauma. This study aims to elucidate the incidence of maxillofacial traumas, particularly among military personnel, various clinical courses, and characteristics, thereby contributing to the literature. METHODS: Forensic reports, primarily related to military personnel and organized between 2011 and 2016 at the Forensic Medicine Department of Gülhane Medical Faculty, Health Sciences University, were retrospectively examined. The study involved a detailed analysis of cases with maxillofacial injuries resulting from trauma, focusing on aspects such as age, gender, the origin of the trauma, degree of injury, the presence of bone and dental fractures, and the occurrence of psychiatric disorders as a result of the trauma. RESULTS: This study demonstrated that maxillofacial traumas predominantly occurred in young male individuals, particularly among military personnel. The most common etiological factor identified was interpersonal violence. The majority of injuries were soft tissue damages, with the nasal bone being the most frequently fractured area. Injuries to the head and upper extremities were also detected in some of the cases, showing that multiple injuries are common in such cases. Post-traumatic psychological disorders developed in some cases, with anxiety disorders being the most commonly observed. CONCLUSION: It has been determined that maxillofacial injuries can affect multiple body regions, necessitating a multidisciplinary approach. This study underscores the importance of developing comprehensive strategies and policies for understanding and managing maxillofacial traumas, providing a fundamental reference for future studies in this field.

The cost of care in maxillofacial fractures treatment in relation to the type of fixation and length of stay at a tertiary care hospital of Karachi, Pakistan: A retrospective chart review.

In addition to the clinical burden of trauma, the financial burden is an important aspect of care globally, especially for patients in low- and middle-income countries. The current retrospective review was done of data from January 2015 to December 2020 related to patients of oral maxillofacial trauma management in a tertiary care setting. Analysis of variance was used to determine the mean difference in the cost incurred depending upon the type of trauma and the number of bone plates used in fracture management. Pearson correlation was applied to explore any correlation involving patient age, aetiology and type of fracture, number of bone plates employed and the length of stay in the hospital. No statistically significant differences were noted in the cost among the different groups. The cost of care was significantly (p<0.001) correlated to the length of stay. Other variables, such as the type of fractures and the number of plates, had no significant impact (p>0.05).

What are the incidence and costs associated with interfacility emergency department transfer patients treated by oral and maxillofacial surgeons?

OBJECTIVE: Interfacility emergency department transfers (IETs) for maxillofacial trauma and infections are prevalent in the United States, with significant implications for health care costs. Limited availability of oral and maxillofacial surgeons (OMS) exacerbates unnecessary transfers and associated expenses. This study aimed to determine the incidence and costs of OMS IET. STUDY DESIGN: A retrospective cohort study was performed for maxillofacial trauma and infection IET at the University of Illinois Health main hospital via electronic medical record query for terms "infection [or] trauma [and] transfer." Inclusion criteria required presentation from January 1, 2022 to June 30, 2022; emergency department (ED)-ED transfer; and or consultation by OMS. Distance transferred, insurance type, location of treatment, weekend presentation, and associated costs were collected. RESULTS: One thousand ninety-nine records were identified, including 46 trauma IET and 122 infection IET. Costs ranged from $2,683,918.90 to $7,984,912.89, indicating ∼$1.5 billion annual expenditure across US OMS programs. Three trauma IET required urgent treatment; no infection IETs were "emergent." Trauma IET averaged 20.7 + 17.1 miles and infection IET 22.0 + 17.4 miles for transfer distance. Among trauma IET, 28 were treated in the operating room (OR), 10 had outpatient follow-up, and 8 had ED treatment. Among infection IETs, 57 received ED treatment, 56 received OR treatment, and 9 received antibiotics/no treatment. CONCLUSIONS: Maxillofacial trauma and infection IET impose significant health care costs. Increased funding for OMS training may mitigate the shortage and improve patient care. Further research is needed for better triaging and reimbursement strategies.

Clinical analysis of 346 minor patients with maxillofacial fractures.

OBJECTIVES: This study aims to analyze the clinical epidemiology, diagnostic and treatment characteristics of minor patients with maxillofacial fracture and provide a reference for the prevention and treatment. METHODS: The clinical data of minor patients with maxillofacial fracture in Departmentof Traumatic and Plastic Surgery, West China Hospital of Stomatology, Sichuan University, from January 1, 2015 to December 31, 2020 were retrospectively studied and statistically analyzed in terms of age, gender, etiology, anatomic sites and treatment modalities. RESULTS: The mean age of the patients was (10.65±5.15) years, and the male-to-female ratio was 1.91∶1. High fall was the primary cause of maxillofacial fractures in minors aged 0-6 years. Traffic accident injuries were the main cause of maxillofacial fractures in minors aged 7-12 and 13-17 years. About 65.13% of the midface and 83.08% non-condylar fractures were mainly treated by surgery, and condylar fractures were treated conservatively in 74.73% and by surgical treatment in 25.27%. CONCLUSIONS: The etiology of maxillofacial fractures in minors differs at different ages, so prevention strategies should be adjusted according to age. Surgical treatment has become the preferred treatment modality for midface and non-condylar fractures. Conservative treatment is still the main treatment method for condylar fractures, but the proportion of surgical treatment increases.

Policy of fourteen maxillofacial divisions towards titanium plates removal after internal fixation of paediatric maxillofacial fractures: A World Oral Maxillofacial Trauma (WORMAT) project.

INTRODUCTION: The aim of this 11-year retrospective multicentric study is to evaluate the policy of 14 maxillofacial surgery divisions in terms of titanium plate removal from paediatric patients who had undergone open reduction and internal fixation (ORIF) to treat maxillofacial fractures. MATERIAL AND METHODS: Patients ≤ 16 years undergoing surgical treatment for fractures of middle and lower third of the face between January 2011 and December 2022, with a minimum follow-up of 6 months, were included. Age (group A: ≤ 6 years, B: 7-12 years, C: 13-16 years), sex, fracture location and type, surgical approach, number, and location of positioned and removed plates, timing and indications for removal were recorded. RESULTS: 191/383 (50 %) patients (median age, 10 years; M:F ratio 2.1:1) underwent removal of 319/708 (45 %) plates. Maxillary dentoalveolar process (91 %), angle/ramus (63 %) and mandibular body (61 %) had a significantly higher removal rate than other fracture sites (p < 0.001). A significant decreasing trend in removal with increasing age was observed, from 83 % in Group A to 24 % in Group C (p < 0.001). On the total of positioned plates, 11 % were removed for symptomatic reasons (5 % infections, 6 % discomfort/pain) and 34 % for other reasons (28 % scheduled removal). DISCUSSION: This multicentric study showed that plate removal was not performed routinely in the paediatric population. The incidence and causes of symptomatic plates removal were consistent with the literature, while the plate removal rate from asymptomatic patients was lower. A correlation was found between increasing age and a reduction in the frequency of plate removal procedures.

Post-traumatic stress disorder in maxillofacial trauma victims- A systematic review and meta-analysis.

BACKGROUND: Maxillofacial trauma often results in visible facial disfigurements and can lead to psychological complications such as post-traumatic stress disorder (PTSD). However, PTSD often remains unrecognized and un/undertreated. The goal of the current systematic review was to determine the incidence of PTSD after maxillofacial trauma, associated risk factors, assessment tools employed, and management. METHODS: A literature search was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane Library databases following PRISMA guidelines up to March 2024. Collected variables included the number of patients included, PSTD assessment tool, PTSD incidence, and risk factors and management. The meta-analysis was conducted using random effect models in STATA 16. RESULTS: The review included 14 studies (1633 patients, male=1025, female=230, not mentioned=378). Assessment tools varied widely among studies. Meta-analysis revealed a pooled incidence of PTSD of 27 % (n = 14, 95 % CI, 24 %-30 %) at 1-3 months post-trauma and 10 % (n = 3, 95 % CI, 3 %-17 %) at the 6-12 months follow-up, with a statistically significant 60 % reduction between these periods. CONCLUSION: The overall incidence of PTSD following maxillofacial trauma was 27 % at 1-3 months and decreased to 10 % after 6 months. The emphasis should be given to the importance of early intervention strategies and awareness among the treating surgeon to prevent PTSD.

Changing of nasal fracture patterns in maxillofacial trauma consultation-impact of the covid-19 pandemic.

BACKGROUND: In 2020, the coronavirus SARS-CoV-2 led to a pandemic that had a major impact on the global health care systems. The aim of this study was to analyze the impact of the Covid-19 pandemic on nasal bone (NB) fracture patterns/distributions and circumstances in a German cranio-maxillofacial trauma center. MATERIALS AND METHODS: This retrospective study compared the nasal fracture patterns of patients in the PreCovid (PC) era (February 2019 - January 2020) with patients in the IntraCovid (IC) era (February 2020 - January 2021). In addition to baseline characteristics, the type of NB fractures, the circumstances leading to NB fracture and hospital admissions/treatments were analyzed. RESULTS: The present study showed a significant decrease in the total number of NB fractures during the Covid-19 pandemic. In the IC period, a significant increase in falls and virus-/flu associated syncopes leading to NB fractures was detected. At the same time, a significant decrease in sports accidents, road traffic accidents and interpersonal violence leading to NB fractures was observed in the IC period. Under the influence of the Covid-19 pandemic, a significant increase in accidents at home, accidents during the weekdays and closed reductions under local anesthesia was detected when being compared to the PC period. The daytime of trauma leading to NB fractures also changed significantly from night-time (PC) to morning-time (IC). CONCLUSION: The Covid-19 pandemic had a significant impact on the NB fracture circumstances and treatment modalities. Therefore, the results of this study can serve as a baseline for further studies of the impact of the Covid-19 pandemic on NB fracture patterns among different countries.

Maxillofacial trauma in geriatric patients in an aging country.

Similar to other developing countries, the elderly population has increased in Türkiye in the last 30 years. Due to this increase, there has been a rise in the number of elderly patients suffering from maxillofacial injuries. This retrospective study aimed to evaluate the data of patients with geriatric facial trauma treated in our trauma center between 2010 and 2022 and the leading types of injuries, their causes, accompanying findings, and preferred treatment methods according to sex and age. In the study, the demographic characteristics, including age, sex, comorbidities, causes and sites of injury, treatment options, accompanying injuries, and facial injury severity scores of 292 patients were analyzed. Among more than 4000 patients undergoing treatment for maxillofacial injuries screened from January 2010 to August 2022, 292 (166 males, 56%; age range, 65-98 years) fulfilled the eligibility criteria for the study, of whom 60 had a surgical operation. Falls were the most typical cause of injury (70.20%), followed by motor vehicle accidents (18.15%) and assaults (7.87%). Zygomaticomaxillary complex fractures were the most frequently encountered fracture type (n=126, 29.92%), followed by nose fractures (n=122), orbital fractures (n=85), and mandible fractures (n=72). It was observed that the fractures were managed by surgical intervention or conservative measures and that conservative treatment was mostly preferred at an increasing rate with advancing age. As the elderly population increases, so does the incidence of geriatric facial trauma. Due to increased age, deterioration of health, and increase in the number of comorbidities, surgical interventions are less preferred.

Epidemiology of Maxillofacial Fracture Injury in a Hospital in Xi'an: A 2-Year Retrospective Study.

Despite their limitations, epidemiological studies provide information useful for formulating effective and efficient injury prevention strategies. The aim is to carry out an epidemiology study of maxillofacial fracture in Xijing Hospital. Level of Evidence: Level II-therapeutic study.

What Is the Relationship Between Maxillofacial Injury Location and Associated Injuries?

BACKGROUND: Patients sustaining maxillofacial fractures are at risk for associated injuries (AIs) to other body regions. The incidence of AIs is reported to be from 20 to 35%. AIs may be life-threatening and play a key role in considering first-line management at the emergency department, as well as planning the definitive treatment of maxillofacial fractures. PURPOSE: The study aimed to determine the frequency and risk factors for AIs in patients with maxillofacial fractures. STUDY DESIGN, SETTING, SAMPLE: The investigators designed and implemented a retrospective cohort study of patients with facial fractures treated at Central Hospital (Lahti, Finland) from January 1, 2009 through December 31, 2019. All adult patients with verified maxillofacial fractures were included. Patients under 18 years of age were excluded from the study. PREDICTOR VARIABLE: The predictor variable was the location of the maxillofacial fractures grouped into three categories: mandible alone, midface alone, and both midface and mandible. MAIN OUTCOME VARIABLE(S): The primary outcome variable was associated body region injuries coded as present or absent. The secondary outcome variable was the location of the AI categorized as skull, neck, thorax, pelvis, or extremity injuries. COVARIATES: Other study variables included demographic data (age, sex, alcohol use), Glasgow Coma Scale, and etiology (fall, traffic- and bicycle accident, assault, pedestrian hit by motor vehicle, work-related, or sports/free-time injuries). ANALYSES: Continuous variables were analyzed for normal distribution using the Shapiro-Wilks test and compared with categorical variables using the Mann-Whitney test. The univariate analyses of categorical variables were analyzed by the χ2 test (P ≤ .05 was considered statistically significant). RESULTS: During the study period, 443 adult (≥18) patients had maxillofacial fractures. AIs were present in 88 subjects (20%). The mean age was 47.6 years (range 18-91); 52 years with AIs (range 19-91), and 47 years (range 18-92) without AIs (P = .03). Subjects with midface and mandible + midface fractures had greater risk to AIs compared to mandibular fractures (relative risk 2.0, P = .002, relative risk 2.8, P = .009). CONCLUSION AND RELEVANCE: Every fifth maxillofacial trauma patient had an associated injury. Trauma patients should be evaluated in institutions with trauma protocols and imaging modalities before determining and executing the treatment plan for maxillofacial fractures.

The incidence and patterns of maxillofacial fractures and associated head and neck injuries.

The aim of this study was to evaluate the incidence and patterns of maxillofacial fractures and the demographic characteristics of associated head and neck injuries. This single-center retrospective cohort study was conducted at the Department of Oral and Maxillofacial Surgery of King Abdullah University Hospital (KAUH) in Irbid, northern Jordan. The data was obtained from the electronic clinical records of all patients in whom maxillofacial fractures and associated head and neck injuries were confirmed. During the five-year period captured by this retrospective study, 481 patients with 1026 maxillofacial fractures (equivalent to 2.13 fractures per patient) were treated. The sample comprised of 369 (76.7%) males and 112 (23.3%) females, resulting in a male/female ratio of 3.3:1. Majority of the patients were in the 21-30 age group and RTA was the most common cause of maxillofacial fractures, accounting for 299 (62.1%) of the analyzed cases. In 316 cases, maxillary fractures were accompanied by associated injuries, 132 (41.77%) of which were intracranial lesions, 80 (25.32%) were skull fractures, and 59 (18.67%) were cervical spine injuries. Based on the obtained data, it can be concluded that the high occurrence of RTA emphasizes the significance of adhering to traffic laws and regulations, as individuals who have suffered serious head and neck injuries as a result of maxillofacial trauma may experience potentially fatal consequences. Thus, management for patients with maxillofacial fractures and concomitant traumas should be multidisciplinary and coordinated.

Impact of the COVID-19 pandemic on maxillofacial trauma surgery in Germany - implications from the national DRG database.

PURPOSE: The COVID-19 pandemic has affected the personal and social lives of millions of people and also impacted the etiological factors of midfacial trauma such as falls, interpersonal violence or traffic accidents. The aim of this study was to analyze the influence of the COVID-19 pandemic on maxillofacial trauma surgery in the German healthcare system. METHODS: Nationwide data regarding the national diagnosis-related-group (DRG) inpatient billing system used in all German hospitals was received from the German Federal Statistical Office. Various trauma-associated procedures of the Operation and Procedure Classification System (OPS), a German modification of the International Classification of Medical Procedures (ICPM), were statistically associated with different epidemiological factors between 2012 and 2021. RESULTS: A statistically significant decrease (p < 0.05) in surgeries regarding maxillofacial fractures was registered during the years 2020 and 2021. Young male patients had the largest decline in maxillofacial trauma surgeries during this period (p < 0.05). In contrast. elderly patients 80 years and older showed a dramatic increase in the frequency of fractures in both the midface and the mandible (p < 0.05). CONCLUSIONS: During the COVID 19 pandemic there has been a shift in the number, composition and etiology of maxillofacial fracture surgeries. Measures of social distancing and personal risk avoidance had a societal positive effect on the frequency of facial injuries. This stands in contrast to the drastic increase in fractures of elderly people who should be protected primarily by the measures taken. These results can help to understand these influences better in future pandemics. TRIAL REGISTRATION: German Clinical Trials Register No: DRKS00032778.

A Comparison of Maxillofacial and Head Injuries Following Electric Scooter and Bicycle Accidents.

BACKGROUND: The prevalence of maxillofacial and head injuries associated with electric scooters (e-scooter, ES) has risen in concordance with its popularity. PURPOSE: The purpose of this study was to compare maxillofacial and head injury location, type, and severity related to ES and bicycle accidents and to identify factors contributing to injury severity. STUDY DESIGN, SETTING, SAMPLE: The authors implemented a multicenter retrospective cohort study in Seattle, Washington, and enrolled a sample of ES riders and bicyclists who sustained maxillofacial injuries between September 2020 and September 2022. The exclusion criteria included nonmotorized scooters, motorized bicycles, injuries with other operators, or vehicles, and pre-evaluation deaths. PREDICTOR VARIABLE: The predictor variable was vehicle type, bicycle or ES. OUTCOME VARIABLES: The outcome variables included maxillofacial injury location, distinguished by horizontal facial thirds and injury type, defined as hard or soft tissue. Associated head injury types were also reported as hard (calvaria) or soft (scalp) tissue injuries. The severity of these injuries was quantified using both the injury severity score and the face and head abbreviated injury scale. COVARIATES: Demographic, injury, and treatment-related variables were collected. ANALYSES: Bivariate, multivariate, and regression statistics were computed. Statistical significance was P < .05. RESULTS: The final sample was composed of 205 total subjects, of which 52 (25.4%) were in the ES group and 153 (74.6%) in the bicycle group. Isolated midface injuries were the most common hard tissue location in the ES (15.4%) and bicycle (29.4%) groups. The most common soft tissue injury location included the upper face and midface in the ES group (19.2%) and the midface in the bicycle group (22.9%). Both hard and soft tissue head injuries were more prevalent in the ES group (P < .0002 and P < .0001). Moreover, intracranial injuries were seen in 36.5% of ES subjects compared to 9.8% bicycle subjects (P < .0001). Between the two groups there was no difference in maxillofacial injury severity, but head injuries were more severe in the ES group (P < .0002). Using regression analysis, drug use was found to have a significant impact on the mean injury severity score (P < .002) and helmet use did not have significant impact on face or head injury severity. CONCLUSION: Maxillofacial injury location, type, and severity are comparable among ES and bicycles. However, ES riders are at greater risk of severe head injuries compared to bicycles, and riding while intoxicated has the greatest effect on injury severity.

Epidemiology of Craniomaxillofacial Fractures Over a 5-year Period at a Midwestern Level 1 Trauma Center Serving a Large Rural Population.

BACKGROUND: Though the epidemiology of craniomaxillofacial (CMF) fractures has been well documented at urban hospitals, the characteristics of these fractures in rural hospitals have not been well studied. PURPOSE: The purpose of this study is to report on the epidemiology of CMF fractures at a regional Level 1 trauma center serving a large rural population in central Illinois. STUDY DESIGN, SETTING, SAMPLE: This is a retrospective cohort study at a community-based regional tertiary referral center that serves a predominantly rural population. Inclusion criteria comprised patients with radiologically confirmed CMF fractures between 2015 and 2019. Patients with incomplete medical records were excluded. PREDICTOR VARIABLE: Predictor variables included demographics (age, admission source, race, and sex) and etiology of CMF fracture (assault/domestic violence, all-terrain vehicle/off-road, falls, farm-related, motor vehicle collisions, gunshot wound, and others). MAIN OUTCOME VARIABLE: The primary outcome variable was the CMF anatomic location including nasal bone, orbit, mandible, malar/maxillary, and other CMF fractures. COVARIATES: The covariates are not applicable. ANALYSES: Descriptive statistics were used to summarize a sample of the population characteristics. Wilcoxon ranked sign tests and χ2 tests of independence were used to assess for statistically significant associations between select variables of interest. Statistical significance was defined as P < .05. RESULTS: Between 2015 and 2019, a total of 2,334 patients presented to the emergency department with a CMF fracture. After applying the inclusion/exclusion criteria, the final sample was composed of 1,844 patients for the management of 2,405 CMF fractures. The majority of patients were male(62.0%) and young adults (aged 18-39) had the highest number of CMF fractures (819) relative to all other age groups. The most common fracture etiology was fall(37.3%), and nasal bone fractures represented the most common fracture location(41.6%). χ2 analyses revealed statistically significant associations between the anatomic location of CMF fracture incurred, and differing categories of age, admission source, race, sex, and etiology. CONCLUSION AND RELEVANCE: Our study shows that patients seen at our Midwestern Level 1 trauma center are more likely to present with nasal bone and malar/maxillary fractures due to falls. In studies based in urban centers, patients are likely to present with orbital and mandibular fractures due to falls and assault.

Maxillofacial trauma and its management presenting at a tertiary care hospital in Lahore during Covid-19 pandemic.

Objectives: The objective of this study was to assess the patterns of maxillofacial injuries, aetiology and their management during the pandemic of Covid-19 in a tertiary care hospital in Lahore, Pakistan. METHODS: This is a single center, prospective cross-sectional study. Patients from all age groups who presented at the Emergency room of Jinnah Hospital Lahore and managed by the Oral and Maxillofacial Surgery Department during 1st December 2020 till 31st January 2021 were included. Data were analyzed using IBM SPSS for Windows, Version 20.0. RESULTS: Total 202 patient were analyzed, 161 (79.7%) were male and 41 (20.3%) were females. Male to female ratio was 4:1. About fifty three percent of patients belonged to the age group 15-35 years. The most common cause was road traffic accidents (RTA), followed by fall. Eighty-three (41.1%) had only soft tissue injuries without any bony fracture and 119 (58.9%) had facial bones fractures. Zygomatic bone fracture was most common (53.8%) followed by mandible fracture (31.1%). Sixty-one out of 119 patients with fractures were treated with Open Reduction Internal Fixation (ORIF). Three patients had complete loss of vision because of facial trauma. Only 56 (28%) patients were managed under General Anaesthesia. CONCLUSIONS: During the initial pandemic era, a large majority of patients presenting with maxillofacial injuries were young male adults. The most common cause of maxillofacial trauma was RTAs. Soft tissue injuries were predominant followed by facial bone fractures and zygomatic bone was more frequent among the fracture cases. Covid-19 pandemic increased the difficulties faced in the management of maxillofacial trauma patients.

Pediatric Trauma During COVID-19: What Have We Learned?

BACKGROUND: In December 2019, an outbreak of a novel pneumonia-like illness, COVID-19 (C-19), emerged in Wuhan, China. In March 2020, as the incidence of C-19 rose, the Israeli government, like that of other nations, declared a national state of emergency, and a full, general lockdown was announced. PURPOSE: The purpose of this study is to determine the incidence and characteristics of pediatric maxillofacial trauma presentation during the 2020 C-19 lockdown restrictions and compare them to periods outside lockdown between 2019 and 2020 (pre-C-19). STUDY DESIGN, SETTING, SAMPLE: A retrospective cohort study was conducted and included all pediatric patients (0-18 years) referred to the emergency department (ED) at Tzafon Medical Center, Israel, and diagnosed with maxillofacial injuries. Patients with missing demographic data and patients who did not complete the medical examination were excluded. PREDICTOR/EXPOSURE/INDEPENDENT VARIABLE: The exposure variable is the date of injury-2020 C-19 lockdown period compared to the previous year (pre-C-19). MAIN OUTCOME VARIABLE(S): The main outcome variable was the number of pediatric maxillofacial trauma ED arrivals out of total pediatric ED arrivals and out of total maxillofacial ED arrivals. COVARIATES: Covariates included patient demographics, etiology, and place of injury. ANALYSES: The association between categorical variables was tested using the Fisher exact test or χ2 test for binary variables with relative risk when appropriate, logistic regression model used to predict outcome variable. P values were 2-tailed and statistical significance was defined as P < .05. RESULTS: The study sample comprised 1174 patients. Relative risk of presenting with oral and maxillofacial trauma out of all pediatric ED patients was 1.85 comparing C-19 period to pre-C-19 period (confidence interval [1.65; 2.073], P < .0001). Most of the injuries recorded during the C-19 restrictions occurred in the domestic environment (56.1% compared to 47.5% in pre-C-19, P < .001). Incidences necessitating treatment increased from 45.8 to 55% during C-19 (P = .002). CONCLUSION AND RELEVANCE: During C-19, there was a higher rate of pediatric injuries compared to pre-C-19. The incidence of domestic oral and maxillofacial injuries increased despite the considered home safety.

Maxillofacial trauma caused by e-scooters: a retrospective review prior to the extension of the UK scheme.

The nationwide extension of the electric scooter (e-scooter) scheme, which began in 2020, aimed to alleviate public transport congestion, to reduce pollution and peak-time road traffic. This retrospective study evaluates the range of e-scooter-related maxillofacial trauma before the recent scheme extension and compares the findings with existing literature on this topic. The Queen Elizabeth Hospital Birmingham, United Kingdom (UK) operates as a Level 1 Regional Major Trauma Centre and serves a population of four million. All patient records between September 2021 to September 2022 were analysed to establish the types of e-scooter-related maxillofacial trauma sustained. A Pearson's chi-squared test was used to assess for significant associations between variables recorded. Falls accounted for the majority of injuries (44.3%), and soft tissue lacerations were the most common maxillofacial injury (38%). Statistically significant results were measured in the following variables: gender and intoxication status (p = 0.007), helmet status and injuries sustained in maxillofacial and non-maxillofacial regions (p = 0.043), mechanism of injury and injuries sustained in both the maxillofacial and non-maxillofacial regions (p = 0.045). E-scooters are an emerging concern within the UK. Further studies across the UK are required to assess the frequency of e-scooter-related injuries. Such data may prove useful in determining the government's decision on e-scooter use on UK roads.