The association between head injury and facial fracture treatment: an observational study of hospitalized bicyclists from a level 1 trauma centre.

PURPOSE: To compare the types of facial fractures and their treatment in bicyclists admitted to a level 1 trauma centre with major and minor-moderate head injury. METHODS: Retrospective analysis of data from bicycle-related injuries in the period 2005-2016 extracted from the Oslo University Hospital trauma registry. RESULTS: A total of 967 bicyclists with head injuries classified according to the Abbreviated Injury Scale (AIS) were included. The group suffering minor-moderate head injury (AIS Head 1-2) included 518 bicyclists, while 449 bicyclists had major head injury (AIS Head 3-6). The mean patient age was 40.2 years (range 3-91 years) and 701 patients (72%) were men. A total of 521 facial fractures were registered in 262 patients (on average 2 facial fractures per bicyclist). Bicyclists with major head injury exhibited increased odds for facial fractures compared to bicyclists with minor-moderate head injury (sex and age adjusted odds ratio (OR) 2.75, 95% confidence interval (CI) 2.03-3.72, p < 0.001. More specifically, there was increased odds for all midface fractures, but no difference for mandible fractures. There was also increased odds for orbital reconstruction in cyclist with major head injury compared to bicyclist with minor-moderate head injury (adjusted OR 3.34, 95% CI 1.30-8.60, p = 0.012). CONCLUSION: Bicyclists with more severe head injuries had increased odds for midface fractures and surgical correction of orbital fractures. During trauma triage, the head and the face should be considered as one unit.

Do Bicycle Helmets Protect Against Facial Fractures? An Observational Study From a Level 1 Trauma Centre.

This study investigates the impact of helmet use on the incidence of facial fractures in bicycle accidents. Analyzing data from hospitalized bicyclists between 2005 and 2016, the research focused on the correlation between helmet usage and various facial fractures. The study included 1256 bicyclists with known helmet use, among whom 277 individuals (22%) were identified with a total of 521 facial fractures. The findings revealed a significant reduction in the likelihood of facial fractures among helmeted cyclists compared with those without helmets (odds ratio, 0.65; confidence interval, 0.50-0.85; P=0.002). Specifically, the odds of sustaining fractures in the zygoma, orbit, nose, and maxilla were decreased by 47%, 46%, 43%, and 33%, respectively, among helmeted cyclists. However, helmet use did not significantly alter the odds of mandible fractures. Overall, the use of helmets in bicycling significantly lowered the risk of midface fractures but showed no notable effect on mandible fractures in severe cycling incidents.

Dentoalveolar injuries, bicycling accidents and helmet use in patients referred to a Norwegian Trauma Centre: A 12-year prospective study.

BACKGROUND/AIM: Despite its many benefits, bicycling carries the risk of accidents. Although numerous studies have reported the effect of helmet use on traumatic brain injury, it remains unclear if, and to what extent, helmet use reduces the risk of facial injuries. This is particularly true in regard to injuries of the lower face. In addition, there is limited evidence of the effect of helmet use on dentoalveolar injuries. Thus, the aim of this study was to determine the frequency and distribution of dentoalveolar injuries in bicycling accidents and to explore the influence of helmet use. MATERIAL AND METHODS: A total of 1543 bicyclists were included from the trauma registry of a Norwegian tertiary trauma center over a 12-year period. Data were collected prospectively, including patient characteristics, type of injury, and helmet use. The prevalence of dentoalveolar injuries was assessed in conjunction with helmet use and facial fractures. RESULTS: Twenty-five percent of the patients had maxillofacial injuries, and 18% of those with facial fractures exhibited concomitant dentoalveolar injuries. The most common type of dentoalveolar injury was tooth fracture (39%). The most frequent location of facial fractures with combined dentoalveolar injuries was the maxilla, which had fractured in 32 patients. Women had a higher risk of sustaining dentoalveolar injuries compared to men (odds ratio 1.50, 95% confidence interval 1.02-2.22). There were 1257 patients (81%) who had reliable registration of helmet use; 54% of these wore a helmet, while 46% did not. Helmet users had an increased risk of dentoalveolar injuries compared to non-helmeted bicyclists (adjusted odds ratio 1.54, 95% confidence interval 1.02-2.31). CONCLUSIONS: Dentoalveolar injuries are fairly common in trauma patients admitted to a trauma center following bicycling accidents. Bicycling helmets are associated with an increased risk of dentoalveolar injuries.