Facial trauma with life-threatening bleeding treated by andexanet alfa administration: A case report.

Recently, anticoagulant reversal has become a treatment option for life-threatening bleeding, especially in intracranial hemorrhage. Although evidence of the beneficial efficacy of andexanet alfa accumulates in cases of intracranial hemorrhage, little is known about its effectiveness in head injuries without intracranial hemorrhage. We present the case of an 87-year-old man who suffered a stroke 1 year previously and had been taking apixaban since then, who was brought to the emergency department with facial trauma due to a fall. Upon arrival at the hospital, the patient was conscious, and his vital signs were normal; however, physical examination revealed epistaxis, and plain head computed tomography (CT) showed multiple facial fractures without intracranial hemorrhage. As epistaxis was challenging to control, upper airway obstruction developed. His percutaneous oxygen saturation (SpO2) decreased rapidly, and he underwent tracheal intubation. Contrast-enhanced head CT revealed at least two extravasations, near the anterior wall of the right maxillary sinus and from the nasal canal to the nasopharynx area. However, embolization using interventional radiology was deemed difficult. Because the bleeding did not stop, we determined the bleeding was life-threatening and uncontrollable. Therefore, we infused andexanet alfa to stop the bleeding. After infusion, hemostasis was confirmed. This case suggests the effectiveness of andexanet alfa in cases of facial trauma and extracranial bleeding difficult to stop, resulting in favorable outcomes and hemostatic effects.

Electric scooter-related oral and maxillofacial injuries in Oxfordshire.

Electric scooters (e-scooters) are becoming increasingly popular amongst the public. Oxfordshire is included as part of the government led e-scooter trial. This study was designed to evaluate maxillofacial injuries occurring following e-scooter accidents. A single-centre retrospective study was conducted from October 2022 to September 2023 reviewing all e-scooter-related maxillofacial injuries which presented to the John Radcliffe Hospital in Oxford. During the study period, forty-nine patients (mean [range] age 28 [13-48] years; 32 [65.3%] male) suffered maxillofacial injuries from riding an e-scooter. Twenty patients (40.8%) were under the influence of alcohol and no individual was recorded to have worn a helmet at the time the injury occurred. Ten patients (20.4%) suffered a facial fracture (two mandibular fractures, three zygomatic-orbital fractures, one nasal fracture, and four patients with multiple fractures involving the sphenoid, zygomatic-orbital, and maxillary sinus). Four (40%) of these facial fractures required surgical management. This included one patient with an orbital floor fracture and an associated inferior rectus entrapment, which is a surgical emergency. Thirty-three patients (67.3%) sustained facial lacerations and nine patients (18.4%) sustained dental trauma. Maxillofacial injuries occurring from e-scooter injuries are significant and pose a notable risk to safety. Our study highlights poor compliance and emphasises the need to improve safety through public education, focussing on sobriety. Considerations should be given to speed limitations, safety clothing, e-scooter training, and whether helmets should be mandatory. The Oxfordshire trial is due to end in May 2026 and our results can inform and influence future legislation.

Concomitant head or neck injury increases risk of traumatic brain injury in facial fracture patients.

Concomitant traumatic brain injury (TBI) is common in facial fracture patients and prompt intervention is crucially important to minimise the risk of potential long-term sequalae. In order to achieve rapid diagnosis, clinicians need to be aware of the risk factors associated with concomitant TBI and facial fractures. Previous literature suggests that a facial fracture can be considered a significant indicator of TBI. Nevertheless, a large data gap remains on specific injury patterns of facial fractures and associated TBI. Therefore, the objective of this study was to estimate and compare the frequency of and risk factors for TBI in patients with and without different types of additional injuries. The retrospective cohort study included 1836 facial fracture patients aged at least 18 years. The outcome variable was TBI with radiological findings in computed tomography or magnetic resonance imaging. The primary predictor variables were associated injury outside the head and neck, associated cranial fracture and associated neck injury. Based on this study, associated cranial fracture increased the risk of TBI 4.7-fold. Patients with associated neck injury had a 2.1-fold risk of TBI. In addition, significant predictors for TBI were increasing age (p = 0.0004), high energy of injury (p < 0.0001) and anticoagulant medication (p = 0.0003). Facial fracture patients with associated injuries in the head and neck region are at significant risk of TBI. In clinical work, multiprofessional evaluation of facial fracture patients should be routine and repeated survey should be targeted especially at high-risk patients to identify TBIs.

New generation vehicles: the impact of electric scooter trauma on the severity of facial fractures assessed by FISS score. A multicentre study.

With the increasing use of sustainable energy sources, the electric scooter has become a widely used vehicle. The aim of the study is to analyse the types of facial fracture related to road traffic accidents to outline the need for dedicated road rules. An observational, retrospective, multicentre study was carried out at the Maxillofacial Surgery Units of six Italian hospitals. Fifty patients (mean age was 34.76 years) from January 2020 to January 2024 were enrolled. The severity of trauma was evaluated by the Facial Injury Severity Scale (FISS) by Bagheri et al. Most of the accidents occurred during the day and the weekend in spring or summer; 24 drivers collided with infrastructures or pedestrians, while 26 involved other vehicles. A total of 33 vehicles were rented, and 17 were privately owned. A total of 43 subjects were not wearing helmets, five patients were drunk, and three patients took drugs. In order of frequency, the facial fractures involved: zygomatico-maxillary-orbital complex (ZMOC) (n = 16), mandibular condyle (n = 13), nasal bone (n = 11), orbit floor (n = 8), and mandibular body (n = 7). Fractures such as Le Fort I (n = 4), naso-orbito-ethmoidal NOE (n = 4) and mandibular ramus (n = 4) were less common. Other types of facial fracture were rare. Thirty patients reported multiple facial fractures. The vast majority of the cases showed a low severity grade FISS score. Fifteen patients suffered polytrauma. The mean hospitalisation time was 8.3 days. As accidents with electric scooters are increasing, it is important to characterise the most frequent facial fractures to improve patient management and encourage the introduction of new road rules.

Automatic detection of midfacial fractures in facial bone CT images using deep learning-based object detection models.

BACKGROUND: Midfacial fractures are among the most frequent facial fractures. Surgery is recommended within 2 weeks of injury, but this time frame is often extended because the fracture is missed on diagnostic imaging in the busy emergency medicine setting. Using deep learning technology, which has progressed markedly in various fields, we attempted to develop a system for the automatic detection of midfacial fractures. The purpose of this study was to use this system to diagnose fractures accurately and rapidly, with the intention of benefiting both patients and emergency room physicians. METHODS: One hundred computed tomography images that included midfacial fractures (e.g., maxillary, zygomatic, nasal, and orbital fractures) were prepared. In each axial image, the fracture area was surrounded by a rectangular region to create the annotation data. Eighty images were randomly classified as the training dataset (3736 slices) and 20 as the validation dataset (883 slices). Training and validation were performed using Single Shot MultiBox Detector (SSD) and version 8 of You Only Look Once (YOLOv8), which are object detection algorithms. RESULTS: The performance indicators for SSD and YOLOv8 were respectively: precision, 0.872 and 0.871; recall, 0.823 and 0.775; F1 score, 0.846 and 0.82; average precision, 0.899 and 0.769. CONCLUSIONS: The use of deep learning techniques allowed the automatic detection of midfacial fractures with good accuracy and high speed. The system developed in this study is promising for automated detection of midfacial fractures and may provide a quick and accurate solution for emergency medical care and other settings.

Conservative Management of Maxillary and Mandibular Fractures in a Pediatric Patient With a Modified Open Cap Splint: A Case Report.

Pediatric maxillofacial fractures, which are not very prevalent, account for around 5% of all face injuries. Children under the age of 13 are more susceptible to craniofacial injuries because they have a larger cerebral mass-to-body ratio than adults. The fracture pattern in children does not resemble that of adults, due to which the treatment of pediatric fractures differs from that of adults and can pose substantial difficulties to the pediatric dentist due to many factors, including the complex anatomy of the developing jaw. In this case report, a 5-year-old male patient presented with an injury to the upper and lower jaw. A case was managed with a conservative approach by using a modified open cap splint. A radiographic investigation, including CT brain and face, was done, which revealed the mandibular symphyseal fracture, bilateral condyle, and right Lefort II fracture. A modified open cap splint was fabricated and fixed with circummandibular and circumzygomatic wiring under general anesthesia. After two months, the fractured site showed good healing on orthopantomography (OPG), and satisfactory occlusion was achieved. The patient was kept on monthly follow-ups for up to five months. Treatment guidelines for pediatric maxillary and mandibular fractures are different from those for adults in that most pediatric cases are managed by a conservative approach. Cap splints are a versatile treatment option for juvenile mandibular fractures because they can be used to restore function and aesthetics with minimal morbidity, do not impede jaw growth or the development of dentition, and can be applied to patients of a wider range of ages.

Pediatric Facial Fracture in Garhwal Himalayan Region of Uttarakhand State: A Retrospective Study.

Background: Pediatric facial fractures are fairly uncommon injuries and comprise less than 15% of all facial fractures in the literature. Objectives: To analyze the pattern of pediatric facial fractures and compare the results with similar studies performed in India and the rest of the world. Materials and Methods: A total of 231 patients were admitted for the treatment of maxillofacial fractures. Data on etiology, anatomical location, mode of treatment, duration of stay, and X-ray advice were recorded. Results: Pediatric trauma comprised 27% of the total population. The most common cause of injury was road traffic accident (RTA), that is, 28 (43.8%) patients. Conclusion: The incidence of pediatric facial trauma is high in the hilly Garhwal-Himalayan region of Uttarakhand state in India as compared to other states of India.

Changing trends in maxillofacial injuries among paediatric, adult and elderly populations: A 22-year statistical analysis of 3424 patients in a tertiary care centre in Northwest Italy.

BACKGROUND: This retrospective study analysed the epidemiology of maxillofacial trauma over 22 years to assess whether there have been significant changes in the causes and characteristics of fractures in paediatric, adult and elderly populations. MATERIALS AND METHODS: The following data were collected: age, sex, injury cause and mechanism, fracture site, Facial Injury Severity Scale, associated injuries, time of injury, type of treatment and length of hospital stay. The patients were analysed by age group (children [≤16 years], adults [17-60 years] and elderly [>60 years]) and divided into two time groups (group 1: 2001-2011; group 2: 2012-2022) that were compared to each other. Statistical analyses were performed using SPSS software. RESULTS: Between 01 January 2001 and 31 December 2022, 3535 patients (2690 males and 845 females, mean age 39.3 years) were admitted for facial fractures. The comparison of the two temporal periods showed a decrease in the prevalence of males (p = .02), in road traffic injuries (p < .001), and in fractures of the lower third of the face (p = .005); there were significant increases in the mean age (p < .001), prevalence of the elderly (p = .006) and in fall- and assault-related injuries (p < .001 and p = .03, respectively). Assault injuries increased only in the 17-60 age group (p = .02) while RTA-related fractures decreased in all age groups (p < .05 for all comparisons). Bicycle accidents increased significantly, with a parallel decrease in motor vehicle accidents (both p < .001). Fall-related fractures increased only in 17-60 and >60 age groups (p < .001 and p = .02, respectively). CONCLUSIONS: This study shows significant changing trends in the epidemiology of maxillofacial trauma. While road traffic policies have been effective in the last years, preventive measures for falls in the elderly population and new legislative measures to prevent interpersonal violence should be advocated.

Age Effects in Facial Fracture Trauma: Disparities in Multisystem Injuries in Non-Fall-Related Trauma.

Background and objective Facial fractures represent a growing concern among an aging population prone to falls. In light of this, this study aimed to investigate differential facial fracture patterns and outcomes based on age effects. Determining the differences between the severity and type of facial fractures in populations of different ages will help guide clinical decision-making when managing patients with facial fractures. Methods This was a single-center study involving trauma registry data, from July 1, 2016, to January 31, 2022. The inclusion criteria were based on the International Classification of Diseases (ICD-10) diagnosis of facial fracture. A linear regression was performed to ascertain the effects of predictor variables on the likelihood that a facial fracture trauma patient would experience various age effects on injury location, mortality, and morbidity. Results A total of 1575 patients were included in the analysis. A significant regression equation was found (F(47,1476)=42.46, p<0.01), with an R2 of 0.57. Older facial fracture trauma patients were more likely to be female (ß=3.13, p<0.01) with fractures to their zygoma (ß=2.57, p=0.02). Higher Abbreviated Injury Scale (AIS) facial region scores (ß=2.21, p=0.03), longer hospital length of stay (ß=0.07, p=0.02), and in-hospital mortality (ß=10.47, p<0.01) were also associated with older age. Older age was additionally associated with a higher level of several morbidity markers. Younger facial fracture trauma patients were more likely to be African American (ß=-5.46, p<0.01) or other, non-Caucasian race (ß=-8.66, p<0.01) and to have mandible fracture patterns (ß=-3.63, p<0.01). The younger patients were more likely to be fully activated (ß=-3.10, p<0.01) with a higher shock index ratio (SIR) (ß=-7.36, p<0.01). Injury mechanisms in younger facial fracture patients were more likely to be assault (ß=-12.43, p<0.01), four-wheeler/ATV accident (ß=-24.80, p<0.01), gunshot (ß=-15.18, p<0.01), moped accident (ß=-13.50, p<0.01), motorcycle accident (ß=-12.31, p<0.01), motor vehicle accident (ß=-16.52, p<.01), or pedestrian being struck by a motor vehicle (ß=-10.69, p=0.02). Conclusions Based on our findings, age effects impact facial fracture patterns and outcomes. Younger patients are more likely to experience multisystem injuries via non-fall trauma. On the other hand, older patients are more likely to experience more severe primary facial injuries. Older patients are also at a higher risk of fall-related trauma. Disparities also exist between genders and races, with male and non-Caucasian patients being at a higher risk of injury from facial fractures at a younger age. With an aging population, the prevalence of falls is likely to increase. Thus, facial fractures represent a growing healthcare burden and warrant future investments related to care and treatment.

Retrospective Study of Orbital and Orbitozygomaticomaxillary Complex Fractures Treated at Aalesund Hospital Between 2002 and 2017.

Study Design: Retrospective study. Objective: To evaluate patient demographics, surgical management, and complications of orbital and orbitozygomaticomaxillary complex (OZMC) fractures treated at a district hospital in Norway. Methods: The medical records of patients with orbital fractures treated at Aalesund hospital between January 2002 and July 2017 were reviewed. Data on demographics, signs and symptoms, cause of injury, fracture type, associated fractures, surgical management, and complications were collected. Results: A total of 36 patients were reviewed. Males predominated (1:4.1), and fractures occurred mostly in patients 40-59 years (mean 41.8 years). Interpersonal violence was the leading cause of injury, followed by falls. Alcohol was significantly associated with assault caused fractures (P = .001). Orbitozygomaticomaxillary fractures were the most frequent, followed by pure orbital fractures. Clinical findings included periorbital ecchymosis (72%), swelling (56%), sensory nerve dysfunction (53%), diplopia (22%), and restricted eye motility (22%). Commotio cerebri was observed in more than half of our sample and 47% had other facial bone fractures. Referral to tertiary hospitals was done in 19% of the cases. The main treatment done was open reduction and internal fixation (ORIF) (45%). Infection was diagnosed in 17% and managed with antibiotics. Conclusions: The incidence of orbital and OZMC fractures in Moere and Romsdal county in western Norway was low, occurring mainly in males over 40 years. The mechanism of injury was predominantly interpersonal violence and falls. A high proportion of the sample had minor traumatic brain injury (mTBI).

Fractures in professional footballers: 7-years data from 106 team seasons in the Middle East.

Epidemiological studies on fractures in European professional football (soccer) are in abundance. However, such data are lacking in Middle Eastern professional footballers and information on fracture treatment is scarce. The aim of this study is to describe the epidemiology of fractures across seven seasons in Qatar Stars League (QSL) footballers. A prospective study of fractures in professional male footballers over 7 consecutive seasons (2013 to 2020), involving 3255 players and 106 team' seasons. Time loss and injuries and illnesses were recorded using standardised digital tools in accordance with international consensus procedures. Fractures were recorded according to onset mechanism, location, diagnoses, treatment and return to play. A total of 108 players sustained fractures during 638,247 hours of player exposure (88.9% training and 11.1% matches), representing 2.7% of all time-loss injuries. The incidence was 0.17 fractures per 1000 h of exposure (match and training incidence of 0.9 and 0.07 fractures / 1000 h, respectively), equivalent to an average of one fracture per team per season. Fractures mostly occurred in the feet (28.2%), hands (21.1%), shoulders (11.3%) and head (i.e., face) (9.9%). Mean (median) absence was 71 (47 days), with 4.6% refractures. Only 34.3% of the fractures required surgery and nearly all players (98.1%) returned to play at the professional level. Almost all professional football players with fractures return to play at the same competitive level after an average of 10 weeks of absence (mean absence was 71 ± 81 (median: 47, Inter Quartile Range [14-93]) days). One in ten continue to play with symptoms and one in twenty may refracture. Long-term effects of fractures are still unknown.

Perioperative Management of Patients with Craniomaxillofacial Trauma.

Successful surgical management of patients with facial fractures requires a detailed preoperative evaluation and postoperative management that differs from elective surgical patients. This review presents evidence-based recommendations from the surgical and anesthesiology literature that address many of the clinical questions that arise during the perioperative management of this group of patients. Surgeons and anesthesiologists must work together at numerous points and make joint decisions, especially where airway and pain management challenges may arise. The multidisciplinary nature of the decision-making process is emphasized.

Retirada de elementos de osteosíntesis asociados a cirugías de trauma maxilofacial en hospital público de Santiago de Chile. Estudio retrospectivo de 4 años / Removal of osteosynthesis elements associated with maxillofacial trauma surgery in a public hospital in Santiago, Chile. Retrospective study of 4 years

Introducción: El manejo quirúrgico del trauma maxilofacial implica el uso elementos de osteosíntesis (OTS) para la reducción abierta y fijación interna rígida. Sin embargo, existen razones que determinan su retirada. El objetivo de este estudio fue evaluar la prevalencia de la retirada del material de osteosíntesis y sus causas en el Hospital San José de Santiago de Chile entre los años 2018 y 2021.Metodología: Estudio retrospectivo descriptivo. Se seleccionaron pacientes intervenidos quirúrgicamente por trauma maxilofacial durante el periodo de 4 años. Se analizaron número de pacientes operados, edad, género, comorbilidades, sitio de fractura, cantidad de cirugías de retirada y tiempo en posición de dichos elementos. Referente a la remoción, se obtuvo localización y etiología.Resultados: Las cirugías por trauma maxilofacial correspondieron a 176; de estas, 17 (9,66 %) requirieron la retirada de OTS, retirando un total de 19 elementos. La edad promedio fue 36,5 años. El género masculino predominó sobre el femenino (3,25:1). La zona anatómica frecuente de retirada fue la mandíbula (94,7 %), especialmente el ángulo mandibular. Las principales causas fueron exposición de placa y/o tornillos y la infección del sitio quirúrgico (36,8 %). La mayoría de las retiradas de OTS ocurrieron antes de los 12 meses (84 %) con un tiempo promedio en posición de 10,23 meses.Conclusiones: Los resultados encontrados muestran una baja prevalencia de la retira de OTS, los hombres son los más afectados, el sitio anatómico de retiro frecuente es el hueso mandibular, las causas principales son la exposición de la placa o infección. Estos hallazgos son concordantes con lo reportado en la literatura. (AU)

Introduction: Surgical management of maxillofacial trauma involves the use of osteosynthesis elements (OTS) for open reduction and rigid internal fixation. However, there are reasons that determine their removal. The aim of this study was to evaluate the prevalence of osteosynthesis material removal and its causes at Hospital San José in Santiago de Chile between 2018 and 2021.Methodology: Retrospective descriptive study. Patients who underwent surgery for maxillofacial trauma during the 4-year period were selected. The number of operated patients, age, gender, comorbidities, fracture site, number of removal surgeries and time in position of these elements were analyzed. Regarding removal, location and etiology were obtained.Results: There were 176 surgeries for maxillofacial trauma, of which 17 (9.66 %) required the removal of OTS, removing a total of 19 elements. The average age was 36.5 years. The male gender predominated over the female (3.25:1). The frequent anatomical area of removal was the mandible (94.7 %), especially the mandibular angle. The main causes were plaque and/or screw exposure and surgical site infection (36.8 %). Most OTS removals occurred before 12 months (84 %) with an average time in position of 10.23 months.Conclusions: The results found show a low prevalence of OTS removal, males are the most affected, the frequent anatomical site of removal is the mandibular bone, the main causes are plaque exposure or infection. These findings are consistent with those reported in the literature. (AU)

Head & Neck Trauma in the Geriatric Population.

Craniofacial trauma in the geriatric population is increasing as our population ages. Due to loss of bone quality and medical comorbidities, injuries for minor trauma can be severe. A more extensive medical evaluation is usually warranted in this population before proceeding with surgery. In addition, unique surgical considerations exist in the repair of atrophic and edentulous bony fractures. Some quality improvement measures have already been undertaken but more is needed to help standardize care in this vulnerable population.

Pediatric Panfacial Fractures.

Pediatric panfacial trauma is a rare occurrence with poorly understood implications for the growing child. Treatment algorithms largely mirror adult panfacial protocols with notable exceptions including augmented healing and remodeling capacities that favor nonoperative management, limited exposure to avoid disruption of osseous suture and synchondroses growth centers, and creative fracture fixation techniques in the setting of an immature craniomaxillofacial skeleton. The following article provides a review of our institutional philosophy in the management of these challenges injuries with important anatomic, epidemiologic, examination, sequencing, and postoperative considerations.

Patterns and Trends of Facial Fractures at a Tertiary Care Trauma Center in India - A 13 years Retrospective Study.

Study Design: Retrospective study. Objective: The purpose of this study was to retrospectively analyze the prevalence, pattern, diagnosis, and treatment of the facial fractures falling under ambit of facial plastic surgery in a multi-specialty hospital at India from the year 2006-2019. Methods: This retrospective study analyzed 1508 patients, having orbital fractures (from 2006 to 2019) for demographic data, cause of trauma, type of fracture, and the treatment given. The data were compiled in excel and analyzed by using SPSS version 21.0. Results: Out of these 1508 patient (1127 (74.73%)-males and 381 (25.27%)-females), the etiology of injuries was Road traffic accident (RTA) (49.20%), assault (26.52%), and sports injuries (11.47%). The most common fracture pattern was Isolated Orbit and/or Orbital Floor fracture in 451 patients (32.08%), followed by Mid-facial fractures (21.93%). Also, 105 patients (6.96%) experienced ocular/retinal trauma along with other fractures. Conclusions: Orbit, peri-ocular, and mid-face trauma comprised a large position of this study. It requires a great deal of expertise to treat such complex trauma, which is not covered in one specialty alone. Hence, a holistic approach of craniofacial fracture management, rather than limiting these skills to water-tight craniofacial compartments becomes necessary. The study highlights the critical need of multidisciplinary approach for predictable and successful management of such complex cases.

Emergency Facial Injuries in Athletics.

Dental and oral injuries are a common occurrence in sport. Initial evaluation should always begin with an assessment of the patient's airway, breathing, circulation, as well as identification of associated injuries. Tooth avulsions are the only true dental emergency. Oral lacerations frequently do not require repair; however, special attention should be paid to lip lacerations involving the vermillion border. Most tooth and oral lacerations can be treated on the field with urgent referral to a dentist.

Choroidal Rupture in the Setting of Multi-Trauma.

Herein the authors call attention to the importance of ophthalmic evaluation in the setting of multi-trauma, particularly with facial and orbital fractures. In institutions such as ours, a tertiary general hospital, where such fractures are initially managed by a non-ophthalmic team such as trauma or maxillofacial surgeons, we would advocate for prompt referral to the ophthalmology team for assessment as described by our case of a choroidal rupture in the setting of multi-trauma.

Trauma Characteristics Associated with E-Scooter Accidents in Switzerland-A Case Series Study.

E-scooters have gained popularity worldwide in the last few years. Due to the increase in users, more accidents related to e-scooters can be observed. The present study aimed to analyse epidemiological data, characteristics, and severity of injuries in patients admitted to a Level I trauma centre in Switzerland (Inselspital Bern, University Hospital Bern) after accidents associated with e-scooters. This retrospective case series evaluated 23 patients who presented to the University Hospital of Bern between 1 of May 2019 and 31 of October 2021 after an e-scooter accident. Data were collected on patient demographics, time and cause of the accident, speed, alcohol consumption, helmet use, type and localisation of injury, number of injuries per patient, and outcome. Men were most frequently affected (61.9%). The mean age was 35.8 (STD 14.8) years. Slightly more than half (52.2%) of all accidents were self-inflicted. Most accidents were reported during the night (7 p.m. to 7 a.m., 60.9%) and in summer (43.5%). Alcohol consumption was reported in 43.5% of cases, with a mean blood alcohol level of 1.4 g/l. Most injuries were observed in the face (25.3%) and head/neck area (20.25%). Skin abrasions (56.5%) and traumatic brain injury (43.5%) were the most common types of traumata in terms of total number of patients. Only in one case it was reported that a protective helmet had been worn. Five patients required hospitalisation and four patients underwent surgery. Three patients underwent emergency orthopaedic surgery, and one patient underwent emergency neurosurgery. E-scooter accidents result in a significant number of facial and head/neck injuries. E-scooter riders would potentially benefit from a helmet to protect them in the event of an accident. Additionally, the results of this study indicate that a significant number of e-scooter accidents in Switzerland occurred under the influence of alcohol. Prevention campaigns to raise awareness of the risks of driving e-scooters under the influence of alcohol could help prevent future accidents.