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Most maxillofacial traumas are caused by road traffic collisions and, in particular, by motorcycle accidents. Helmets represent an efficient protective tool in these traumas but they do not provide complete protection. The aim of this study was to perform an epidemiological analysis of facial fractures pattern in relation to the helmet type worn during the accident. The study was a retrospective analysis of 282 patients with a diagnosis of maxillofacial fracture caused by a motorcycle accident. The patients were divided in three groups based on helmet type (Group A: full-face helmet; Group B: modular [half-face] helmet; Group C: open-face helmet). For each group, fractures type and trauma severity, using the Comprehensive Facial Injury (CFI) scale, were recorded. Results showed that isolated midface fractures were strongly related to full-face helmet wearing (p < 0.001), while mandibular fractures and panfacial trauma/combined fractures were negatively correlated (p < 0.001). Mandibular fractures (p < 0.001) and panfacial trauma/combined fractures (p < 0.001) were strongly related to open helmet. Moreover, severe trauma (CFI 8.16) was recorded for open-face helmet wearing. In conclusion, full-face helmet wearing reduced the risk of facial fracture, in particular panfacial trauma/combined fractures, while open-face helmet wearing increased the risk of these fractures., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2024 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Purpose: Trauma accounts for the leading cause of morbidity and mortality worldwide in the present day and may rightly be called the new pandemic. The prominent nature of the face exposes it to various traumatic injuries. A timely, prompt diagnosis along with employment of correct and quick treatment greatly improves the outcome for these patients. The aim of this retrospective study was to analyse the characteristics of maxillofacial injuries over a decade., Methods: The data were collected manually from the medical records of patients who reported to the tertiary centre from 1 January 2011 to 31 December 2019. All injured patients irrespective of age/gender with complete hospital records of clinical and radiographical diagnosis of maxillofacial injuries were included. The demographic data, etiology, site and type of injury, and seasonal variation were analyzed. Data were tabulated into 6 age groups (0 - 7 years, 8 - 18 years, 19 - 35 years, 36 - 40 years, 41 - 59 years, and > 60 years). Five etiological factors, i.e. road traffic accidents, falls, assaults, sports-related, and occupational accidents, were further evaluated based on genders. Facial injuries were classified into 6 types: panfacial fractures, mandibular fractures (subcategorized), midface fractures (subcategorized), dentoalveolar fractures, dental injuries, and soft tissue injuries. The monthly and seasonal variation of the injuries was also charted. Data were expressed as frequency and percent., Results: A total of 10,703 maxillofacial injuries were included from the tertiary centre from the period of 2011 - 2019, including 8637 males and 2066 females, with the highest occurrence in the 19 - 35 years age group. Road traffic accident was the principal etiological factor of maxillofacial injuries in both genders (80.5%), followed by falls (9.6%), assaults (8.0%), occupational accidents (1.2%), and sporting injuries (0.7%). Midface fractures accounted for 52.5% (5623 fractures), followed by mandibular fractures (38.1%)., Conclusion: The current study describes a change in the incidence of maxillofacial injuries along with variation in the demographic data. The implementation of safety gears and stricter traffic laws along with public awareness may aid in the reduction of maxillofacial injuries., (Copyright © 2022 Chinese Medical Association. Production and hosting by Elsevier B.V. All rights reserved.)

In India, 21.20% of annual road traffic accidents (RTA) result in maxillofacial injuries, with most victims being young adults aged 18-45 years. Such RTAs cause personal losses to individuals and families and adversely impact the country's health system facilities. These losses result from the expenses for medical care, lost wages for individuals who are rendered unable to work, and lost productivity for family members who must miss work or school in order to care for the injured. Most nations lose 3% of their gross domestic product to road accidents. RTA injuries, often associated with severe morbidity, cause functional impairments and have immense psychological impact. Rehabilitating these patients and their future treatment needs constitute an economic burden to themselves and their families, more so in a developing country like India, where a majority of the population cannot afford the treatment costs and lack health insurance coverage. These injuries therefore, as defined by the International Classification of Functioning, Disability and Health 2001, fall within the ambit of impairment and disability. However, Indian law does not identify maxillofacial injuries and the ensuing trauma as disabilities. Addressing this could be an important step towards improvement in the care and compensation provided to survivors of such life changing accidents.

Background: The oral and maxillofacial complex is subject to a range of traumas. Injuries to the region are devastating and have a great impact on social health outcomes. This review intends to investigate the aetiologies of maxillofacial trauma across Australia., Methods: This review was written in accordance with the PRISMA-ScR. Comprehensive searches of CINAHL, MEDLINE, Ovid, Scopus, and Web of Science databases were conducted to identify potentially relevant literature. Quantitative observational epidemiological studies were sought and were required to include at least one aetiology to the maxillofacial region in their data set. A total of 31 eligible studies were included., Results: The greatest recorded causes of maxillofacial injuries included inter-personal violence (34.98%) falls (20.87%), sports (15.62%), and motor-vehicle accidents (14.31%). These four aetiologies cumulatively accounted for more than 85% of maxillofacial injuries. From all sustained injuries (n = 7661), the orbit was the most prevalent site of fracture (31.85%), followed by the zygoma (22.01%), mandible (21%), nasal bone (12.45%), maxilla (10.04%), dentoalveolus (1.84%), antrum (<1%), and frontal bone (<1%)., Conclusion: Violence was an unprecedented cause of trauma-additional research is recommended to further characterize the correlation between the two variables. Research is also recommended specifically in regional/rural communities, where data was particularly limited. © 2024 Australian Dental Association., (© 2024 The Authors. Australian Dental Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Dental Association.)

Introduction: Shared vehicles, such as e-scooters and electric bicycles, could potentially accelerate the transition toward sustainable mobility. Focusing on e-scooters, the aim of this study is to show, compared with previous years when e-scooter use was significantly reduced, the increased incidence of maxillofacial bone injuries from e-scooters and the most frequent type of fractures., Methods: We conducted a monocentric observational retrospective and prospective analysis during the pandemic, from January 1, 2020, until December 31, 2022, on patients' access for maxillofacial traumas at the San Giovanni Addolorata emergency department, trauma hub center, for Lazio district. A total of 383 patients were included. Data on the causes of traumas, type of injury produced, age, gender, nationality, and helmet use were collected. Especially, we analyzed the e-scooter-related facial traumas that had gained a lot of popularity in this period due to the restriction in mobility because of Covid-19, subsequent reduced use of public transport, and the new benefits introduced by the government for e-scooters or bikes. We compared e-scooter facial trauma with all the other kinds of facial fracture etiologies during this period., Results: In our study, the most frequent causes of trauma were assaults (32.6%), accidental falls (24.2%), and sports activities (7.8%). The percentage of trauma among road traffic injuries was almost 24% of the total; in particular, motorcycle/e-scooter traumas was 7.1%, car crashes was 5.5%, pedestrian hits was 4.2%, and bike accidents was 3.1%. Other causes detected were syncope (5.5%), accidental traumas (1.8%), and epileptic crisis (1.1%). Focusing on road traffic injury access in our emergency department, compared with those between 2017 and 2019, it emerged that e-scooter-related facial traumas in the past two years have had a remarkable rise. In fact, there was a total of 27 patients (52% male and 48% female) instead of 5 between 2017 and 2019. The average age was 29 years. The most frequent types of e-scooter-related fractures were those to the nasal bones (29.7%), followed by mandibular fractures (unifocal 7.4%, bifocal 18.5%, trifocal 7.4%, and condylar 7.4%), zygomatic-maxillo fractures (18.4%), complex fractures (7.4%), and maxilla (3.7%). Among 27 observed electric scooter riders, nobody wore a helmet., Conclusions: Injuries associated with the use of e-scooters are a new phenomenon and mainly affect the craniofacial region due to the dynamic nature of the trauma. Although these vehicles have become increasingly common over the years and accepted within regulatory frameworks, the traffic rules are not ready to integrate e-scooters into the transport systems due to the lack of adequate legislation, and the lack of implementation in the form of facial safety devices or safety skills training for e-scooter riders., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 by Mutaz B. Habal, MD.)

Abstract: The purpose of this prospective multicenter study was to analyze the epidemiology, patterns, and management of maxillofacial fractures due to road traffic accidents (RTAs) worldwide.Between Monday September 30, 2019 and Sunday October 4, 2020,1066 patients with RTAs related fractures were admitted to 14 maxillofacial surgery departments. The following data were analyzed: age, gender, mechanism of injury, alcohol or drug abuse at the time of trauma, maxillofacial fracture site, facial injury severity scale (FISS) score, associated injuries, day and month of trauma, time of treatment, type of treatment and length of hospital stay. Data were analyzed using bivaried and multivaried statistical analysis.Eight hundred seventy patients were male, and 196 were female. The most common mechanism of injury was motorcycle accidents (48%). More than half of the patients had fractures of the middle third of the maxillofacial skeleton. In total, 59% of the study sample underwent open reduction internal fixation. The median facial injury severity scale (3 points) and the medial hospital stay (3 days) were significantly lower in patients with seatbelts and helmet (P  < 0.001).This first prospective, multicenter epidemiological study shows that motorcycle accidents are the leading cause of RTAs related fractures, mostly in young males. Particularly in Australia and Europe, the incidence of RTAs was significantly lower. Moreover, this study found that the severity of maxillofacial lesions was significantly higher in patients without safety devices, with consequent longer hospital stay demonstrating the efficacy of road safety policies in preventing maxillofacial injury., Competing Interests: The authors report no conflicts of interest., (Copyright © 2021 by Mutaz B. Habal, MD.)

Introduction: Maxillofacial fractures are often associated with severe morbidity, functional deficit, disfigurement and significant financial implications. The aim of this review was to investigate whether the aetiology, prevalence and management modalities of facial trauma can identify the common causes of facial trauma with a view to recommending measures to the appropriate governing bodies to change the current practice wherever possible., Methods: The records of 1,112 patients referred to our oral and maxillofacial unit in Andhra Pradesh, India, between February 2008 and October 2017 were analysed retrospectively. Data including age, sex, aetiology, fracture site and treatment were evaluated., Results: Men aged 20-40 years were the most common victims of facial trauma. Road traffic accidents (RTAs) were responsible in 70% of cases. Mandibular fractures constituted 47% of the overall fractures, and 55% of the total fractures were treated with open reduction and internal fixation., Conclusions: The main cause of maxillofacial injury among patients reporting to our hospital was RTAs. Mandibular fractures were the most common, accounting for almost half of the cases. Over half (55%) of all maxillofacial fractures were treated with open reduction and internal fixation. Reasons for this high frequency may include the large number of poorly maintained, overloaded vehicles on unsuitable roads, violation of traffic regulations (particularly by inexperienced young drivers), abuse of alcohol or other intoxicating agents and the sociocultural behaviours of some drivers.

Introduction: Maxillofacial injury is one of the commonest causes of surgery performed by an oral and maxillofacial surgeon. Socioeconomic conditions, cultural variation, age, and gender affect the etiology of the injury. The study is aimed to find the prevalence of facial injury that is operated by the oral and maxillofacial surgeons in the College of Medical Sciences and Teaching Hospital, Bharatpur, Chitwan, a tertiary hospital., Methods: A descriptive cross-sectional study was performed using the chart from the hospital registry for the patient being operated under general anesthesia from April 1, 2017, to March 2019. Simple random sampling was done using computer-generated random numbers. Ethical approval was received from the Institutional Review Committee of the hospital. The Data for the reason for surgery, age, age groups etiology, and tissue involvement were analyzed using Statistical Package for the Social Sciences version 20., Results: Facial injury occupies 378 (71.59%) of the total operation performed by Oral and Maxillofacial surgeon in a tertiary hospital. Soft tissue 196 (52.85%) and facial bone fracture 182 (48.15%) is distributed among the facial injuries. Young adults are commonly affected, and the road traffic accident is the major cause of facial trauma., Conclusions: Facial injury-related surgeries are more prevalent in the tertiary hospital of Bharatpur.

Objectives: It was the aim of the study to analyse the prevalence of maxillofacial trauma (MFT) in severely injured patients after road traffic accidence (RTA) and to investigate associated factors., Materials and Methods: In a retrospective study, data from patients after RTA by the TraumaRegister DGU® from 1993 to 2014 were evaluated for demographical and injury characteristics. The predictor variable was mechanism of injury and the outcome variables were type of injury, severity and hospital resources utilization., Results: During the investigation period, n = 62,196 patients were enclosed with a prevalence of maxillofacial injuries of 20.3% (MFT positive). The injury severity score of MFT-positive patients was higher than in the MTF-negative subgroup (27 ± 12.8 vs. 23.0 ± 12.7). If MFT positive, 39.8% show minor, 37.1% moderate, 21.5% serious and 1.6% severe maxillofacial injuries. Injuries of the midface occurred in 60.3% of MTF-positive patients. A relevant blood loss (> 20% of total blood volume) occurred in 1.9%. MFT-positive patients had a higher coincidence with cervical spine fractures (11.3% vs. 7.8%) and traumatic brain injuries (62.6% vs. 34.8%) than MFT-negative patients. There was a noticeable decrease in the incidence of facial injuries in car/truck drivers during the study period., Conclusions: Every 5th patient after RTA shows a MFT and the whole trauma team must be aware that this indicates a high prevalence of traumatic brain and cervical spine injuries., Clinical Relevance: Even if sole injuries of the face are seldom life threatening, maxillofacial expertise in interdisciplinary trauma centres is strongly recommended.

Background: Every year, there are significant numbers of motorcycle accident casualties in Taiwan. These accidents are the leading cause of maxillofacial trauma. Age should be an important factor of maxillofacial fracture patterns yet there is limited literature on the topic. Therefore, this study aims to evaluate the correlation of age with maxillofacial fracture in motorcycle accidents., Methods: This is a retrospective descriptive analysis conducted over 2-year period at Linkou Chang Gung Memorial Hospital. We focused on the population of maxillofacial injury caused by motorcycle accidents. Data, including demographics, age, fracture patterns of facial bones, and other associated injuries, were collected., Results: Among 881 admissions, there were 179 patients in the minor group, 644 patients in the adult group, and 58 patients in the geriatric group. With patterns of maxillofacial fracture, midface fracture was the most common type. The minor group had higher incidence of mandibular fracture. The geriatric group sustained more midface fracture. Associated injuries, such as severe head injuries and c-spine injury, were more likely to occur with the old age victims. The overall mortality rate was 3.1%., Conclusions: Our study presents the different trends of fracture patterns in different age groups, which is associated with different types of treatment required. We summarized all these data in the hope of providing further assistance to trauma doctor dealing with motorcycle accidents.

Understanding facial trauma behaviors in different populations can help enhance effective prevention and efficient management of public resources in order to offer better treatment in large health systems. The aim of this study was to assess the epidemiology of maxillofacial trauma treated by a public health emergency care service. A cross-sectional study was conducted to assess maxillofacial trauma in patients treated by a public health service of emergency care at a midsize city in southern Brazil. Facial trauma records were retrieved directly from medical records from January 2010 to April 2014. The following variables were collected: patient age, sex, destination of patient after initial treatment, cause of trauma, and type of injury. Statistical analyses were performed using G tests with Williams' corrections (p < .05). The most frequent cause was road traffic collision (39.6%), followed by falls (33.6%) and interpersonal violence (22.0%). The prevalence of falls was higher in older adults. A statistically significant association was observed between age and causes (p < .05). After the initial care provided by the prehospital service, 44.1% of the patients were referred to secondary care centers and 40.1% to hospitals. Traffic accidents were the most common cause of facial trauma in Brazil, with a higher prevalence in young men. Falls were also a big concern for facial injuries, especially among older adults. Although most lesions could be classified as minor trauma, many patients are being treated at hospitals, which may increase the costs to the public health system.

Background: The aim of this study is to review motor-vehicle accident-related maxillofacial injuries (MVA-MFI) trauma cases and to investigate whether the growing population and traffic congestion, as well as differences in driving practice, vehicle safely devices and infrastructure facilities might differentially affect the pattern of MVA-MFI among Jewish and Arab populations., Methods: This retrospective study reviews maxillofacial injuries (MFI) identified among all trauma patients who were admitted to Hadassah Ein Kerem hospital, Jerusalem, between the years 2000 to 2013., Results: Out of 29,997 trauma patients, 1,720 presented with MFI, with motor-vehicle accident (MVA) being the major cause of injury (705 patients, 41%). Their mean age was 29.9±21.0 years with a prominent male and Jewish predominance (4.3:1 and 1.8:1, respectively). Most MVA-MFI casualties were car drivers (41%), followed by pedestrians (30%). Pedestrians with MVA-MFI were mainly children and aged persons, whereas drivers were mainly adults. Males and Arabs were more likely to present with higher injury severity score (ISS). Safety belts were not used in the majority of car MVA-MFI patients (54%). Yet, the ISS score did not correlate with the use of safety devices. Mandibular fractures were the most common (21%), followed by nasal bones (20%), zygoma (17%), orbit (16%), maxilla (15%) and teeth (11%). Age was significantly associated with increased maxillary and nasal fractures and with decreased incidence of mandibular and teeth fractures., Discussion: Based on our review, young males and specifically Arab patients suffered from MFI and high ISS scores as a result of MVA. The findings and their interpretations are discussed.

Purpose: The purpose of this retrospective study was to analyze the epidemiology, patterns, and management of maxillofacial due to road traffic accidents over a 17-year period., Methods: Between January 2001 and December 2017, 2924 patients with maxillofacial fractures were admitted to the Division of Maxillofacial Surgery, Turin, Italy.The following data were analyzed: age, gender, data of the trauma, alcohol and drug abuse, mechanism of injury, fracture site, facial injury severity scale, associated injuries, type of treatment, and length of hospital stay., Results: Of the 605 patients included in the study, 419 were male and 186 were female (ratio, 2.2:1). The most common mechanism of injury was car accidents (62.6%).More than half of the patients had fractures of the middle third of the maxillofacial skeleton.Associated injuries were detected in 172 (45.5%) patients. In total 5.3% of patients did not undergo surgery. The average hospital stay was 7.3 days., Conclusions: This study shows an important reduction in maxillofacial fractures following road traffic accidents since the turn of the new millennium. At least in north-western Italy, road safety policies implemented in the last 30 years seem to have affected the behavior of motorists and motorcyclists.

Aim: This study aimed to evaluate the scientific evidence regarding the risk factors for maxillofacial injuries among victims of traffic accidents., Method: A systematic review of articles published until February 2017 was carried out in the following databases: PubMed, Web of Science, Scopus, and Cochrane Library. Studies were selected by two independent reviewers (ϰ = 0.841). The risk of bias in the selected studies was assessed using an adapted version of the Newcastle-Ottawa Scale for observational studies., Results: A total of 2703 records were found, of which only three articles fulfilled the inclusion criteria and were analyzed, including 422 244 patients. The male/female ratio ranged from 3.4: 1 to 6: 1. All eligible studies performed the multivariate statistical analysis. Eleven risk factors for maxillofacial traumas were identified: victim's gender (P < 0.05), age group (P < 0.05), residence region (P < 0.05), impact characteristics (P < 0.05), increased net change in velocity due to collision (P < 0.05), increase in occupant's height (P < 0.05), nonuse of protective equipment (P < 0.05), type of accident (P < 0.05), time of occurrence (P < 0.05), lesion severity (P < 0.05), and occurrence of concomitant lesions (P < 0.05)., Conclusion: The results suggest that sociodemographic characteristics, as well as those related to the collision patterns and circumstances of traffic accidents, may influence the occurrence of maxillofacial injuries. However, the results should be interpreted with caution due to the high heterogeneity among studies., (© 2018 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.)

Background/aims: Road traffic accidents are considered a major cause of oral and maxillofacial trauma. Given that many traumatic injuries and deaths involve motorcyclists, the aim of this study was to investigate this vulnerable group in terms of oral and maxillofacial injuries following accidents., Materials and Methods: This cross-sectional study was conducted on 330 patients with oral and maxillofacial injuries at Shahid Rajaee Hospital in Shiraz, Iran, from April to September 2017. A questionnaire with questions regarding age, gender, helmet use, and driver's license was completed for all the patients and their injury type (including dental injuries). Data were analyzed using descriptive statistics and the chi-squared test with a significance level of 95%., Results: Of the 330 patients, 291 (88.2%) were male and 39 (11.8%) were female. There were 283 (85.75%) patients aged 21-30 years, and their mean age was 27.2 ± 6.5. Most of them (287, 87%) had not been wearing helmets at the time of the accident. Dental injuries were observed in 168 (50.9%) of the patients. Uncomplicated crown fractures were diagnosed in 25.4% of the patients, luxation injuries in 23.2%, and avulsion in 18.9%. Only 19.9% of the patients under the age of 25 had suffered facial injuries., Conclusion: Most injuries in motorcycle accidents were dental trauma in men due to not wearing a helmet. Dental injuries had the highest frequency of damage., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Maxillofacial injury poses a challenge to oral and maxillofacial surgeons working in developing countries with limited resource and human power. The present study aimed to determine the etiology, pattern, and management of maxillofacial trauma in Gondar university of Gondar hospital., Methods: A retrospective descriptive study design was used. Medical registration retrieving of patients with maxillofacial trauma visited dental center of University of Gondar Hospital from September 2013 to August 2015 was done. During data collection, etiology of trauma, pattern of fracture, treatment modality and complications were recorded using predesigned data collection template and analyzed using SPSS computer software version 20. Statistical analysis was done to show the sex distribution of maxillofacial trauma and the effect of alcohol intake on the incidence of trauma., Results: During 2-year period, September 2013-August 2015, 326 patients of maxillofacial trauma were treated in the dental center of university of Gondar hospital. The mean age was 29.12 (± 8.62) with age range of 11-75 years. Majority of the study participants (47.2%) were within the age group of 21-30 years. Eighty percent of the participants were male with a male to female ratio of 4.02:1. Interpersonal violence (75.8%) and Road traffic accident (21.5%) were the leading causes. Males are at high risk of maxillofacial trauma relative to females (P < 0.0001). There was high incidence of trauma in the weekend, rural residents, December to February, mandibular fractures and soft tissue injuries were the most common injuries. There was an associated injury in 79 (24.2%) patients in head and neck area, thoracic, abdominal and extremities. Half of the patients were managed conservatively (49.7%) with debridement and suture, while 45.7% of the patients were closed reduction and 4.6% were surgical open reduction. There were 25 post procedure complications especially in mandibular fractures., Conclusion: Interpersonal violence was the major cause of maxillofacial trauma, while mandible and soft tissue were the most affected maxillofacial areas. The federal ministry of health, Ethiopia should have well-organized maxillofacial center in tertiary hospitals for emergency management to avoid morbidity and mortality.

Introduction: Previous reports indicated that there is geographic and sociodemographic variation in the epidemiology of maxillofacial fractures. Audit of maxillofacial injuries managed at any institution is therefore necessary to understand the trends and proffer strategies for prevention. We therefore embarked on this study to determine the pattern of maxillofacial fractures and concomitant injuries in our institution., Methods: We carried out a retrospective review of information on demography, aetiology and type of maxillofacial fracture, patients' status, type of crash, level of consciousness and concomitant injuries. The data collected was analysed with SPSS Version 20., Results: A total of 233 patients aged 2 to 66 years were reviewed. A higher male preponderance (M:F 3.4:1) was observed. Road traffic crashes (RTC) accounted for 78.5% of injuries. Motorcycle related crashes were responsible for 69.4% of RTC and 54.5% of all fractures. Fracture of the mandible (63.2% n=172) was the most predominant skeletal injury and the body (25% n=43) was the most common site of fracture while the zygoma (29%) was predominantly affected in the midface. Ninety three patients (40%) suffered loss of consciousness. The relationship between aetiology of injuries and consciousness level of the patients was statistically significant (p=0.001). Of the 43 patients who had concomitant injuries, craniocerebral affectation (60.5%) was the commonest., Conclusion: RTC remains the major aetiology of maxillofacial fractures. The mandible was mostly affected and nearly half of the patients have associated loss of consciousness. There is need for continual advocacy and enforcement of laws on preventive measures among road users., Competing Interests: The authors declare no competing interest.

Introduction: Motor vehicle accidents (MVA) and falls are major causes of maxillofacial injuries posing real challenges for the medical staff., Purpose: To describe the demographic and injury characteristics, as well as the treatment procedures of casualties diagnosed with maxillofacial injuries., Methods: The investigators implemented a multicenter retrospective study composed of hospitalized maxillofacial trauma patients recorded in the Israel Trauma Registry for 2000 to 2011. The predictor variable was mechanism of injury and the outcome variable was type of injury, severity, and hospital resources utilization. Descriptive and bivariate statistics with P values was set at 0.05., Results: The study included 11,592 reported hospitalized maxillofacial trauma patients (39.4% of them were MVA, 33.5% were falls), with a male predominance of a 3:1 ratio. The high-risk age groups were the first 3 decades of life in both etiologies, while age groups above 75 years were also frequent in falls. Severity of maxillofacial injuries, multiple injuries, admission to intensive care units, hospitalization for more than 15 days, inpatient mortality, and rehabilitation after discharge was significantly higher in MVA compared with falls. Conversely, maxillofacial surgeries were performed slightly more among patients injured in falls (34.1% and 31.1% respectively), as tongue and mouth are more prone targets in falls, compared with zygoma, maxilla, mandible, and teeth in MVA., Conclusion: The results of this study suggest that the etiologies present an entire separate pattern of trauma. A better understanding and proper identification of their high-risk groups should lead to appropriate prevention programs and treatment protocols.

Objective: A cross-sectional study to determine the pattern of craniomaxillofacial (CMF) injuries among children involved in road traffic crashes was performed. The association of protective equipment use with the CMF injuries was evaluated., Methods: Retrospective records of children treated in the University Malaya Medical Centre, Kuala Lumpur, Malaysia, after road traffic crashes between January 1, 2008 and December 31, 2012 were reviewed, and, after that, telephone interviews were made., Results: Seventy-one children were included in this study. Fifty-two (73.6%) were involved in a motorcycle injury and 19 (23.4%) in a car crash. Their mean age was 6.02 years; SD, 3.46 (range between 0 to 13 years old). More male children were observed (52.1%) compared with females (47.9%). Thirty-nine point four percent of the children sustained CMF injuries, 33.8% body injuries, and 23.9% had both CMF and other body parts injuries. The highest injury severity score was 26, whereas the lowest was 0. Many children did not use protective equipment during traveling, 44.2% of children among motorcycle pillion riders, and 78.9% among car passengers. The association between helmet use and CMF injuries was shown to be statistically significant (P < .001)., Conclusion: Craniomaxillofacial injuries could be prevented with the use of motorcycle helmet and seat belt., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Purpose: The aim of this study was to investigate the difference in incidence and pattern of bony and soft tissue injuries sustained by helmeted versus non-helmeted motorcycle accident patients., Materials and Methods: The medical records of motorcycle accident patients over a 10-year period were reviewed. Basic demographic data including age, gender, and Injury Severity Score (ISS) were collected. The patients were separated into 2 groups based on helmet use. For each group, the incidence of specific maxillofacial injuries (based on the International Classification of Diseases, Ninth Revision) was tallied. Statistical analysis was performed with the Fisher exact test., Results: A total of 717 patients were included in the study: 598 patients (mean age, 41.6 years; male gender, 90.8%; ISS, 18.2) were in the helmeted group and 119 patients (mean age, 40.8 years; male gender, 90.8%; ISS, 19.5) were in the non-helmeted group. Among the helmeted riders, 26.1% (n=156) sustained a maxillofacial injury, and among the non-helmeted riders, 45.4% (n=54) sustained a maxillofacial injury (P=.0001). The non-helmeted riders also had a significantly higher incidence of malar and maxillary fractures (P=.040), orbital fractures (P=.044), and soft tissue contusions and abrasions (P=.031)., Conclusions: The results of this study suggest that not only do helmets protect against facial injuries in totality, they appear to be more effective at preventing midfacial fractures when compared with mandible fractures., (Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Unlabelled: Background: Walking is the most basic form of mobility and forms an important part of daily activities; however, walking could often be associated with risks. This is more so when pedestrians share a common space with motorized vehicles especially in developing countries. Despite the frequency of road traffic crashes (RTC) related pedestrian injuries in many developing countries, there is a dearth of documentation of maxillofacial injuries in victims of pedestrian road traffic crashes. The aim of this study was to determine the causes, frequency, pattern, severity, concomitant injuries and outcome of pedestrian maxillofacial injuries observed at a tertiary trauma centre in Nigeria., Method: Pedestrian victims of RTC were prospectively recruited from among all maxillofacial trauma patients seen at the Accident and Emergency department and the Department of Oral and Maxillofacial Surgery of the University College Hospital, Ibadan between April 2011 and November 2011. Ethical approval was obtained from the UI/UCH Joint Ethics Review Board before the commencement of the study and informed consent was obtained from participants. Patients' demography, the crash events, types of maxillofacial injuries, and concomitant injuries were recorded. Severity of maxillofacial injury was estimated based on the Maxillofacial Injury Severity Scale (MFISS)., Results: Forty-six participants (22.9% of all victims of road traffic crashes seen within the study period) were victims of pedestrian RTC. Pedestrian RTC occurred in all age groups with almost 40% of the victims in their 1st and 2nd decades of life. The most severe MFISS was observed in the 21 - 30 year age group while the least severe injury observed was in the 71 - 80 years age group. Thirty participants (65.2%) were hit by a car or minibus while fourteen (30.4%) were knocked down by a motorcycle. Two (4.4%) were hit by a truck. Soft tissue injury was the most common maxillofacial injury and head injury was the commonest concomitant injury observed. The median MFISS score of victims of motorcycle was 4.0 while the median scores for victims of car/minibus pedestrian RTC was 9.0. The most severe maxillofacial injury was seen in victim of car/minibus pedestrian crashes. Seventeen percent (8) of the victims had a fatal outcome. Conclusion: Pedestrian RTC resulting in maxillofacial injuries are common in the studied environment. It is particularly common among the 11 -20 year age group and victims are usually hit by cars/minibuses. These injuries are often severe and fatal outcome is not infrequent. Therefore, definitive preventive measures are imperative.

Background: The aim of this study was to determine the prevalence of facial trauma among victims of road traffic accidents and investigate factors associated with it., Methods: A cross-sectional study was carried out using the medical and dental charts of 2570 victims of road traffic accidents with bodily and/or facial injuries between 2008 and 2011. Sociodemographic variables of the victims and characteristics of the accidents and injuries were evaluated. Statistical analyses included the χ(2) test as well as the Poisson univariate and multivariate regression analyses for the determination of the final hierarchical model., Results: The prevalence of facial injuries was 16.4%. Most of the victims were male. Among the victims with facial injuries, 44.3% had polytrauma to the face. The prevalence of facial injuries was high among accidents that occurred at night (Prevalence Ratio (PR), 1.42; 95% confidence interval [CI], 1.10-1.84; P = .007) and victims up to 9 years of age (PR, 2.31; 95% CI, 1.03-5.17; P = .041). Moreover, the prevalence of facial injuries was lower among victims of motorcycle accidents than victims of automobile accidents (PR, 0.59; 95% CI, 0.44-0.89; P = .001)., Conclusion: The prevalence of facial injuries was high in this study and was significantly associated with the place of residence, time of day, age group, and type of accident., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Background: Victims of motor vehicle accidents may suffer multiple lesions, including maxillofacial injuries. The aim of this study was to evaluate the prevalence and factors associated with head, facial, and maxillofacial injuries in child and adolescent victims of automobile accidents. A cross-sectional study was carried out with analysis of forensic medical reports from the Legal Medical Institute of Campina Grande, Brazil, between January 2008 and December 2011. Descriptive and inferential statistical analysis was conducted using the chi-square test (α = 0.05). From 1613 medical reports analyzed, the sample is composed 232 (14.4%) reports referring to child and adolescent victims of automobile accidents aged 0-19 years of both sexes. Victims were mostly adolescents aged from 15 to 19 years (64.2%), males (73.7%), and motorcyclists (51.3%). More than half of the victims had single lesions (54.3%) located in the head (20.7%) and face (21.6%). Head injuries occurred more frequently in children aged 0-4 years (53.8%, PR = 5.065, 95% CI = 1.617-5.870) and pedestrians (30.4%, PR = 2.039, 95% CI = 1.024-4.061), while facial and maxillofacial injuries occurred in higher proportion among females (31.1%, PR = 0.489, 95% CI = 0.251-0.954). Our findings suggest that accidents involving motorcyclists are the most prevalent, affecting male adolescents aged from 15 to 19 years, resulting in a high frequency of injuries in the head and face regions.

Objective: Maxillofacial injuries in children always present a challenge in respect of their diagnosis and management. The phenomenal increase in automotives on the road has led to a tremendous rise in the number of road traffic accidents leading to facial injuries, of which children are the most unfortunate victims. The purpose of this retrospective study was to evaluate the epidemiology, etiology and pattern of facial injuries and also to access the most feasible method for the management of facial injuries in children without hampering the facial growth., Methods: The records and radiographs of 110 patients within the age range of 0-16 years were retrospectively reviewed who have presented with maxillofacial injuries to our department from October 2008 to June 2012. The information extracted from patient's case records included patient's gender (male/female), age, etiology, fracture type (single fractures and multiple fractures), occlusal status, fracture site and treatment performed., Results: Patient's age at the time of accident ranged from 0 to 16 years, with a mean of 6.1 years. 54.54% (n = 60) of the patients were under 6 years (infants and preschool), 31.82% (n = 35) were between 6 and 11 (school age), and 13.64% (n = 15) were between 12 and 16 years (adolescents). Road side accident was the most frequent cause of injury. Most fractures occurred in the mandible (54.54%; n = 60). The fractures with minimal or no occlusal disturbance were managed by liquid diet alone., Conclusion: We believe that even after so much advancement in surgical techniques and armamentarium, conservative treatment is still the most reliable approach in managing maxillofacial injuries in children., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Background: The Department of Oral and Maxillofacial Surgery, D.A.V [C] Dental College and Hospital, Yamuna Nagar, Haryana, India conducted a study on patients with maxillofacial fractures in a time span of seven years (2003-2010). The purpose of this study was to evaluate their aetiology, incidence, patterns and different modalities employed for management., Methods: In this study, 740 patients with 1054 fractures were evaluated clinically and radiographically, based on which closed reduction and open reduction was undertaken. Review of patient records included: Age, sex, time, mechanism and etiology of injury, history of bleeding, unconsciousness and prior first aid, type of vehicle and use of preventive measures, type of fracture and treatment modalities., Results: Road traffic accidents accounted for highest number of fractures predominantly occurring in the age group of 21-30 years (38.3%)1,2. Males incurred more fractures with a male female ratio of 4.2: 1.Mandible was the most commonly fractured bone with parasymphysis being the commonest affected site.76.66% patients had associated head injury and 15.68 % had history of unconsciousness. Open reduction and internal fixation was the preferred modality for mandible whereas the mid face fractures were treated more often by closed methods., Conclusions: Injuries occurred more commonly in 20-40 age range with road traffic accident being the major etiological factor. Majority of the patients were driving two wheelers and most were under the effect of alcohol. Most of the injuries occurred during night and road traffic accidents (71.89%) were found to be the major etiological factor. Out of 532 road traffic accidents, 490 patients (66.2%) were on two wheelers, among whom 49(10%) were wearing helmet. In the mandible, fractures occurred most commonly in the parasymphyseal region (224, 30.2%), and out of the 314 fractures of the middle third showed, 155 (49.4%) ZMC. OPG was the most commonly advised X-ray. With regard to treatment modalities, 36.8% of all the mandibular fractures (740) were treated by closed reduction, 62.6% were treated using open reduction and 0.5% was under observation only.

Introduction: Brazil is among the countries with the highest prevalence of people injured by traffic accidents, showing that in 2008, levels reached 18.3 victims for 100,000 habitants were victims of traffic accidents., Materials and Methods: This retrospective study involved data collected from treated patients' charts at seven different hospitals located in three different cities all in the state of São Paulo, Brazil. Information was obtained through a standardized form, which was designed to investigate the epidemiologic features of maxillofacial traumas, restricted to victims of car accidents., Results: Three hundred ninety-six patients were victims of car crashes with mean age 29.75 years. The age group 18-30 years showed an association with facial trauma in 96 patients, 41.56 % of whom reported using seat belt. Le Fort I, II and III (70 %) and mandible (63.11 %) were more associated with body traumas and seat belt use. The most common soft tissue lesion was laceration with 189 cases (42.3 %). The treatment way was assessed, 93 (23 %) were treated surgically and 303 (77 %) underwent conservative treatment., Discussion: Classically, it is known front seat belt use was positively correlated with back seat belt use, healthy diet, dental and general health, regular walking, adequate sleep and no smoking. Accidents involving cars occurred more frequently in age group 18-30 years, suffering more general traumas and representing the nonusers group that wore fewer seat belts, caused, perhaps, by bigger access of the youth to cars, driving in high speed and to an inefficient fiscalization of the traffic laws.

Objective: The aim of this study was to evaluate the incidence and etiology of maxillofacial fractures in the Greek population over the past 5 years. A comparison of findings with 2 earlier studies from the same department was also performed., Study Design: Seven hundred twenty-seven patients treated for a total of 1,142 facial fractures in the period from 2005 to 2009 were included in a retrospective, clinical, and epidemiologic study. Cause, type, site of injury, gender, age, and nationality of the patient were the parameters evaluated., Results: Road traffic accidents remained the most common cause of injury (50.8%) followed by assaults (26.3%), falls (13.8%), work-related injuries (3.2%), and sport injuries (3%)., Conclusions: Road traffic accidents remain the most frequent etiology of maxillofacial fractures. Fractures of the facial skeleton caused by assault increased significantly in the period assessed. Concomitant injuries were most frequently associated with motorcycle accidents., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objectives: To determine the aetiological factors and pattern of occurrence of maxillofacial soft tissue injuries (MF-STIs) presenting at a Kenyan National Referral Hospital in Nairobi., Design: A cross-sectional study., Settings: The accident and emergency department of the Kenyatta National Hospital (KNH) between September 2009 and December 2009., Subjects: Four hundred and twenty two patients treated for MF-STIs., Results: The male to female ratio was 3.3:1. Motor vehicle accidents (MVA) were the leading cause of MF-STIs (44.6%) followed by interpersonal violence (IPV) (39.1%). MVA (50.0%) was the leading cause of MF-STIs in the less than 12-year-olds while falls from heights (58.3%) was the leading cause in under five-year-olds. IPV (48.1%) was the leading cause of facial fractures. There were no skeletal fractures observed in the under five-year-olds. Head injury (36%) and fractures of the long bones (52%) were the most common associated injuries., Conclusion: The leading causes of MF-STIs apparently differ from those of skeletal fractures.

This study aimed to evaluate the occurrence of injuries to the head and face in adolescent and teenager victims of non-natural deaths. A retrospective study was undertaken by the analysis of medical forensic reports obtained from medical forensic examinations performed at the Department of Forensic Medicine of the city of Campina Grande, PB, Brazil, between January 2003 and December 2007. From a total of 607 reports issued during this time span, the study sample consisted of 423 reports (69.6%) referring to adolescents and teenagers of both genders, aged 12 to 18 years, who were confirmed to have died from external causes. The causes of death were encoded according to the Chapter XX of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). The majority of victims were 17 year old males (25.8%). Firearms (33.3%) and transport accidents (32.2%) were the most common causes of death, with boys showing a 3.7 times greater likelihood of getting killed by firearms than girls. There was statistically significant relationship between the occurrence of transport accidents and gender. The majority of victims (71.6%) presented with multiple injuries throughout the body. There was statistically significant relationship between the occurrence of transport accidents and the presence of multiple injuries. A high percentage of the victims presented with injuries to the head and face. There was statistically significant relationship between the occurrence of transport accidents and the presence of injury to the head. Fatal gunshot wounds and transport accidents were the main causes of death of male adolescents and teenagers. The victims presented with multiple injuries, especially to the head and face, and the mandible was the most frequently injured facial bone. .

Purpose: To clarify the incidence and mechanisms of maxillofacial injuries sustained by motor vehicle passengers, in-depth data from the Institute for Traffic Accident Research and Data Analysis, Japan, were retrospectively analyzed., Materials and Methods: From the Institute for Traffic Accident Research and Data Analysis in-depth data for 1993 through 2005, data were collected for 226 individuals with maxillofacial injuries who were adult passengers involved in frontal motor vehicle collisions. The accident information, a subject's medical data, and anatomic Injury Severity Scores were examined., Results: The median Injury Severity Score was 2, and the mean equivalent barrier speed of the vehicles was 35.2 ± 13.0 km/hour. The most common maxillofacial injuries were lacerations (46.7%), followed by abrasions (41.9%), fractures (14.0%), and dental injuries (5.7%). Maxillofacial fractures occurred more often in unrestrained drivers without airbag deployment (18.4%) and less often in restrained drivers with airbag deployment (4.3%). The incidences of fractures caused by impacts with areas other than the steering wheel were markedly decreased using any safety device (35.5% to 0%)., Conclusion: Combined use of seat belts and airbags by occupants decreases fractures compared with completely unrestrained occupants. Furthermore, wearing a seat belt prevents the free flight of drivers within a vehicle and contact with the interior of a vehicle (other than the steering wheel). Although the anatomic Injury Severity Score of maxillofacial injuries was relatively low, because these injuries are also associated with socioeconomic costs, the correct use of safety devices and further development of more effective injury prevention systems are needed., (Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Objectives: The aim of this study is to highlight the overall uniqueness of the pattern of presentation of maxillofacial injuries seen at the Department of Oral and Maxillofacial Surgery of the University of Calabar Teaching Hospital, Calabar south-south Nigeria between January 2000 and December 2004 and to share our experience in terms of occurrence, seasonal fluctuations and the adequacy of treatment methods in our environment., Materials and Methods: Case notes of all. the 200 maxillofacial trauma patients were retrieved, examined and analyzed with regards to age, gender and cause of injury, socio-demographic data, diagnosis, pattern of presentation, distribution and treatment., Results: A male-to-female ratio of 3.65:1 was obtained. Out of the 200 patients the highest incidence of injury was in the 20-30 year age group 85 (n=85; 42.5%). The major causes of injuries were motorcycle (n=74; 37%), vehicle (n=62; 31.5%) and assault (n=40; 20%). Six (3%) river-related or boat accidents were recorded. Industrial and sports related accidents contributed the least (n=5; 2.5%)., Conclusion: Road traffic accident had the highest proportion of the entire maxillofacial injuries with more males affected than females. Seasonal distribution showed a bimodal peak variation of May-June and September-January. This paper calls for the reinforcement of measures for the prevention of automobile accident and the establishment of more maxillofacial specialist centers with modern equipment for effective management of maxillofacial injuries.

Objective: To review the 2461 cases of maxillofacial fractures., Methods: From 2003 to 2009, 2461 maxillofacial fracture cases were treated in Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Traditional Chinese Medicine. Data regarding sex, age, cause of injury, occupation, geographic distribution, blood type, fracture site, multiple associated injuries, injury severity, the patient's first admitted department, treatment results were reviewed., Results: The male and female ratio was 4.28:1, 1424(57.86 %) patients were between 20 and 40 years of age. The most common cause of injury was road traffic accident (938 cases, 40.98%). People in tertiary industry (900 cases, 78.53%) were most vulnerable to injuries. The zygomatic complex (22.08%), nasal bone (20.67%) and mandible (16.35%) were the most frequent fracture sites, which were often associated with skull (21.74%), brain (38.36%) and soft tissue contusion injury (48.84%). 85.98% (2116/2461 cases), of patients' AIS score was less than 2. Orthopaedics (939/2461 cases, 38.16%) was the first admitted department., Conclusions: The traffic accidents are the main cause of the maxillofacial fractures. Most injuries are found in the young and middle-aged people.

Background/aim: Maxillofacial injuries are among the commonest forms of body injuries. There are three divisions, namely, facial bone fractures, soft tissue injuries, and dentoalveolar injuries. Etiologies include motor vehicle accidents, assaults, falls, and sporting injuries. The aim of this study was to determine the profiles including the causes of maxillofacial injuries seen in an urban government hospital in the mainland of Penang State, Malaysia., Materials and Methods: This was a cross-sectional study that recruited cases reported within a period of 1 year. The source population was maxillofacial injury patients presenting to the Oral and Maxillofacial Surgery Department of an urban hospital in the Penang Mainland, North Malaysia between May 2007 and May 2008. Cases of patients involved in accidents that occurred outside the reference vicinity were excluded. A case report form was developed and completed by the attending clinicians. Data were analyzed using spss version 12.0., Results: A total of 194 cases were studied, with the mean patient age being 27.8 (SD 15.20) years. The majority of patients were Malay men between 20 and 29 years of age. The main cause of injury was motorcycle accident (53.6%). The commonest injury (in isolation/combination with other injuries) involved the soft tissues (87.2%), dentoalveolar region (33.4%), and facial bones (23.9%). Laceration was the commonest soft tissue injury, and crown fracture was the most frequent dentoalveolar injury. The facial bone that was most highly involved in the injury was the zygoma. Subjects involved in motorcycle accidents had a significantly higher incidence of sustaining facial bone fractures., Conclusions: Motorcycle accidents were the commonest cause of maxillofacial injuries in the Penang Mainland, Malaysia. Most patients were young men. Hence, it is prudent to reinforce appropriate road safety and awareness interventions particularly focusing young male motorcyclists so as to reduce the risk of accidents., (© 2011 John Wiley & Sons A/S.)

Introduction: Two wheeler users in India are the most vulnerable for road fatalities and two wheelers constitute the major portion of vehicular traffic., Objectives: To assess the prevalence of maxillofacial injuries among the victims of motorized two wheeler road traffic accidents in Bangalore city., Materials and Methods: Medical records of cases reported during January 2006-June 2007 to hospitals were considered and data regarding age, sex, date of trauma, rider or pillion rider, alcohol consumption, site of injury on the face and associated injuries to other parts of the body were recorded., Results: The prevalence of injuries among males and females was in the ratio of 3:1. Most of them were in the age group of 21-30 years. Most of the cases were recorded on Saturdays (17.4%) and in the months of August (9%) and September (9.7%) and the least number of cases were reported in January, March and June (2.1%) of 2007. The decrease in number of cases coincides with the implementation of the Helmet Rule in the city., Conclusion: There is a need to stress on the importance of usage of helmets and adherence to traffic rules during the high-risk periods to reduce the incidence of road traffic accidents and accompanying maxillofacial injuries.

Objective: This 12-month prospective multi-center study was designed to ascertain the entire injury profile, injury severity, and risk factors in motorcycle injured Nigerian maxillofacial patients., Methods: With a validated investigator-administered questionnaire, we obtained data from motorcycle-injured in- and out-patients managed in the maxillofacial units of four Nigerian teaching hospitals. Standardized information on host factors, agent, and type of crash as well as location, type, and extent of injury were elicited. Injuries were scored using the Facial Injury Severity and Abbreviated Injury scales (FISS, AIS)., Results: A significant male preponderance was observed (p = 0.003) with peak age 21-30 years; 62.7% of the patients were riders. Alcohol/substance abuse was implicated in 31.2% of riders, fatigue in 13.5%, and bad roads in 17.6%. The rate of helmet use was 3%. The predominant type of crash was head-on collision (HOC) 58%). Glasgow Coma Scale (GCS) score ranged from 5 to 15 with mean 13.3 (3.5); Facial Injury Severity Score (FISS) ranged from 1 to 11, mean 3.7 (1.9); and Abbreviated Injury Score was mostly 2. FISS was not significantly different between both genders (p = 0.26) and road types (p > 0.05). The mean FISS was greater with multiple passengers than with single or no passengers (p = 0.12) and lower with crashes involving motorcycles carrying heavier loads (p = 0.022). Six of the patients died (2.7% fatality) in the course of their hospitalization all within a month of injury., Conclusion: We advocate prompt legislation of a ban on greater than one passenger on a motorcycle, impaired (substance abuse) operation on a motorcycle, and stronger enforcement of speed limit and adoption of legislation that would make it mandatory to wear a full-face helmet when operating a motorcycle in Nigeria.

The objective of this paper was to study the epidemiological characteristics of orofacial damage resulting from road accidents among victims assessed in the Oporto delegation of the Legal Medicine Institute, in Portugal. It was also our goal to analyze in which way orofacial sequelae was reflected in the victims' complete social reintegration.

Motorcycle casualties represent significant number in road traffic accidents in Malaysia, and among all the injuries, facial injuries pose many significant problems physiologically, functionally, and aesthetically. The aim of this study was to analyze the pattern of maxillofacial as well as other injuries in motorcyclists who were seen at Hospital Universiti Kebangsaan Malaysia.Patients' records from January 2004 to December 2005 were reviewed. Data related to demographics, vehicle/object involved in collision, involvement as a rider or pillion, whether a helmet was worn or not, location of injuries on the face/facial bones, and other associated injuries were collected.A total of 113 cases of motorcycle accidents were recorded; 106 males and 7 females were involved. Mean age was 25.8 years. Among all the races, Malay had the highest involvement (72.3%), followed by Chinese (14.3%), Indians (8.9%), and others (5.4%). The types of collision were either a single-vehicle collision (i.e., skidded) or with another vehicle/s or object (e.g., tree, stone, or lamppost). The injuries were mainly seen on the lower face (46.9%) followed by midface (25.7%) and a combination of the midface and lower face (15%) and others (12.4%). The most frequent other associated injuries recorded were orthopedic and head injuries.

Background: Maxillofacial fractures commonly present to the emergency department, interpersonal violence (IPV) and motor vehicle accidents (MVA) being two of the main causes. There is a changing trend in these two aetiologies, which is reflected in a change in demographics, the pattern of fractures and the treatment of maxillofacial fractures., Methods: A prospective database of patients presenting to the Oral and Maxillofacial Surgery service at Christchurch Hospital during an 11-year period was reviewed. Of a total of 2581 patients with radiographic confirmation of facial fractures, 1135 patients sustained injuries following IPV and 286 patients following MVA. Variables examined include demographics, type of fracture, mode of injury, and treatment., Results: The male:female ratio was 9:1 in patients following IPV and 7:3 following MVA; 16-30-year-olds accounted for greatest proportion of injuries (48 and 68%, respectively). There was alcohol involvement in 87% of fractures caused by IPV, compared with 58% for MVA. Mid-facial fractures were more frequently seen in MVA, whereas mandibular fractures were more prevalent in IPV. Sixty-two per cent of the patients from MVA required active treatment and 87% were hospitalized, compared with 56% actively treated and 59% hospitalized in the IPV group., Conclusion: Interpersonal violence has continued to be the main cause of maxillofacial fractures. Both IPV and MVA commonly involve alcohol and young male adults. They frequently require hospitalization and surgical intervention.

Background: Road Traffic Accidents (RTAs) are a major cause of morbidity and mortality in Kenya. Victims may suffer multiple injuries including maxillofacial injuries. In most developing countries RTAs are the leading cause of maxillofacial injuries. In an attempt to reduce RTAs, the government of Kenya has enacted a legislation requiring mandatory fitting of speed governors and safety belts by passenger service vehicles., Objective: To describe the characteristics and pattern of maxillofacial and associated injuries sustained in road traffic accidents., Design: A cross-sectional study., Setting: Kenyatta National Hospital (KNH)., Subjects: All patients involved in RTAs brought to casualty and the dental department of KNH as well as accident victims admitted to the KNH mortuary over a four- month period from September 2004 to December 2004., Results: Four hundred and thirteen (85.7%) had non-fatal injuries whereas 69 (14.3%) had sustained fatal injuries. Males in the 21-30-year age group were the most affected. Most accidents occurred during weekends with pedestrians being the leading casualties in 59.5% and 71.4% of non-fatal and fatal cases respectively. Most accidents were caused by passenger service vehicles (matatus) which were responsible for 62% and 40.6% of non-fatal and fatal injuries respectively. Non-use of safety belts was reported in 56.6% of the cases who suffered non-fatal injuries. In the non-fatal category 89.6% of the casualties had soft tissue injuries (STIs) involving the craniofacial region with facial cuts being the majority (69.2%). Two hundred and seventy three (66.1%) incidents of other STIs than those of the head region were noted, the lower limbs accounting for 45.4% of these. Only 5.1% of the casualties with non-fatal injuries had fractures involving the maxillofacial skeleton. Skeletal injuries other than those involving the maxillofacial region were found in 142 (34.1%) incidents. In the fatal category head injury alone was the leading cause of death accounting for 37.7% of the cases followed by head and chest injuries combined which were responsible for 13% of the cases., Conclusion: Injuries to the maxillofacial skeleton appear to be uncommon in this series. Pedestrians in their third decade of life are most affected with passenger service vehicles being responsible in the majority of the cases., Recommendations: Interventional programmes targeting pedestrians and those in the third and fourth decades of life should be enacted.

Background: Maxillofacial fractures in children are rare when compared to those occurring in adults. To establish the incidence, pattern, and aetiology of maxillofacial fractures in children aged 15 years and below in Lagos, Nigeria., Design: A review of patients with maxillofacial fractures aged 15 years and below seen and treated at the Lagos University Teaching Hospital, Lagos, Nigeria between January 1997 and December 2004 was conducted., Results: Of the 225 patients with maxillofacial fractures seen within the study period, 37 (16.4%) were children aged 15 years and below, with a male-to-female ratio of 1.5 : 1. The highest incidence recorded was found within the age group 12-15 years (41%), with the lowest incidence occurring in the age group 0-5 years (27%). Multiple fractures were commoner in older patients (P > 0.05), and in boys (P > 0.05). There were no statistically significant relationships between the age of the patients, gender distribution, and mechanisms of injury. Road traffic crashes were the most common aetiological factor (64.9%), with the mandible being the most involved facial bone (63.8%). Majority of the mandibular fractures (33.3%) were located in parasymphyseal region. Zygomatic complex fractures were the most common in the mid-facial region. Most of the fractures (81.1%) were immobilized by simple methods (arch bars, eyelet wires, acrylic splint with circum-mandibular wiring) with or without intermaxillary fixation. Of the cases, 18.9% were managed conservatively., Conclusion: The incidence of facial fractures in this study was found to be higher than previously reported in Nigeria and worldwide, with almost two-thirds of cases a result of road traffic crashes. There is a need to enforce legislation aimed at preventing road traffic crashes to reduce maxillofacial injuries in children.

Purpose: Nearly 40% of all-terrain vehicle (ATV) crash-related fatalities involve pediatric patients, with many of these patients dying from head and neck injuries. West Virginia is in a unique position to examine these injuries because of its high rate of ATV use. This study examines craniofacial ATV-related trauma in children., Patients and Methods: We conducted a single-center, retrospective, descriptive study of 26 children presenting with a craniofacial injury(ies) resulting from an ATV crash from January 2001 to December 2004., Results: Twenty-six children (65% boys) with a mean age of 13.1 years presented with craniofacial injuries during the study period. Two patients were helmeted. Mortality was 3.8% (n = 1, head injury related, postinjury day 3). Patients were most often drivers of the ATV (65%), although girls were more likely to be passengers (P = .03). Facial contusions, lacerations, and abrasions were highly prevalent (62%, 69%, 65%, respectively), as were fractures of the facial bones and skull (77%). Thirty-five percent sustained closed head injuries, which were significantly associated with mandible fractures (odds ratio 12.8%; 95% CI, 1.15-143). Mean length of hospital stay was 4.6 +/- 5 days, and 36% required an ICU stay (mean, 5.1 +/- 3 days). Twenty-four percent required ventilator support (mean, 107 +/- 43 hours; range, 48 to 168 hours). Operative intervention was required in 72% of patients (n = 18)., Conclusion: Maxillofacial injury patterns from ATV-related crashes in children suggest a high percentage of significant facial injuries and closed head injuries. As new ATV legislation that addresses operator use is enacted, a decrease in the number and severity of craniofacial injuries may be seen.

Background: In spite of employing numerous devices improving the safety in motor vehicles, traffic accidents are still among the main reasons of maxillofacial injuries. The maxillofacial injuries remain the serious clinical problem because of the specificity of this anatomical region. The knowledge of etiologic factors and mechanisms of injuries can be helpful in a satisfactory trauma prevention. The aim of this study was to find out the incidence and the pattern of maxillofacial injuries resulting from traffic accidents in the patients treated in the Department of Maxillofacial Surgery (Silesian Medical Academy in Katowice, Poland) from January 2001 to December 2005., Methods: The material consisted of 1024 case records of patients with maxillofacial injuries treated in the Maxillofacial Surgery Department of Silesian Medical Academy. The detailed analysis was carried out on the case records of 198 patients in the age of 3 to 68 with maxillofacial injuries resulting from traffic accidents. On the basis of data from a history, examination on admission, consultations and radiological examinations, patients' age and gender, we obtained the information on a pattern of injury and detailed description of an accident (the date and the time of an accident, the role of the patient in an accident)., Results: The traffic accidents were the cause of 19.93% maxillofacial injuries in the analyzed period of time. Most of the patients had injuries to the soft tissues of the face (22.21%), followed by tooth and alveolar process injuries (20.71%) and mandibular fractures (18.69%). All the types of injuries were more common in men than in women. The majority of the patients were car drivers followed by car passengers, pedestrians, cyclists and motor cyclists. The peak age of the patients was between 18 to 25 years. The prevalent number of accidents resulting in injuries to this region took place in spring, especially between noon and 4 PM., Conclusion: Our results exhibit that road traffic accidents remain among the main reasons of maxillofacial injuries following the traumas resulting from assaults and interpersonal violence. This succession of etiologic factors is in accordance with the data from the most developed countries. The relatively high incidence of injuries resulting from traffic accidents indicates the necessity to reinforce legislation aimed to prevent road traffic crashes and thus to reduce maxillofacial injuries among children and adults.

Purpose: We sought to determine the etiology and pattern of motorcycle-related maxillofacial injuries among intracity road users in Nigeria., Patients and Methods: We conducted a prospective review of all patients presenting at the maxillofacial surgery units of the Obafemi Awolowo University Teaching Hospital Ile-Ife and Usmanu Dan Fodiyo University Teaching Hospital Sokoto with motorcycle-related injuries., Results: One hundred seven patients were included in the study. A significant male preponderance was observed (P = .002). Overall, the peak age incidence was 20 to 29 years, whereas female patients had a peak age incidence of 10 to 19 years. Victims were mostly riders (50.5%) but none of them was a female. While 8.4% of accidents occurred on motorcycles with more than one pillion passenger, none of the victims reported using a crash helmet. Mechanism of accident was mostly head-on collision (39.2%). The injuries sustained were predominantly soft tissue injuries or in combination with bone injury. Bone and dental injuries were attributed mostly to falls. Facial bone injuries occurred mostly in the mandible (64 of 104). A symmetric distribution of injuries was observed in the upper, middle, and lower thirds of the face, but the middle third had the highest injury sites while the upper third had the least., Conclusions: Motorcycle-related maxillofacial injuries among Nigerians affect males predominantly. The injuries sustained have a symmetric distribution and were mostly soft tissue injuries in isolation or in combination with bony injuries. The middle third of the face is most vulnerable. Mandatory use of safety helmets and education of cyclists on the appropriate number of pillion passengers are imperative to minimize the morbidity and mortality associated with motorcycle accidents.

Purpose: The study purpose was to assess the changes in the pattern of maxillofacial fractures in 2 different study periods., Patients and Methods: We conducted retrospective study of 341 patients treated for maxillofacial fractures between January 1978 and December 1982 and a prospective study of 483 patients treated between January 1995 and December 1999 at the Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan, Nigeria. Data were collected on age, gender, etiologic factor, and site of injury., Results: The male-to-female ratio reduced in the second period by a factor of 2.0. Patients in the age groups of 21 to 30 years and older than 60 years increased by a factor of 1.8 and 2.9, respectively, in the second period. Assaults, falls, sporting injuries, and industrial accidents in the second period increased by a factor of 1.4, 1.5, 3.5, and 1.5, respectively. The ratio between road traffic accidents and other causes changed from 3.4:1 to 2.2:1 in the second period. Mandibular fractures increased by 2% in the second study period., Conclusion: The data confirmed that although other etiologic factors are increasing in number, road traffic accidents remains the major etiologic factor of maxillofacial fractures in Nigeria. There is a need to enforce seat belt use, speed limit, and drink driving laws to reduce maxillofacial injuries caused by road traffic accidents; to organize preventive programs to minimize assaults, and to legislate the wearing of headgear by industrial workers.

The objective of this study was to determine the influence of positions on the incidence and severity of maxillofacial injuries in vehicular crashes. Two hundred and fifty cases of RTA were seen and studied from October 1999 to May, 2000. They comprised 72.8% males and 27.2% females with a male to female ratio of 2.7:1. The age range was 1 to 80 years with a mean age of 40 years. The most common vehicle involved in RTA was the mini bus, 34.3% followed by motorcycle, 26.5%. Middle seat passengers, drivers and motorcycle passengers and riders sustained more and severe injuries during crashes. The mandible was more frequently fractured at the symphysis (24.6%) than at any other site while the maxilla was frequently fractured at the zygomatic bone and arch (10.8%). More injuries occurred in the age range of 20-30 years and these accounted for 31.8% of the cases. Only 6 occupants of motor vehicles wore seat belts before accident while no motorcycle rider or passenger wore any helmet. In conclusion, drivers, middle seat occupants of a vehicle, motorcycle passenger and riders sustained more and severe injuries than back seat occupants.

Twenty cases of maxillofacial trauma to vehicle occupants in motor crashes were retrospectively analysed using data from the CIREN project (Crash Injury Research Engineering Network - a collaboration between eight level 1 trauma centres in America). The facial fractures and lacerations were classified and a correlation was made between the deformation of the vehicle and the injuries sustained. The importance of airbags as supplemental restraint systems is emphasized, as is the necessity for coexistent seatbelt use. The vehicle 'A' pillar as a source of injury is highlighted. Although there is no doubt that airbags save lives, the possible risks of powerful airbag deployment to small stature, out of position, vehicle occupants is discussed.

A prospective study of 159 patients seen with maxillofacial fractures as a result of road traffic accidents in a Nigerian inner city was performed. The male to female ratio was 2.9:1 and the dominant age group was 21-30 years. Occupants of commercial vehicles were the ones mostly involved; involvement of rear seat occupants was high. Increased numbers of patients were seen on Saturdays and in the month of June. This study substantiates the fact that there is added risk of sustaining facial fractures during the rainy and leisure periods. Therefore, there is a need to stress the importance of common restraint devices and good road habits during these 'high risk' periods to reduce the incidence of maxillofacial fractures due to the road traffic accidents.

Objective: To evaluate the effect driver-side and passenger-side airbags have had on the incidence and severity of maxillofacial trauma in victims of automobile accidents., Design: Retrospective analysis of all automobile (passenger cars and light trucks) accidents reported in 1994., Setting: New York State., Patients: Of the 595910 individuals involved in motor vehicle accidents in New York in 1994, 377054 individuals were initially selected from accidents involving cars and light trucks. Of this subset, 164238 drivers and 62755 right front passengers were selected for analysis., Main Outcome Measures: Each case is described in a single record with approximately 100 variables describing the accident, eg, vehicle, safety equipment installed and utilized or deployed, occupant position, patient demographics, International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnoses, and procedural treatments rendered. A maxillofacial trauma severity scale was devised, based on the ICD-9-CM diagnoses., Results: Individuals using airbags and seat belts sustained facial injuries at a rate of 1 in 449, compared with a rate of 1 in 40 for individuals who did not use seat belts or airbags (P<.001). Those using airbags alone sustained facial injuries at the intermediate rate of 1 in 148, and victims using seat belts without airbags demonstrated an injury rate of 1 in 217 (P<.001)., Conclusion: Use of driver-side airbags, when combined with use of seat belts, has resulted in a decrease in the incidence and severity of maxillofacial trauma.

Objective: To determine the pattern and severity of maxillofacial injuries sustained in a motor vehicle accident (MVA) resulting from automobile restraint use., Design: Retrospective database review of patients injured in a MVA who were admitted to the level I trauma center at the University of Louisville Hospital in Louisville, Kentucky., Methods: Demographic data, drug and alcohol impairment screening, and comorbidity data were obtained from database searches of trauma records. Forty-four patients had an airbag deployed, 34 patients wore seat belts, and 94 patients were unrestrained. All maxillofacial Abbreviated Injury Scale (AIS) ratings were compared among the three groups., Results: Twenty-two of the 44 patients (50%) in the airbag group sustained only facial injuries. Fifteen of them had lacerations; four others had only facial abrasions. Three of the airbag patients had moderate facial injuries (AIS = 2); none required operative management. The airbag group had a mean AIS rating of 1.13, the seat belt group a mean AIS of 1.29, and the unrestrained group a mean AIS of 1.46. Patients using either seat belts (mean age, 40.5 y) or airbags (mean age, 44.9 y) were older than the unrestrained group (mean age, 39.6 y). Drug and/or alcohol impairment was significantly greater in the unrestrained group (mean, 38%) compared with the seat belt group (mean, 26%) and the airbag group (mean 11%.)., Conclusions: Use of airbags is associated with less severe maxillofacial injuries compared with either a seat belt alone or no restraint. There is an inherent risk of minor maxillofacial injuries with airbag usage, but the severity of injury is distinctly reduced.