Maxillofacial Trauma Following Road Accidents and Falls

Einy, Shmuel; Rahman, Nura Abdel; Siman‐Tov, Maya; Aizenbud, Dror; Peleg, Kobi

doi:10.1097/scs.0000000000002555

Cited by 17 publications

(32 citation statements)

References 31 publications

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“…During the first three decades of life, road users are more susceptible to RTC 4,5 and a significant male predominance is a known characteristic of maxillofacial trauma (MFT) caused by RTC 7,8 . Similar findings were reported in the Israeli population taken from a large‐scale database of 11 592 maxillofacial injuries between 2000 and 2011, in which hospitalizations among casualties with RTC‐related maxillofacial injuries were two to three times greater among males compared to females, with significant statistical differences 9 . Among hospitalized casualties, maxillofacial trauma is characterized by multiple organ injuries, 10 causing high injury severity scores, admission to intensive care units, hospitalization exceeding 15 days, inpatient mortality, and rehabilitation after discharge.…”

Section: Introductionsupporting

confidence: 65%

Maxillofacial trauma following road accidents—An 11‐year multi‐center study in Israel

Einy

Goldman

Radomislensky

et al. 2020

Dental Traumatology

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Background/Aim Road traffic collisions (RTC) are known to be one of the major causes of maxillofacial trauma (MFT). The road user factor is of crucial importance in the prevalence, severity, and treatment of maxillofacial injuries. The aims of the study were to determine the prevalence of maxillofacial trauma among road users, to illustrate injury patterns and to identify road users at high risk. Methods This historical prospective multi‐center study was based on Israel's Trauma Registry between 2008‐2018, which included 4829 hospitalized patients following RTC with MFT. Data were analyzed according to six road user types (vehicle driver, passenger, bicyclist, motorcyclist, pedestrian, and e‐bike/scooter), maxillofacial injury location, and maxillofacial treatment. Results MFT, which accounted for 5% of the hospitalized RTC injuries, was not equally distributed among road users, as bicyclists and e‐bike/scooters were more prone to maxillofacial trauma (7.2% and 10.1%, respectively) than vehicle drivers (3.2%). Children (age 0‐14 years) comprised almost half of the cyclists, 25% of the pedestrians and 20% of the passengers. Some MFT patients experienced multiple injuries, with the majority involving jaw and facial bones and to a lesser extent the mouth, teeth, gingivae, and alveolar bone (mouth and dento‐alveolar (DA) trauma). Approximately 30% of hospitalized road casualties with MFT underwent MF surgery, with the need for surgery lowest among pedestrians. Conclusion Hospitalized road casualties had different types of MFT in terms of prevalence, location, severity, and treatment, depending on the road user type.

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Section: Introductionsupporting

confidence: 65%

Maxillofacial trauma following road accidents—An 11‐year multi‐center study in Israel

Einy

Goldman

Radomislensky

et al. 2020

Dental Traumatology

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“…Schneider et al came to the conclusion that only 13% of maxillofacial fractures were result of traffic accidents [4,15,16]. Nevertheless, this seems to apply for Germany/Central Europe only as other countries reported different major causes for maxillofacial injuries [10].…”

Section: Regions Of Injury Within the Maxillofacial Trauma Group (N=12613)mentioning

confidence: 99%

“…In order to develop and implement effective interventions to reduce the medical burden, a better understanding of maxillofacial injuries in severely injured patients after traffic accidents is needed. Though, as the causes of maxillofacial injuries have been shown to vary not only from one country to another but even within the same country depending on the prevailing socioeconomic, cultural, and environmental factors [10], studies with large case numbers are needed in order to allow general conclusions. Therefore, the aims of this study on a large cohort of affected patients were to describe the patterns of the respective injuries and to identify those factors associated with road traffic accidents.…”

Section: Introductionmentioning

confidence: 99%

Maxillofacial injuries in severely injured patients after road traffic accidents—a retrospective evaluation of the TraumaRegister DGU® 1993–2014

Pietzka

Kämmerer²,

Pietzka³

et al. 2019

Clin Oral Invest

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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.

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“…The direct consequence of blow-out trauma may cause additional symptoms, including diplopia, enophthalmos (the posterior displacement of the eyeball), loss of sensation over the upper lip and gums on the injured side, a handicapped upward gaze (as a result of entrapment of the inferior rectus muscle) or crepitus by palpation around the inferior orbital ridge 5 . There are also several potential factors that are responsible for the occurrence of blow-out trauma, such as competitive sports or military conflicts, but the most common are traffic accident cases and violent assaults, according to surveys and statistics from across various developed countries 6 – 8 .…”

Section: Introductionmentioning

confidence: 99%

Nonlinear dynamic analysis of the pure “buckling” mechanism during blow-out trauma of the human orbit

Trzebiatowski

Kl̵osowski

Skorek

et al. 2020

Sci Rep

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Considering the interplay between orbital bones and intraorbital soft tissues, commonly accepted patterns of the blow-out type of trauma within the human orbit require more thorough investigation to assess the minimal health-threatening impact value. Two different three-dimensional finite element method (FEM) models of the human orbital region were developed to simulate the pure “buckling” mechanism of orbital wall fracture in two variants: the model of orbital bone elements and the model of orbital bone, orbit and intraorbital tissue elements. The mechanical properties of the so-defined numerical skull fragment were applied to the model according to the unique laboratory tensile stress tests performed on small and fragile specimens of orbital bones as well as using the data available in the literature. The nonlinear transient analysis of the contact problem between bodies that differ substantially in terms of the Young’s modulus was carried out to investigate the interaction of different bodies within an instant injury. Potential damage areas were found within the lower orbital wall as well as the destructive load values for both FEM skull models (7,660 N and 8,520 N). Moreover, numerical simulations were validated by comparing them with computed tomography scans of real injuries.

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Maxillofacial Trauma Following Road Accidents and Falls

Abstract: 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.

Cited by 17 publications

References 31 publications

Maxillofacial trauma following road accidents—An 11‐year multi‐center study in Israel

Maxillofacial trauma following road accidents—An 11‐year multi‐center study in Israel

Maxillofacial injuries in severely injured patients after road traffic accidents—a retrospective evaluation of the TraumaRegister DGU® 1993–2014

Nonlinear dynamic analysis of the pure “buckling” mechanism during blow-out trauma of the human orbit

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