Maxillofacial Injuries in Cyclists: A Biomechanical Approach for the Analysis of Mechanisms of Mandible Fractures

Background/Aim: The mandible makes up a substantial part of the lower face, and is susceptible to injury. Even in helmeted cyclists, accidents may lead to fractures of the mandible because conventional helmets provide little protection to the lower part of the face. In addition, some studies indicate that helmets may lead to an increased risk of mandibular fractures. Thus, the aim of this study was to examine the anatomic distribution of mandibular fractures in injured cyclists and to assess if helmet use influenced the fracture locations.Material and Methods: Data from a Norwegian Level 1 trauma center were collected in the Oslo University Hospital Trauma Registry over a 12-year period. Of 1543 injured cyclists, the electronic patient charts of 62 cyclists with fractures of the mandible were retrospectively evaluated in detail. Demographic data, helmet use, and fracture type were assessed.Results: Sixty-two patients (4%) had fractures of the mandible, and women had an increased risk (OR 2.49, 95% CI 1.49-4.16, p < .001). The most common fracture site was the mandibular body, followed by the condyle. Isolated mandibular fractures occurred in 45% of the patients and 55% had other concomitant facial fractures. There were 42% of the patients with fractures in multiple sites of the mandible, and 42% had a concomitant dentoalveolar injury. Half of the cyclists were wearing a helmet at the time of the accident and 39% were not. There was no significant difference in fracture distribution between the helmeted and non-helmeted groups.Conclusions: Fracture of the mandibular body was the most prevalent mandibular fracture type following bicycle accidents. Women had an increased risk of mandibular fractures compared with men, whereas helmet wearing did not affect the anatomical fracture site.

Section: Discussioncontrasting

confidence: 96%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Anatomical distribution of mandibular fractures from severe bicycling accidents: A 12‐year experience from a Norwegian level 1 trauma center

Døving

Næss

Galteland

et al. 2022

“…Helmeted users were 40% less likely to have facial injury from bicycle accidents, but there was no difference between the severity of facial injuries among injured patients 29 . In bicycle‐related injuries, the mandible is the most affected site in the maxillofacial region, mainly due to falling on a level surface 30–32 . Hence, the design of bicycle helmets should be modified to improve facial protection 33 .…”

Section: Discussionmentioning

confidence: 99%

Characteristics of pediatric maxillofacial fractures in Kuwait: A single‐center retrospective study

AlAli

Ibrahim

Algharib

et al. 2021

Background Pediatric maxillofacial fractures always present a challenge due to the unique nature of the facial skeleton anatomy and development. The aim of this study was to investigate the incidence, etiology, site of fracture, and management modalities of pediatric maxillofacial fractures in Kuwait. Methods A retrospective cross‐sectional study was conducted. The records of all pediatric patients who were diagnosed with maxillofacial fractures and admitted to one of the major hospitals in Kuwait between January 2007 and March 2020 were reviewed. Results A total of 186 patients aged between 0 and 13 years old were included. An average of 13 patients was seen each year between 2007 and 2020. The leading cause of the pediatric maxillofacial trauma was road traffic accidents (RTA) that accounted for 38.2% of the patients followed by 22% falls from height (FFH). Male patients were more affected than females, with a ratio of 2.3:1. More than half of the children had mid‐face fractures, of which 57% were in multiple sites. Conservative management was the main approach for 52.2% of the patients. Conclusions Pediatric maxillofacial fractures were mainly attributed to road traffic accidents in Kuwait. Mid‐face bone fractures were reported more than mandibular fractures and were mostly managed conservatively.

“…This result was consistent with a study investigating the occurrence of maxillofacial fractures among cyclists. Tsutsumi et al 36 determined that age was an independent risk factor for maxillofacial fractures. Several explanations underlie these trends.…”

Section: Discussionmentioning

confidence: 99%

Patterns of craniomaxillofacial trauma among helmeted cyclists

Stanbouly

Selvi

Patel

et al. 2022

Bicycles are an efficient means of transportation, especially for urban environments, and they have a myriad of health benefits. 1,2 Participation in cycling has been steadily increasing in the USA. Since 2006, the total number of cyclists has increased by nearly 10 million in 2019. 3 Notwithstanding the perks of cycling, the activity carries some risks. In 2015, over 1000 bicyclists died and 467,000 bicyclerelated injuries occurred in the USA. 4 The typical injured cyclist is a male in his 30s or 40s and upper limb injuries predominate, followed by those to the head. [5][6][7][8] Cycling helmets are designed to attenuate impacts to the head during accidents, 9 and they have the capacity to substantially reduce fatality rates, 10 intensive care admission rates, 11 and length of hospital stays. 12 Nevertheless, helmets are not protective of the lower third of the face since their shielding structure does not extend to envelop the respective craniomaxillofacial regions. 13,14 A previous National Electronic Injury Surveillance System (NEISS) study on all cycling injuries that occurred between 2010 and 2019