Risk Factors for Cervical Spine Injury in Patients With Mandibular Fractures

Färkkilä, Esa; Tannyhill, R. John; Petrovick, Laurie; Gervasini, Alice; Velmahos, George C.; Kaban, Leonard B.

doi:10.1016/j.joms.2018.07.032

Cited by 19 publications

(16 citation statements)

References 27 publications

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“…Based on the ndings in the fracture group, we suppose that the same distribution will apply for patients that suffered soft tissue injuries only. In contradiction to our study, Färkkilä et al report in total higher MFI-CSI rates in patients with mandibular fractures than in those with midface fractures 1,2 . After a detailed analysis of these papers, a higher incidence of CSI is reported in more cranial fractures of the lower jaw, like fractures of the mandibular collum 2 .…”

Section: Discussioncontrasting

confidence: 99%

“…This is comparable with the literature but is lower than the international average (0.8% 3 to 12% 5 ). This result is less than reported from the German registry study by Pietzka et al (11.3%) or single-center studies from the UK or USA 1,2,11 , but more than 0.8% reported by Roccia et al from Italy 3 . All these studies analyze a similarly long period of time, Färkkilä et al from the same years 1,2 .…”

Section: Discussioncontrasting

confidence: 62%

“…The incidence of MFI-CSI ranges from 0.8-12% according to the recent literature [1][2][3][4][5][6] . However, the largest registry studies,, report an incidence of 1.1-11.3% [7][8][9][10] , single-center studies estimate the occurrence of 0.8-9.7% [1][2][3]11 . In lethally injured patients this incidence is reported as high as 46.4% 12 .…”

Section: Introductionmentioning

confidence: 99%

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Fracture Heat Map of The Facial Skull Demonstrates a Danger Zone of Concomitant Cervical Spine Injuries

Bicsák

Sarge

Müller

et al. 2020

Preprint

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Concomitant maxillofacial and cervical spine injuries occur in 0.8%-12% of the cases. We examined the relation of injury localization and the probability of cervical spine fracture.A retrospective study was conducted on patients that have been treated at Dortmund General Hospital for injuries both to the maxillofacial region and to the cervical spine between January 1st, 2007 and December 31th, 2017. Descriptive statistical methods were used to describe the correlation of cervical spine injuries with gender, age as well as maxillofacial injury localization.7708 patients were hospitalized with maxillofacial injury, among them 173 were identified with cervical spine injury. The average ages for both genders lie remarkably above the average of all maxillofacial trauma patients (36.2 y.o. in male and 50.9 y.o. in female). In the group of men, most injuries were found between the ages of 50 and 65. Whereas most injuries among women occurred after the age of 80. The relative ratio of cervical spine injuries (CSI) varies between 1.1% and 5.26% of the maxillofacial injuries (MFI), being highest in the soft tissue injury group, patients with forehead fractures (3.12%) and patients with panfacial fractures (2.52%). Further, nasal, Le Fort I and II, zygomatic complex and mandibular condyle fractures are often associated with CSI. Fractures next to the Frankfurt horizontal plane represent 87.7% of all MFI with concomitant CSI. Patients in critical age groups with a high-energy injury are more likely to suffer both, MFI and CSI injuries. Our findings help to avoid missing the diagnosis of cervical spine injury in maxillofacial trauma patients.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 62%

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Fracture Heat Map of The Facial Skull Demonstrates a Danger Zone of Concomitant Cervical Spine Injuries

Bicsák

Sarge

Müller

et al. 2020

Preprint

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“…Midface fractures propose an independent risk factor for cervical spine injuries [20]. In our cohort the incidence of cervical spine fractures in patients with midface fractures was 7.8% (16/204) which indicates similar relevant levels as previously reported by other teams (2.6% by Ardekian et al-9.7% by Mithani et al) [20][21][22][23][24][25]. Therefore, diagnostics and treatment of CMF and OT patients in trauma centers with a department for spinal surgery is strongly advised.…”

Section: Cervical Spine Injuries In Patients With Midface Fracturessupporting

confidence: 90%

“…Types of brain-injuries in our cohort: subdural hematoma (n = 31), subarachnoid hemorrhage(21), intracerebral hemorrhage (5), extradural hematoma(2) …”

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confidence: 99%

Combined trauma in craniomaxillofacial and orthopedic-traumatological patients: the need for proper interdisciplinary care in trauma units

Mühlenfeld

Thoenissen

Verboket

et al. 2020

Eur J Trauma Emerg Surg

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Aim The primary aim of this study was to analyze frequency and characteristics of combined facial and peripheral trauma with consecutive hospitalization and treatment. Materials and methods The study included all patients with concomitant orthopedic-traumatolgical (OT) and craniomaxillofacial (CMF) injuries admitted to our level I trauma center in 2018. The data were collected by analysis of the institution's database and radiological reviews and included age, sex, injury type, weekday and time of presentation. All patients were examined and treated by a team of surgeons specialized in OT and CMF directly after presentation. Results A total number of 1040 combined OT and CMF patients were identified. Mean age was 33.0 ± 26.2 years. 67.3% (n = 700) were male patients. Primary presentation happened most frequently on Sundays (n = 199) and between 7 and 8 pm (n = 74). 193 OT fractures were documented, where cervical spine injuries were most frequent (n = 30). 365 facial and skull fractures were recorded. 10.8% of the 204 patients with fractures of the viscerocranium presented with at least one fracture of the extremity, 7.8% (16/204) with cervical spine fractures, 33.3% (68/204) with signs of closed brain trauma and 9.8% (20/204) with intracranial hemorrhage. Discussion The study shows a high frequency of combined facial with OT-injuries and brain damage in a predominantly young and male cohort. Attendance by interdisciplinary teams of both CMF and OT surgeons specialized in cervical spine trauma surgery is highly advisable for adequate treatment. Conclusion Diagnostics and treatment should be performed by a highly specialized OT and CMF team, with a consulting neurosurgeon in a level-1 trauma center to avoid missed diagnoses and keep mortality low.

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