Young men, cyclists at risk for facial fractures

By Sarah Guy, medwireNews Reporter

Young men and individuals involved in road accidents on a bicycle are the most likely candidates for maxillofacial fractures, indicate Dutch study results.

The findings indicate that the use of a bicycle helmet could achieve a large reduction in injuries to the brain and upper face, remark the researchers, who believe the data are important to "help develop more efficient ways to deliver care."

"Socioeconomic ramifications of maxillofacial trauma are the cost of treatment and admission to hospital, hospital resources, and macroeconomic loss of revenue," write Ellen Van Cann (University Medical Center Utrecht, the Netherlands) and team in the British Journal of Oral and Maxillofacial Surgery.

"For individual patients," they continue, "consequences may comprise functional problems, physical discomfort, aesthetic problems, emotional or psychological distress, an intensive treatment regimen (often in hospital), frequent visits to the outpatient department after discharge, and loss of revenue."

During a 6-year period between January 2005 and December 2010, 394 patients were treated surgically at the researchers' institution for maxillofacial fractures. Injuries to the mandible and zygoma were the most common, with those of the midface, orbit, nose, and frontal sinus less common.

In all, there were significantly more male than female patients, at 296 versus 98, and men were significantly younger than women, with the majority of male patients aged between 21 and 30 years.

Fracture incidence rates were higher in the Spring months of April, May, and June, and incidence was higher on weekends than weekdays, report the authors.

Road accidents were the most common cause of fractures, at 42%, with bicycle crashes the most common road accident, at 18%. This was followed by car accidents (13%), moped accidents (6%), and motorcycle accidents (3%).

More than a third (36%) of patients had other injuries, most commonly orthopedic trauma, and of those who had a bicycle accident, 19% also had neurotrauma compared with just 4% of those who had an accident involving a moped or motorcycle.

"We expect that increase in the use of helmets or adopting laws that make helmets compulsory for cyclists will lead to a considerable reduction in cycling-related neurotrauma and facial injuries to the upper and middle part of the face," suggest Van Cann et al.

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