Arbogast Kristy B, Durbin Dennis R, Kallan Michael J, Menon Rajiv A, Lincoln Andrew E, Winston Flaura K
TraumaLink and the Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
J Trauma. 2002 Apr;52(4):693-8. doi: 10.1097/00005373-200204000-00014.
Recently, head and brain injuries were identified as consequences of the inappropriate use of seat belts by children. The proposed mechanism of these injuries might also place a child at risk for facial fracture.
A probability sample of children under age 16 involved in crashes were enrolled in an ongoing crash surveillance system (1998-2001) that links insurance claims data to telephone survey and crash investigation data (unweighted, n = 12,659; weighted, n = 131,717). Incidence of facial fracture was estimated and a series of cases were examined using in-depth crash investigation to identify the mechanisms of these injuries, specifically, the role of seating position and restraint use in the mechanism of injury.
Ninety-two children suffered a fracture of the facial bones (0.07% of all children in crashes). Among restrained children with facial fractures (n = 68), those inappropriately restrained were at a 1.6-fold higher risk (95% confidence interval, 1.2-2.1; p = 0.001) of significant injury than those appropriately restrained for their age. The in-depth investigations revealed that excessive head excursion resulting from suboptimal torso restraint caused facial impact, which resulted in the facial injuries described.
The potential for disfigurement associated with these facial injuries may resonate strongly with parents, and prevention of disfigurement may provide additional motivation for proper restraint, in particular, booster seats and rear seat location, for this pediatric population.
最近，头部和脑部损伤被认定为儿童不当使用安全带的后果。这些损伤的推测机制可能还会使儿童面临面部骨折的风险。
在一个正在进行的碰撞监测系统（1998 - 2001年）中纳入了16岁以下涉及碰撞事故的儿童概率样本，该系统将保险理赔数据与电话调查及碰撞事故调查数据相链接（未加权，n = 12,659；加权，n = 131,717）。估计面部骨折的发生率，并通过深入的碰撞事故调查检查一系列病例，以确定这些损伤的机制，特别是就座位置和约束装置使用在损伤机制中的作用。
92名儿童发生了面部骨折（占所有碰撞事故儿童的0.07%）。在发生面部骨折的受约束儿童中（n = 68），约束不当的儿童比按其年龄适当约束的儿童遭受严重损伤的风险高1.6倍（95%置信区间，1.2 - 2.1；p = 0.001）。深入调查显示，由于躯干约束不佳导致的头部过度偏移造成了面部撞击，进而导致了所述的面部损伤。
与这些面部损伤相关的毁容可能性可能会引起家长的强烈共鸣，预防毁容可能会为该儿科人群正确使用约束装置，特别是增高座椅和后排座位位置，提供额外的动力。
