Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany.
Department of Trauma Surgery, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany.
Knee Surg Sports Traumatol Arthrosc. 2018 Apr;26(4):1295-1302. doi: 10.1007/s00167-017-4431-z. Epub 2017 Feb 8.
The injury mechanisms of midfacial fractures may be typical causes of concussion, but hardly any scientific data on midfacial injuries sustained in football are available. Head and brain trauma represent frequent injuries in athletes of different sports that require appropriate treatment by sports and trauma physicians. This study investigated the management of midfacial fractures in football and the association of such fractures with concomitant brain injury.
In a prospective cohort study lasting 24 months (2012 to 2013), midfacial injuries of football players were analysed with regard to the injury mechanisms, first aid procedures on the field, treatment and return-to-play. To analyse concomitant and potentially overlooked minor brain injuries due to the trauma, we retrospectively investigated the neurological symptoms of the study population.
The study included 132 football players (37 semi-professionals and 95 amateurs) with midfacial fractures. The main injury mechanisms were head-to-head and head-to-elbow trauma. The mean period of return-to-play after trauma was 33.5 days, which was significantly shortened if a protective face mask was worn (mean 10.4 days earlier, p = 0.0006). Semi-professional football players returned to play earlier (p = 0.009) and more often used protective face masks (p = 0.001). 55 players (41.6%) had neurological symptoms immediately after trauma as a possible sign of concomitant minor brain injury. 5 of 132 players with concussion had been hospitalised for 24 h, but no persistent neurological symptoms were detected.
In football, midfacial fractures represent moderate-to-severe injuries with time away from sports of more than 4 weeks. Over 40% of athletes with a midfacial fracture showed concomitant neurological symptoms as a sign of minor brain injury. Therefore, sports physicians and other staff supervising athletes in daily practice should be aware of the presence of neurological symptoms.
Level III.
面中部骨折的损伤机制可能是 concussion 的典型原因，但几乎没有足球运动中面中部损伤的科学数据。头部和脑外伤是不同运动项目运动员常见的损伤，需要运动医学和创伤医学专家进行适当的治疗。本研究调查了足球运动中面中部骨折的处理方法，以及此类骨折与并发脑损伤的关系。
在一项为期 24 个月的前瞻性队列研究（2012 年至 2013 年）中，分析了足球运动员面中部损伤的损伤机制、现场急救程序、治疗和重返赛场情况。为了分析因外伤导致的潜在被忽视的轻微脑损伤，我们回顾性调查了研究人群的神经症状。
本研究纳入了 132 名面中部骨折的足球运动员（37 名半职业运动员和 95 名业余运动员）。主要损伤机制为头对头和头对肘创伤。创伤后重返赛场的平均时间为 33.5 天，如果佩戴防护面罩，则平均缩短 10.4 天（p=0.0006）。半职业足球运动员更早重返赛场（p=0.009），更常使用防护面罩（p=0.001）。132 名运动员中有 55 名（41.6%）在创伤后立即出现神经症状，可能是并发轻微脑损伤的迹象。5 名患有 concussion 的运动员被住院 24 小时，但未发现持续的神经症状。
在足球运动中，面中部骨折是一种中度至重度损伤，需要 4 周以上的时间才能离开运动。超过 40%的面中部骨折运动员出现并发神经症状，这是轻微脑损伤的迹象。因此，在日常实践中监督运动员的运动医学专家和其他工作人员应意识到神经症状的存在。
III 级。
