Plawecki Andrea, Bobian Michael, Kandinov Aron, Svider Peter F, Folbe Adam J, Eloy Jean Anderson, Carron Michael
Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan.
Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan.
JAMA Facial Plast Surg. 2017 Dec 1;19(6):453-458. doi: 10.1001/jamafacial.2017.0332.
As the US population ages, public health agencies have released guidelines encouraging aerobic activity and muscle-strengthening exercises among older individuals. Facial trauma from such activities among elderly individuals has long been underappreciated.
To evaluate the incidence of recreational activity-associated facial fractures among older adults and to further delineate injury characteristics including demographics, fracture location, and specific activities.
DESIGN, SETTING, AND PARTICIPANTS: The National Electronic Injury Surveillance System was used to collect data on emergency department visits from January 1, 2011, to December 31, 2015, for individuals 55 years of age or older who sustained facial fractures from recreational activities. Individual entries were evaluated for activity code, fracture site, and demographics. Weighting data were used to extrapolate national incidence.
Incidence and location of facial fractures and associated recreational activity.
During the study period, there were 20 519 emergency department visits for recreational activity-associated facial fractures among adults 55 years of age or older (8107 women and 12 412 men; mean [SD] age, 66.5 [9.1] years). The annual incidence of facial fractures increased by 45.3% from 2011 (n = 3174) through 2015 (n = 4612). Bicycling (26.6%), team sports (15.4%), outdoor activities (10.1%), and gardening (9.5%) were the most common causes of facial fractures. Walking and jogging caused 5.5% of fractures. In cases specifying site of fracture, nasal (65.4%) and orbital (14.1%) fractures were the most common. A greater proportion of men than women sustained bicycle-associated fractures (35.7% vs 14.9%; P = 3.1056 × 10-170), while more women than men sustained fractures associated with gardening (15.5% vs 6.1%; P = 2.1029 × 10-97), outdoor activities (14.6% vs 7.7%; P = 4.3156 × 10-50), and gym exercise (7.7% vs 1.3%; P = 3.0281 × 10-114). Men harbored a greater likelihood than women of orbital (14.9% vs 12.8%; P = 6.1468 × 10-5) and mandible fractures (9.3% vs 2.0%; P = 9.3760 × 10-64). Walking and jogging and gardening comprised a greater proportion of injuries in older cohorts.
Facial fractures sustained from recreational activity increased by 45.3% during a 5-year period among older adults. Although bicycling was the most common activity facilitating these injuries, many other pursuits represent areas of concern. Nasal fractures predominated, although orbital fractures increased with age. These findings offer areas for targeted prevention and provide valuable information for patient counseling. Furthermore, initiatives encouraging greater activity among this population may need to be accompanied by guidelines for injury prevention.
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随着美国人口老龄化，公共卫生机构发布了指南，鼓励老年人进行有氧运动和肌肉强化锻炼。老年人因这类活动导致的面部创伤长期以来未得到充分重视。
评估老年人中与娱乐活动相关的面部骨折的发生率，并进一步描述损伤特征，包括人口统计学特征、骨折部位和具体活动。
设计、地点和参与者：利用国家电子伤害监测系统收集2011年1月1日至2015年12月31日期间55岁及以上因娱乐活动导致面部骨折的个体到急诊科就诊的数据。对每条记录的活动代码、骨折部位和人口统计学特征进行评估。使用加权数据推断全国发病率。
面部骨折的发生率和部位以及相关的娱乐活动。
在研究期间，55岁及以上成年人因娱乐活动相关面部骨折到急诊科就诊共计20519例（女性8107例，男性12412例；平均[标准差]年龄为66.5[9.1]岁）。从2011年（n = 3174）到2015年（n = 4612），面部骨折的年发病率增加了45.3%。骑自行车（26.6%）、团队运动（15.4%）、户外活动（10.1%）和园艺（9.5%）是面部骨折最常见的原因。步行和慢跑导致5.5%的骨折。在明确骨折部位的病例中，鼻骨骨折（65.4%）和眼眶骨折（14.1%）最为常见。与自行车相关骨折的男性比例高于女性（35.7%对14.9%；P = 3.1056×10-170），而与园艺、户外活动和健身房锻炼相关骨折的女性比例高于男性（园艺：15.5%对6.1%；P = 2.1029×10-97；户外活动：14.6%对7.7%；P = 4.3156×10-50；健身房锻炼：7.7%对1. 3%；P = 3.0281×10-114）。男性发生眼眶骨折（14.9%对12.8%；P = 6.1468×10-5）和下颌骨骨折（9.3%对2.0%；P = 9.3760×10-64）的可能性大于女性。步行、慢跑和园艺在老年人群中导致的损伤占比更大。
在5年期间，老年人因娱乐活动导致的面部骨折增加了45.3%。虽然骑自行车是导致这些损伤最常见的活动，但许多其他活动也值得关注。鼻骨骨折占主导，但眼眶骨折随年龄增长而增加。这些发现为有针对性的预防提供了方向，并为患者咨询提供了有价值的信息。此外，鼓励该人群增加活动的倡议可能需要同时伴有预防损伤的指南。
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