Clinical Instructor, Department of Oral Maxillofacial Surgery, Shiga University of Medical Science, Otsu, Japan.
Associate Professor, Faculty of Societal Safety Sciences, Kansai University, Osaka, Japan.
J Oral Maxillofac Surg. 2021 Apr;79(4):871-879. doi: 10.1016/j.joms.2020.11.005. Epub 2020 Nov 16.
The investigators characterized the occurrence of maxillofacial injuries in cyclists and biomechanically analyzed the mechanisms of mandible fractures.
We retrospectively analyzed injury data and performed biomechanical analyses with finite element models. Hospital records from 2011 through 2019 were reviewed to identify patients who had sustained oral and maxillofacial injuries while riding a bicycle. Patients with maxillofacial fractures were compared to those without. Logistic regression analysis was performed to identify which variables were independently associated with the occurrence of maxillofacial fractures. To reconstruct the injury scenario (one in which a person falls from a bicycle and contacts the road surface with their face), computer simulations using The Total Human Model for Safety model were performed.
The hospital records of 94 patients (62 men, 32 women; 26.1 ± 17.3 years of age) who sustained oral and maxillofacial injuries while riding a bicycle were reviewed. Twenty patients (21.3%) sustained maxillofacial fractures; mandible fractures were most common (16 patients). Patients with maxillofacial fractures were significantly older and had higher severity injuries; however, logistic regression analysis showed that only age was an independent predictor of the occurrence of maxillofacial fracture (odds ratio, 1.03; P = .025). In simulations, higher von Mises stresses were found in the mandible when the cyclist fell with the neck extended and the body horizontal, and consequently, the center of mandibular body strikes the road surface. Contact forces were approximately 8 kN. High tensile stresses occurred laterally and high compressive stresses occurred medially in the mandibular ramus, which indicated that the mandibular ramus deformed in the transverse plane.
Biomechanical analyses show that mandible fractures can occur when a cyclist falls from a bicycle and their lower face strikes the road's surface.
研究人员对自行车骑手颌面损伤的发生情况进行了描述，并对下颌骨骨折的力学机制进行了生物力学分析。
我们回顾性分析了损伤数据，并使用有限元模型进行生物力学分析。回顾了 2011 年至 2019 年的医院记录，以确定因骑自行车而发生口腔颌面损伤的患者。将有颌面骨折的患者与无颌面骨折的患者进行比较。采用逻辑回归分析确定哪些变量与颌面骨折的发生有独立相关性。为了重建损伤场景（人从自行车上摔下，面部与路面接触），使用 The Total Human Model for Safety 模型进行计算机模拟。
共回顾了 94 名因骑自行车而发生口腔颌面损伤的患者（62 名男性，32 名女性；年龄 26.1±17.3 岁）的医院记录。20 名（21.3%）患者发生颌面骨折；最常见的是下颌骨骨折（16 名患者）。有颌面骨折的患者年龄明显更大，损伤严重程度更高；然而，逻辑回归分析显示，只有年龄是颌面骨折发生的独立预测因素（优势比，1.03；P=0.025）。在模拟中，当骑自行车的人颈部伸展且身体水平摔倒时，下颌骨的 von Mises 应力更高，因此下颌骨体的中心撞击路面。接触力约为 8 kN。下颌支的外侧出现高拉伸应力，内侧出现高压缩应力，表明下颌支在横平面上变形。
生物力学分析表明，当骑自行车的人从自行车上摔下且其下脸部撞击路面时，可能会发生下颌骨骨折。
