Galteland Pål, Næss Ingar, Døving Mats, Sehic Amer, Utheim Tor Paaske, Skaga Nils Oddvar, Eken Torsten, Helseth Eirik, Ramm-Pettersen Jon
Departments of Maxillofacial Surgery.
Institute of Clinical Medicine.
J Craniofac Surg. 2023;34(1):34-39. doi: 10.1097/SCS.0000000000009032. Epub 2022 Dec 30.
Bicyclists are vulnerable road users. The authors aimed to characterise facial fractures and their association with head and neck injuries in bicyclists admitted to a Scandinavian Level 1 trauma center with a catchment area of ~3 million inhabitants. Data from bicycle-related injuries in the period 2005 to 2016 were extracted from the Oslo University Hospital trauma registry. Variables included were age; sex; date of injury; abbreviated injury scale (AIS) codes for facial skeletal, head and neck injuries; and surgical procedure codes for treatment of facial fractures. Anatomical injury was classified according to AIS98. A total of 1543 patients with bicycle-related injuries were included. The median age was 40 years (quartiles 53, 25), and 1126 (73%) were men. Overall, 652 fractures were registered in 339 patients. Facial fractures were observed in all age groups; however, the proportion rose with increasing age. Bicyclists who suffered from facial fractures more often had a concomitant head injury (AIS head >1) than bicyclists without facial fractures (74% vs. 47%), and the odds ratio for facial fracture(s) in the orbit, maxilla and zygoma were significantly increased in patients with AIS head >1 compared to patients with AIS head=1. In addition, 17% of patients with facial fractures had a concomitant cervical spine injury versus 12% of patients without facial fractures. This results showed that facial fractures were common among injured bicyclists and associated with both head and cervical spine injury. Thus, a neurological evaluation of these patients are mandatory, and a multidisciplinary team including maxillofacial and neurosurgical competence is required to care for these patients.
骑自行车的人是易受伤害的道路使用者。作者旨在描述在一个服务人口约300万的斯堪的纳维亚一级创伤中心收治的骑自行车者面部骨折的特征及其与头部和颈部损伤的关联。从奥斯陆大学医院创伤登记处提取了2005年至2016年期间与自行车相关损伤的数据。纳入的变量包括年龄、性别、受伤日期、面部骨骼、头部和颈部损伤的简明损伤定级（AIS）编码，以及面部骨折治疗的手术操作编码。根据AIS98对解剖损伤进行分类。共纳入1543例与自行车相关损伤的患者。中位年龄为40岁（四分位数间距53, 25），1126例（73%）为男性。总体而言，339例患者共登记了652处骨折。各年龄组均观察到面部骨折；然而，该比例随年龄增长而上升。与无面部骨折的骑自行车者相比，发生面部骨折的骑自行车者更常伴有头部损伤（AIS头部>1）（74%对47%），与AIS头部=1的患者相比，AIS头部>1的患者眼眶、上颌骨和颧骨骨折的比值比显著增加。此外，面部骨折患者中有17%伴有颈椎损伤，而无面部骨折患者中这一比例为12%。这些结果表明，面部骨折在受伤的骑自行车者中很常见，且与头部和颈椎损伤相关。因此，对这些患者进行神经学评估是必需的，并且需要一个包括颌面和神经外科专业能力的多学科团队来护理这些患者。
