Department of Oral and Maxillofacial Surgery, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands.
Department of Emergency Medicine, Erasmus Medical Center Rotterdam, Rotterdam, the Netherlands.
Int J Oral Maxillofac Surg. 2024 Jan;53(1):28-35. doi: 10.1016/j.ijom.2023.01.013. Epub 2023 Apr 7.
Maxillofacial injury is a common injury resulting from bicycle (including e-bike) and scooter accidents. With 80,000 admissions to emergency departments in 2019, bicycle accidents account for more than half of all traffic-related emergency department visits in the Netherlands. The United States reports approximately 130,000 injuries and 1000 fatalities related to cycling annually. This systematic review and meta-analysis was performed to examine the protective effect of helmets against maxillofacial injuries resulting from bicycle and scooter (including e-bike and e-scooter) accidents. After a systematic literature search, 14 studies were found to be eligible for this systematic review. Of these, 11 were included in the meta-analysis. None of the included studies focused on vehicles with motors (e-bikes and e-scooters); all focused only on non-motorized vehicles. All included studies were non-randomized, which could have led to bias in the pooled results. Data from the included studies were tested for heterogeneity using the binary random-effects model (DerSimonian-Laird method), and the odds ratio for the occurrence of maxillofacial injury in cyclists wearing a helmet versus those not wearing a helmet was calculated by random-effects meta-analysis. Patients who had worn a helmet suffered significantly fewer maxillofacial injuries than patients who had not, in bicycle accidents (odds ratio 0.682). In conclusion, wearing a helmet has a significant protective effect against maxillofacial injury, indicating the need for strict helmet legislation.
颌面损伤是由自行车（包括电动自行车）和滑板车事故引起的常见损伤。2019 年，荷兰有 8 万人因急诊入院，自行车事故占所有与交通相关的急诊就诊人数的一半以上。美国每年报告约 13 万例与骑自行车相关的伤害和 1000 例死亡。本系统评价和荟萃分析旨在研究头盔对自行车和滑板车（包括电动自行车和电动滑板车）事故引起的颌面损伤的保护作用。经过系统的文献搜索，发现有 14 项研究符合本系统评价的条件。其中，有 11 项研究被纳入荟萃分析。这些研究均未关注带发动机的车辆（电动自行车和电动滑板车）；所有研究都只关注非机动车辆。所有纳入的研究均为非随机的，这可能导致汇总结果存在偏倚。使用二项随机效应模型（DerSimonian-Laird 方法）对纳入研究的数据进行异质性检验，并通过随机效应荟萃分析计算出戴头盔的骑自行车者与未戴头盔的骑自行车者发生颌面损伤的比值比。在自行车事故中，戴头盔的患者发生颌面损伤的风险明显低于未戴头盔的患者（比值比 0.682）。总之，戴头盔对颌面损伤有显著的保护作用，这表明需要严格的头盔立法。
