Profile and costs associated with the use of osteosynthesis materials in victims of traffic accidents

Profile of Facial Trauma Victims of Motorcycle Accidents: A Prospective Study

OBJECTIVE

To outline the profile of patients with facial trauma, victims of motorcycle accidents, treated at the Hospital da Restauração, Recife/PE, Brazil, from December 2020 to July 2021.

METHODS

The collection was carried out through questionnaire and analysis of medical records. Data were analyzed descriptively, as well as Pearson's chi-square test or Fisher's exact test.

RESULTS

Among the patients, 88.6% were male, 47.5% were between 18 and 29 years old, and 59.6% lived in rural areas; 72.15% of the victims used the motorcycle for work and 43.52% were working at the time of the accident. Most victims did not have a national motorcycle license (62%) and were not wearing a helmet at the time of the accident (60%), with 37.6% wearing a full-face helmet, 16.5% an open helmet, and 5.9% an articulated full-face helmet. Soft tissue injuries were the most prevalent. Zygomatic complex fractures were the most common facial fractures and were significantly associated with helmet use and type.

CONCLUSIONS

Most victims of motorcycle accidents are young adult men, without a regular driver's license and residing in rural areas. Preventive and educational actions and continuous traffic inspections are necessary to minimize these accidents.

Epidemiology of maxillofacial injury among adults in sub-Saharan Africa: a scoping review

BACKGROUND

Injuries remain one of the leading causes of death globally. These disproportionately affect young adults and are particularly prevalent in sub-Saharan Africa (SSA). Maxillofacial injuries (MI) pose significant challenges to public health systems. However, much remains unknown regarding the epidemiology and extent of the financial burden in resource-limited areas, such as SSA, further necessitating more research and support. This scoping review aims to investigate the mechanism, distribution, and financial impact of MI in adults aged ≥ 18 years in SSA.

MAIN BODY

The scoping review was guided by the methodological frameworks of Arksey and O'Malley and Levac. An electronic literature search for English-published articles on maxillofacial injuries in adults ≥ 18 years was conducted in Scopus, Medline, PubMed, Science Direct, CINAHL, Health Source: Nursing/Academic Edition, and grey literature. The PRISMA chart was used to document database searches and screening outcomes while reporting was guided by PRISMA-ScR. The data extraction process revolved around the predefined study outcomes, which encompassed the study characteristics and epidemiological parameters. The review used a narrative approach to report findings and evaluate publication quality using the STROBE checklist. The database search yielded 8246 studies, of which 30 met the inclusion criteria. A total of 7317 participants were included, 79.3% of whom were males. The peak age range for incidence was between 18 and 40 years. Road traffic collision (RTC) was the leading cause of MI, 59% of which resulted from motorcycle collisions. Assault/interpersonal violence ranked as the second leading cause of MI. The mandible was MI's most frequently affected hard tissue, followed by the midface. Factors such as alcohol/illicit drug use, poor knowledge of traffic regulations, and non-observance of these regulations were associated with MI. In our study, the cost range for mandibular fractures was $200-$468.6, borne by victims and their families.

CONCLUSIONS

Maxillofacial injuries are predominantly caused by road traffic collisions and assaults in SSA. The findings can provide valuable insights into policy decisions and prevention strategies aimed at reducing injury burden. Further research is warranted to explore the psychological impact of MI, including PTSD, for tailored support and intervention. Scoping Review Registration The protocol has been registered on the Open Science Framework. Registration DOI: https://doi.org/10.17605/OSF.IO/BWVDK .

Relationship between the use and types of helmets with facial injuries - a prospective study

INTRODUCTION

many studies have demonstrated the benefits of helmet to prevent and reduce severity of injuries in motorcyclists.

OBJECTIVE

the aim of the present study was to evaluate a possible relationship between the use of different types of helmets and the occurrence of facial injuries among victims of motorcycle accidents, seen at Hospital da Restauração, Recife/PE, Brazil.

MATERIALS AND METHODS

demographic and trauma data were collected from hospitalized motorcycle accident victims with facial injuries from December 2020 to July 2021. Pearsons chi-square test was used to assess association between two categorical variables using a margin of error of 5%.

RESULTS

among the participants, the average age was 33.46 years. The age group between 18 and 29 years was the most prevalent. Most participants were male. 60.0% of motorcyclists used helmets at the time of the accident and of this percentage 37.6% used fixed full-face helmet, 16.5% open-face helmet and the other 5.9% articulated full-face helmet. 62.7% of participants had facial fractures. Among the fractures, those of the zygomatic-orbital complex were the most common fracture and were significantly associated with the use of helmets, especially with open-face helmet.

CONCLUSIONS

the use of helmets was associated with a lower number of facial fractures among patients who were victims of motorcycle accidents. Fracture of the zygomatic-orbital complex was related to the absence of a helmet at the time of the accident, as well as the use of open-face helmets.

Pattern of oral and maxillofacial trauma and associated factors: An 8-year prospective study

BACKGROUND/AIMS

Oral and maxillofacial trauma (OMFT) is a public health problem due to its high occurrence and demand for resources for its management and the financial and social impact of OMFT victims on the health system. The aim of this study was to conduct an 8-year prospective analysis of OMFT cases from an emergency service.

MATERIALS AND METHODS

A hospital-based 8-year prospective study on OMFT and associated factors was performed on data from December 2011 to December 2019. Data regarding sociodemographic (gender, age, and skin color) and socio-economic profiles (educational level, family income, and occupation), OMFT profile (etiology, OMFT type, and treatment), associated factors [alcohol consumption and personal protective equipment (PPE) use], OMFT occurrence (injury day and hour), length of hospital stay, and cost were collected. Descriptive and inferential analyses of data were performed.

RESULTS

Most OMFT cases involved men with low schooling and family income, resulting from traffic accidents. OMFT severity was associated with longer hospital stay, higher hospital costs and nonuse of PPE, midface fractures (mainly orbital-zygomatic fractures), closed reduction, and open reduction/internal fixation. Traffic accidents were the main cause of longer hospital stays for victims aged 41-60 years with better socio-economic status compared with cases that had higher hospital costs. In general, higher hospital costs were associated with victims of violence under 40 years of age, with low schooling and farmers. Alcohol consumption and non-use of PPE also contributed to increasing the length of hospital stay.

CONCLUSION

Oral and maxillofacial trauma severity was associated with longer hospital stay and higher hospital costs. Associated factors such as alcohol consumption and non-use of PPE contributed to increase the length of hospital stay and OMFT severity.

Relação entre o uso e os tipos de capacetes e os traumatismo faciais - um estudo prospectivo

RESUMO Introdução: muitos estudos têm demonstrado os benefícios do uso de capacete para prevenir e reduzir a gravidade das lesões em motociclistas. Objetivo: o objetivo do presente trabalho consistiu em avaliar uma possível relação entre o uso dos diversos tipos de capacete e a ocorrência do trauma facial entre vítimas de acidentes motociclísticos atendidos no Hospital da Restauração, Recife/PE, Brasil. Materiais e Métodos: os dados demográficos e referentes ao trauma foram coletados de vítimas de acidentes motociclísticos hospitalizados com lesões faciais durante o período de Dezembro de 2020 a Julho de 2021. O teste do qui-quadrado de Pearson foi utilizado para avaliar a relação entre duas variáveis categóricas utilizando uma margem de erro de 5%. Resultados: a idade média dos participantes foi 33,46 anos. A faixa etária entre 18 a 29 anos foi a mais prevalente. A maioria dos participantes eram do gênero masculino. 60,0% dos motociclistas utilizavam capacetes no momento do acidente e deste percentual 37,6% utilizavam capacete fechado, 16,5% capacete aberto e os outros 5,9% capacete escamoteável. 62,7% dos participantes tiveram fraturas faciais. Dentre as fraturas, as do complexo zigomático-orbitário foram as mais prevalentes e foram associadas com o uso de capacetes, especialmente os abertos. Conclusões: o uso de capacetes foi associado com um menor número de fraturas faciais entre os paciente vítimas de acidentes motociclísticos. A fratura do complexo zigomático-orbitário foi relacionada com a ausência de capacete no momento do acidente, bem como com o uso de capacetes abertos.

Maxillofacial trauma due to traffic accidents and falls: an exploratory study of associated factors

Background

This study aimed to determine the pattern of Maxillofacial trauma (MFT) due to traffic accidents and falls in a reference hospital in a rural region of northeastern Brazil between December 2011 and December 2018 and to identify associated factors.

Material and Methods

This was a cross-sectional study using 585 medical records of patients with MFT. The data were subjected to a Poisson-Tweedie multiple regression analysis to estimate the Prevalence ratio (PR), with a 95% confidence interval (95% CI) and a significance level of p<0.05.

Results

MFT due to traffic accidents was more prevalent among patients 21 to 40 years old (PR=2.30; 95% CI=1.20-4.41; p<0.001) diagnosed with zygomatic-orbital complex fractures (PR=1.80; 95% CI=1.08-2.98; p=0.023). Falls were more frequent among older groups of 41 to 60 years (PR=1.83; 95% CI=1.09-3.06; p=0.022) and over 61 years (PR=2.23; 95% CI=1.09-3.06; p=0.022). In traffic accidents, alcohol consumption increased the length of stay (PR=2.081; 95% CI=1.553-2.787; p<0.001), and patients who did not use personal protective equipment (PPE) had higher hospital costs (PR=179.964; 95% CI=1.485-1.994; p<0.001) for this etiology. Traffic accidents and falls are two of the main etiologies of MFT, especially for males in the young adult age group (traffic accidents) and those above 41 years (falls). Alcohol consumption and the nonuse of PPE influenced the length of the hospital stay and hospital costs.

Conclusions

Strategies to confront this problem, such as road and highway improvements, effective enforcement of laws and intersectoral coordination involving the entire community to implement policies and prevention programs targeted at these populations, can be implemented.

Key words:Maxillofacial Injuries, public policy, hospital cost.

Pattern of Maxillofacial Trauma and Associated Factors in Traffic Accident Victims

INTRODUCTION

Maxillofacial trauma (MFT) due to road traffic accidents are responsible for part of care provided at trauma centers.

PURPOSE

This research aimed to analyze the pattern of MFTs and associated factors in victims of road traffic accidents.

METHODS

A total of 873 medical records of patients with MFTs in 2 reference hospitals for trauma in Northeastern Brazil during the period from January 2011 to December 2018 were analyzed. Data were included in the Tweedie multiple regression analysis to estimate the prevalence ratio (PR), with 95% confidence interval (95%CI) and P < 0.05.

RESULTS

Motorcycle accidents were the most prevalent (76.4%). Higher hospital costs were the result of patients victims of motorcycle accidents (PR = 1.56; 95%CI = 1.29-1.88; P < 0.001), diagnosed with mandible fracture (PR = 1.41; 95%CI = 1.07-1.86; P = 0.001) who had consumed alcoholic beverages (PR = 1.12; 95%CI = 1.00-1.25; P = 0.04) and did not use personal protective equipment (PPE) (PR = 1.29; 95%CI = 1.10-1.50; P = 0.001). Patients victims of motorcycle accidents remained in hospital longer than other etiologies (PR = 1.47; 95%CI = 1.23-1.76; P < 0.001). The consumption of alcoholic beverages resulted in more severe MFTs (PR = 2.05; 95%CI = 1.34-3.14; P = 0.001).

CONCLUSION

Victims of motorcycle accidents remained hospitalized longer and resulted in higher hospital costs compared to other etiologies. Alcohol consumption increases hospital costs and the severity of MFTs. Higher hospital costs were also observed in patients who did not use PPE. Strategies need to be adopted to understand associated factors in MFTs such as the reallocation of resources to fund, implement and improve services and the surveillance in roads and highways, as well as prevention programs aimed at this health problem.