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Observational Study
. 2024 Mar 12;166(1):132.
doi: 10.1007/s00701-024-06019-9.

The association between head injury and facial fracture treatment: an observational study of hospitalized bicyclists from a level 1 trauma centre

Pål Galteland  1   2 , Mats Døving  3   4 , Ingar Næss  5 , Amer Sehic  3   4 , Tor Paaske Utheim  3   4 , Torsten Eken  5   6 , Nils Oddvar Skaga  6   7 , Eirik Helseth  5   8 , Jon Ramm-Pettersen  5   8
Affiliations
Observational Study

The association between head injury and facial fracture treatment: an observational study of hospitalized bicyclists from a level 1 trauma centre

Pål Galteland et al. Acta Neurochir (Wien). .

Abstract

Purpose: To compare the types of facial fractures and their treatment in bicyclists admitted to a level 1 trauma centre with major and minor-moderate head injury.

Methods: Retrospective analysis of data from bicycle-related injuries in the period 2005-2016 extracted from the Oslo University Hospital trauma registry.

Results: A total of 967 bicyclists with head injuries classified according to the Abbreviated Injury Scale (AIS) were included. The group suffering minor-moderate head injury (AIS Head 1-2) included 518 bicyclists, while 449 bicyclists had major head injury (AIS Head 3-6). The mean patient age was 40.2 years (range 3-91 years) and 701 patients (72%) were men. A total of 521 facial fractures were registered in 262 patients (on average 2 facial fractures per bicyclist). Bicyclists with major head injury exhibited increased odds for facial fractures compared to bicyclists with minor-moderate head injury (sex and age adjusted odds ratio (OR) 2.75, 95% confidence interval (CI) 2.03-3.72, p < 0.001. More specifically, there was increased odds for all midface fractures, but no difference for mandible fractures. There was also increased odds for orbital reconstruction in cyclist with major head injury compared to bicyclist with minor-moderate head injury (adjusted OR 3.34, 95% CI 1.30-8.60, p = 0.012).

Conclusion: Bicyclists with more severe head injuries had increased odds for midface fractures and surgical correction of orbital fractures. During trauma triage, the head and the face should be considered as one unit.

Keywords: Bicycling; Face; Fractures; Head injury.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of 967 injured bicyclists with head injury admitted to OUH-U from 2005 to 2016
Fig. 2
Fig. 2
The correlation between the location of facial fractures, including those surgically treated, and the severity of head injury. It compares patients with major head injuries (AIS Head 3–6) against those with minor to moderate head injuries (AIS Head 1–2). Displayed in the figure is the tally of different facial fractures, with the number requiring surgical treatment specified in parentheses
See this image and copyright information in PMC

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