Mandible Fractures Associated With the Introduction of an E-Scooter-Sharing System

Electric scooter-related oral and maxillofacial injuries in Oxfordshire

Electric scooters (e-scooters) are becoming increasingly popular amongst the public. Oxfordshire is included as part of the government led e-scooter trial. This study was designed to evaluate maxillofacial injuries occurring following e-scooter accidents. A single-centre retrospective study was conducted from October 2022 to September 2023 reviewing all e-scooter-related maxillofacial injuries which presented to the John Radcliffe Hospital in Oxford. During the study period, forty-nine patients (mean [range] age 28 [13-48] years; 32 [65.3%] male) suffered maxillofacial injuries from riding an e-scooter. Twenty patients (40.8%) were under the influence of alcohol and no individual was recorded to have worn a helmet at the time the injury occurred. Ten patients (20.4%) suffered a facial fracture (two mandibular fractures, three zygomatic-orbital fractures, one nasal fracture, and four patients with multiple fractures involving the sphenoid, zygomatic-orbital, and maxillary sinus). Four (40%) of these facial fractures required surgical management. This included one patient with an orbital floor fracture and an associated inferior rectus entrapment, which is a surgical emergency. Thirty-three patients (67.3%) sustained facial lacerations and nine patients (18.4%) sustained dental trauma. Maxillofacial injuries occurring from e-scooter injuries are significant and pose a notable risk to safety. Our study highlights poor compliance and emphasises the need to improve safety through public education, focussing on sobriety. Considerations should be given to speed limitations, safety clothing, e-scooter training, and whether helmets should be mandatory. The Oxfordshire trial is due to end in May 2026 and our results can inform and influence future legislation.

E-Scooter-Related Maxillofacial Fractures: A New Emerging Epidemic During the COVID-19 Period in the Province of Rome, Lazio, Italy: A Monocentric Study Review of 843 Patients Compared With the Pre-COVID-19 Two-Year Period

INTRODUCTION

Shared vehicles, such as e-scooters and electric bicycles, could potentially accelerate the transition toward sustainable mobility. Focusing on e-scooters, the aim of this study is to show, compared with previous years when e-scooter use was significantly reduced, the increased incidence of maxillofacial bone injuries from e-scooters and the most frequent type of fractures.

METHODS

We conducted a monocentric observational retrospective and prospective analysis during the pandemic, from January 1, 2020, until December 31, 2022, on patients' access for maxillofacial traumas at the San Giovanni Addolorata emergency department, trauma hub center, for Lazio district. A total of 383 patients were included. Data on the causes of traumas, type of injury produced, age, gender, nationality, and helmet use were collected. Especially, we analyzed the e-scooter-related facial traumas that had gained a lot of popularity in this period due to the restriction in mobility because of Covid-19, subsequent reduced use of public transport, and the new benefits introduced by the government for e-scooters or bikes. We compared e-scooter facial trauma with all the other kinds of facial fracture etiologies during this period.

RESULTS

In our study, the most frequent causes of trauma were assaults (32.6%), accidental falls (24.2%), and sports activities (7.8%). The percentage of trauma among road traffic injuries was almost 24% of the total; in particular, motorcycle/e-scooter traumas was 7.1%, car crashes was 5.5%, pedestrian hits was 4.2%, and bike accidents was 3.1%. Other causes detected were syncope (5.5%), accidental traumas (1.8%), and epileptic crisis (1.1%). Focusing on road traffic injury access in our emergency department, compared with those between 2017 and 2019, it emerged that e-scooter-related facial traumas in the past two years have had a remarkable rise. In fact, there was a total of 27 patients (52% male and 48% female) instead of 5 between 2017 and 2019. The average age was 29 years. The most frequent types of e-scooter-related fractures were those to the nasal bones (29.7%), followed by mandibular fractures (unifocal 7.4%, bifocal 18.5%, trifocal 7.4%, and condylar 7.4%), zygomatic-maxillo fractures (18.4%), complex fractures (7.4%), and maxilla (3.7%). Among 27 observed electric scooter riders, nobody wore a helmet.

CONCLUSIONS

Injuries associated with the use of e-scooters are a new phenomenon and mainly affect the craniofacial region due to the dynamic nature of the trauma. Although these vehicles have become increasingly common over the years and accepted within regulatory frameworks, the traffic rules are not ready to integrate e-scooters into the transport systems due to the lack of adequate legislation, and the lack of implementation in the form of facial safety devices or safety skills training for e-scooter riders.

Electric Scooter-related Craniofacial Injuries

OBJECTIVES

Injuries associated with the use of electric scooters are a serious problem in modern society and traffic in relation to their increasing frequency of use. Although injuries involving all body parts are seen in such injuries, craniofacial ones are also very common. The aim of this study was to evaluate the craniofacial and other accompanying injuries in electric scooter-related accidents in Istanbul.

MATERIALS AND METHODS

Between January 2020 and December 2022, patients with electric scooter-related trauma among the patients admitted to the emergency unit for trauma were evaluated retrospectively. All electronic medical records, CT scans, other examinations, and treatments were retrospectively reviewed, and craniofacial fractures and other injuries seen in the patients were classified.

RESULTS

A total of 20.358 patients were admitted to the trauma unit between January 2020 and December 2022. Two hundred ten patients (142 male, 68 female) had electric scooter-related trauma and 58.1 % of them had craniofacial injuries. Thirty patients (14.3 %) (23 male, 7 female) had craniofacial fractures, whereas 43.8 % of them had craniofacial soft tissue injuries. The nasal fracture was the most common craniofacial fracture (14 patients, 46.7%). Orbital wall and zygomaticomaxillary complex fractures were found to be the second most common fractures.

CONCLUSIONS

The rate of electric scooter-related injuries among all trauma patients admitted to the emergency trauma unit during the mentioned period was 1.03%. The results of this study were found to be in accordance with the data in the literature. The craniofacial region is the most frequently injured body part in patients with electric scooter-related trauma, and patients should be comprehensively evaluated for possible soft tissue injuries, craniofacial fractures, and other accompanying system injuries.

E-Scooters and Craniofacial Trauma: A Systematic Review

Study Design

Systematic review.

Objective

Standing electric scooters (e-scooters) provide a cheap and environmentally friendly transport alternative, but also elicit substantial concern regarding their volume of associated injuries especially in the craniofacial region. This review aims to explore the demographics, risk factors, types of injury and surgical management of craniofacial trauma associated with e-scooters.

Methods

PubMed and Scopus databases were systematically searched. Inclusion criteria were clinical studies investigating craniofacial trauma associated with e-scooters. Exclusion criteria were duplicates; non-English publications; non-full-text publications; studies with insufficient data.

Results

Of the 73 articles identified, 10 eligible articles representing 539 patients were included. The mean age was 31.5 years. Most cases were male (63.7%). Common risk factors were alcohol/drug intoxication, absence of distal extremity injuries and lack of helmet use. The most common mechanism of injury was mechanical falls (72.4%). The most common facial fracture pattern was middle third fractures (58.3%). Surgical management was required for 43.3% of fractures. Other types of injuries reported were traumatic brain injuries (17.6%), soft tissue injuries (58.3%), dental injuries (32.9%) and ophthalmological injuries (20.6%).

Conclusions

The findings of this review suggest common presentations for craniofacial trauma associated with e-scooters. Robust longitudinal evaluations with standardised descriptions of types of injuries are required. Gaps in knowledge relate to surgical management, post-operative complications and associated risk factors.

Likelihood of Craniofacial Injury and Hospitalization with Alcohol Use While Skateboarding and Scootering

Study Design: We designed a cross-sectional epidemiologic study to evaluate the influence of substance use on craniofacial injuries in a population of skateboard and scooter users. Objective: The primary outcome of our study was craniofacial injury. The secondary outcome was hospitalization. Methods: We report a cross-sectional study of patients reported to the National Electronic Injury Surveillance System (NEISS) from January 1, 2019, to December 31, 2020, in the United States. Patients were included in our study if they were evaluated in the emergency department (ED) for a skateboard- or scooter-related injury. Results: There were over 5396 total patients who presented to a NEISS-participating ED after skateboard- or scooter- related trauma during the study period. There were 1136 patients with a craniofacial injury (primary endpoint), and patients under the influence of alcohol or drugs had greater odds of experiencing a craniofacial injury than those not under the influence (odds ratio [OR]: 4.16, 95% confidence interval [CI]: 3.24-5.32, P < .0001). Four hundred-thirty patients were hospitalized (secondary endpoint), and patients under the influence had greater odds of being hospitalized than those not under the influence (OR: 2.83, 95% CI: 2.04-3.91, P < .0001). Conclusions: Alcohol and drug use while skateboarding or scootering drastically increases the likelihood of craniofacial injury and subsequent hospitalization and should be avoided whenever possible. The importance of wearing a helmet while operating these devices cannot be overstated.