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Boiron A, Barazer C, Clement C, Sahli Vivicorsi S, Bellamy L, Le Toux G, Boisramé S. Craniofacial Trauma of Equestrian Origin. J Craniofac Surg 2024:00001665-990000000-01645. [PMID: 38810245 DOI: 10.1097/scs.0000000000010126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/14/2024] [Indexed: 05/31/2024] Open
Abstract
Horse riding is a popular yet dangerous sport, often resulting in facial traumas due to unpredictable horse reactions or falls. This retrospective study examines 20 patients. The aim of the study is to analyze maxillofacial traumas of equine origin and discuss prevention strategies. Conducted from 2004 to 2021 at our university hospital's emergency department in France, inclusion criteria encompassed patients with maxillofacial trauma admitted to the emergency department and referred to ENT and/or dentistry post-horse-related accidents. Patients were identified from the Health Data warehouse. While 35 medical files were accessed, 15 did not meet inclusion criteria. Analysis of patient parameters, including age, sex, injury date, circumstances, injury type, management, helmet usage, operative interventions, and potential sequelae, revealed a predominantly female population (16 versus 4) under 48 years old. Traumas were most prevalent in summer (80%) and frequently involved riders on foot (60%). Seventy percent of patients sustained at least 1 facial fracture, with helmet use documented in only 1 case. In conclusion, horse riding can lead to various traumas, often necessitating surgical intervention. Preventive measures such as protective helmets, even for nonmounted riders, are crucial as the literature highlights many injuries occurring due to helmet omission.
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Affiliation(s)
- Adeline Boiron
- Brest University Hospital, Western Brittany University, Brest
| | - Camille Barazer
- UFR Odontologie, Université de Bretagne Occidentale/Odontology, oral medicine and oral surgery service, Sense Organs Center, University Hospital Center, Brest, France
| | - Camille Clement
- Brest University Hospital, Western Brittany University, Brest
| | | | - Lorenn Bellamy
- Medical Information Department, Health Datawarehouse Brest, France
| | - Guy Le Toux
- Brest University Hospital, Western Brittany University, Brest
| | - Sylvie Boisramé
- Brest University Hospital, Western Brittany University, Brest
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Kozlowski KM, Rosston PA, Park AC, Hakimi AA, Socolovsky L, Wong BJF. A Thirteen-Year Analysis of Facial Fractures among Professional Soccer Players. Facial Plast Surg 2024; 40:120-126. [PMID: 36509105 DOI: 10.1055/a-1996-7595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
This study aims to identify the epidemiology and effects of facial fractures on return to play (RTP) in Major League Soccer (MLS) and the English Premier League (EPL). A total of 39 MLS players and 40 EPL players who sustained facial fractures from 2007 to 2019 were identified. Data on player demographics, the injury, and the impact of their injury on RTP were collected. Elbow-to-head was the most common mechanism of injury (20.3%). The most common fracture involved the nasal bone (48.3%). Most players (90%) RTP the same season. Players who sustained nasal fractures missed significantly fewer games (p < 0.001) than those who suffered other craniofacial fractures. Players treated surgically missed significantly more games (3.21 vs. 0.71, p = 0.006) and days (30.1 vs. 8.70, p = 0.002) than those managed nonoperatively. Significantly more EPL players who sustained facial fractures wore headgear upon RTP compared to MLS players (82% vs. 56%, p <0 .01). Most professional soccer players who sustain a facial fracture RTP the same season, but their recovery time can vary depending on the type of fracture, injury management, or injury severity. Our findings can help inform future craniofacial injury management as well as guidelines on player safety and fracture prevention.
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Affiliation(s)
- Konrad M Kozlowski
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California
| | | | - Asher C Park
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California
| | - Amir A Hakimi
- Department of Otolaryngology - Head and Neck Surgery, Medstar Georgetown University Hospital, Washington, District of Columbia
| | - Leandro Socolovsky
- Department of Otolaryngology - Head and Neck Surgery, Medstar Georgetown University Hospital, Washington, District of Columbia
| | - Brian J-F Wong
- Beckman Laser Institute & Medical Clinic, University of California, Irvine, California
- Department of Biomedical Engineering, University of California, Irvine, Irvine, California
- Department of Otolaryngology - Head & Neck Surgery, University of California - Irvine, Orange, California
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Liang L, Chuang SK. Trends in Soccer-Related Craniomaxillofacial Injuries, United States 2003-2022. J Oral Maxillofac Surg 2023; 81:1495-1503. [PMID: 37743045 DOI: 10.1016/j.joms.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/31/2023] [Accepted: 09/01/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Soccer is one of the most popular sports worldwide. However, it has risks of injury to craniomaxillofacial regions such as the head, neck, and mouth. PURPOSE The purpose of this study is to determine which demographic and injury characteristics among soccer players with craniomaxillofacial injuries are associated with increased hospitalizations. STUDY DESIGN, SETTING, AND SAMPLE This is a retrospective cohort study utilizing the National Electronic Injury Surveillance System. Subjects included in this study experienced an injury to a craniomaxillofacial area from soccer between January 1, 2003, and December 31, 2022. PREDICTOR VARIABLE The predictor variables included demographics (age, sex, race) and injury characteristics (craniomaxillofacial region, diagnosis). MAIN OUTCOME VARIABLE The primary outcome variable was injury severity defined as hospitalization outcome after injury (yes/no). The secondary outcome variable was the trends in the incidence of soccer craniomaxillofacial injuries over time (2003-2022). COVARIATES The covariates were the heterogenous set of predictor variables in this study. ANALYSES Descriptive statistics and univariate analyses were computed. Survey-weighted univariate and multivariate logistic regression were used to measure the association of demographic and injury variables with hospitalization outcome. Statistical significance was defined as P < .05. RESULTS The study sample included 26,642 subjects (national estimate, 799,393). The national incidence of craniomaxillofacial soccer injuries generally increased between 2003 and 2012 and decreased between 2016 and 2020. Subjects in the ≥30 age group had increased odds of hospitalization compared to those in the 10-19 age group (odds ratio [OR], 2.12; P < .001). Compared to females, males had significantly higher odds of hospitalization (OR, 1.53; P < .001). Head (OR, 8.42; P < .001) and neck (OR, 15.8; P < .001) injuries had increased odds of hospitalization compared to facial injuries. Relative to contusions/abrasions, subjects with fractures (OR, 94.7; P < .001), dental injuries (OR, 41.3; P < .001), and concussions (OR, 5.33; P = .017) were at significantly higher odds of hospitalization. CONCLUSION AND RELEVANCE Age, sex, craniomaxillofacial region, and diagnosis were significant predictors of hospitalization outcome after craniomaxillofacial soccer injury. Safer playing styles, use of mouthguards, and proper medical management may reduce future risks of craniomaxillofacial injury from soccer.
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Affiliation(s)
- Lang Liang
- Dental Student, Harvard School of Dental Medicine, Boston, MA.
| | - Sung-Kiang Chuang
- Clinical Professor, Department of Oral and Maxillofacial Surgery, University of Pennsylvania, School of Dental Medicine, Philadelphia, PA; Attending, Department of Oral and Maxillofacial Surgery, Good Samaritan Medical Center, Brockton, MA
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Manninen IK, Klockars T, Mäkinen LK, Blomgren K. Epidemiology and aetiology of sport-related nasal fractures: Analysis of 599 Finnish patients. Clin Otolaryngol 2023; 48:70-74. [PMID: 36054526 PMCID: PMC10087601 DOI: 10.1111/coa.13976] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/02/2022] [Accepted: 08/19/2022] [Indexed: 01/07/2023]
Affiliation(s)
- Iida-Kaisa Manninen
- Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Tuomas Klockars
- Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Laura K Mäkinen
- Department of Pulmonary Medicine, Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Karin Blomgren
- HUS Joint Resources, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Aung TK, Churei H, Tanabe G, Kinjo R, Togawa K, Li C, Tsuchida Y, Tun PS, Hlaing S, Takahashi H, Ueno T. Air Permeability, Shock Absorption Ability, and Flexural Strength of 3D-Printed Perforated ABS Polymer Sheets with 3D-Knitted Fabric Cushioning for Sports Face Guard Applications. Polymers (Basel) 2021; 13:polym13111879. [PMID: 34198902 PMCID: PMC8201100 DOI: 10.3390/polym13111879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/27/2021] [Accepted: 06/02/2021] [Indexed: 01/26/2023] Open
Abstract
Sports face guards (FGs) are devices that protect athletes from maxillofacial injury or ensure rapid return to play following orofacial damage. Conventional FGs are uncomfortable to wear owing to stuffiness caused by poor ventilation and often slip off due to increase in weight due to absorption of moisture from perspiration, lowering players’ performance. Herein, combinations of 3D-printed perforated acrylonitrile butadiene styrene (ABS) polymer sheets and 3D-knitted fabrics with honeycomb structures as cushioning materials were investigated to balance better wearing feel and mechanical properties. The flexural strength, weight, and shock absorption ability of, and air flow rate through, the ABS sheets with five different perforation patterns were evaluated and compared with those of conventional FG materials comprising a combination of polycaprolactone sheets for the medical splint and polychloroprene rubber for the cushioning material. The ABS sheets having 10% open area and 2.52 mm round holes, combined with knitted fabric cushioning, exhibited the requisite shock absorbing, higher air permeability, and lower weight properties than the conventional materials. Our results suggest that FGs fabricated using combinations of 3D-printed perforated ABS polymer sheets and 3D-knitted fabrics with honeycomb structures may impart enhanced wearing comfort for athletes.
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Affiliation(s)
- Thet Khaing Aung
- Department of Sports Medicine/Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (T.K.A.); (H.C.); (G.T.); (R.K.); (K.T.); (C.L.)
| | - Hiroshi Churei
- Department of Sports Medicine/Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (T.K.A.); (H.C.); (G.T.); (R.K.); (K.T.); (C.L.)
| | - Gen Tanabe
- Department of Sports Medicine/Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (T.K.A.); (H.C.); (G.T.); (R.K.); (K.T.); (C.L.)
- Department of Maxillofacial Prosthetics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Rio Kinjo
- Department of Sports Medicine/Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (T.K.A.); (H.C.); (G.T.); (R.K.); (K.T.); (C.L.)
| | - Kaito Togawa
- Department of Sports Medicine/Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (T.K.A.); (H.C.); (G.T.); (R.K.); (K.T.); (C.L.)
| | - Chenyuan Li
- Department of Sports Medicine/Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (T.K.A.); (H.C.); (G.T.); (R.K.); (K.T.); (C.L.)
| | - Yumi Tsuchida
- Department of Oral Biomaterials Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (Y.T.); (H.T.)
| | - Phyu Sin Tun
- Moe Myitta Dental Clinic, No.117, Corner of 26th x 76th Street, Chaayetharsan Township, Mandalay 05024, Myanmar;
| | - Shwe Hlaing
- Department of Prosthodontics, The University of Dental Medicine, Mandalay, 62nd Street, Chan Mya Thazi Township, Mandalay 05041, Myanmar;
| | - Hidekazu Takahashi
- Department of Oral Biomaterials Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (Y.T.); (H.T.)
| | - Toshiaki Ueno
- Department of Sports Medicine/Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (T.K.A.); (H.C.); (G.T.); (R.K.); (K.T.); (C.L.)
- Correspondence: ; Tel.: +81-03-5803-5867
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Abstract
ABSTRACT Soccer is one of the most popular sports in the world. Despite the concept that soccer is not a violent game, it can lead to several injuries in amateur and professional settings, including facial fractures. Previous studies of facial fractures in soccer were all retrospective and, to date, no prospective studies are available in the literature.The authors performed a comprehensive literature search using the terms "soccer" AND "facial fracture" OR "craniofacial fracture" and "football" AND "facial fracture" OR "craniofacial fracture" and retrieved 693 articles. After applying inclusion and exclusion criteria, 11 articles were included in the present study.A total of 647 patients had suffered facial trauma, with a male-to-female ratio of 63.7:1. The patients' mean age was 27.3 years.The articles reported 670 fractures as follows: 219 (32.7%) in the zygoma, 197 (29.4%) in the nasal bone, 153 (23.6%) in the mandibula, 54 (8.0%) in the orbital wall, 12 (1.8%) in the frontal sinus, 10 (1.5%) in the alveolar bone, 3 (0.4%) in the maxilla, 3 (0.4%) in a Le Fort pattern, and 1 (0.1%) in a naso-orbito-ethmoid (NOE) pattern.Sports are a frequent cause of maxillofacial trauma and are responsible for 9.2% to 33.2% of such injuries. Soccer is a contact sport more associated with lower-limb injuries, but with a significant rate of facial fractures. As soccer is a popular sport played without facial protection and involving high-intensity movements and contact, the prevention of facial fractures related to this sport is crucial to improve the players' safety.
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Wada T, Churei H, Yokose M, Iwasaki N, Takahashi H, Uo M. Application of Glass Fiber and Carbon Fiber-Reinforced Thermoplastics in Face Guards. Polymers (Basel) 2020; 13:polym13010018. [PMID: 33374594 PMCID: PMC7793102 DOI: 10.3390/polym13010018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/20/2020] [Accepted: 12/21/2020] [Indexed: 12/03/2022] Open
Abstract
Face guards (FGs) are protectors that allow for the rapid and safe return of athletes who are to play after sustaining traumatic facial injuries and orbital fractures. Current FGs require significant thickness to achieve sufficient shock absorption abilities. However, their weight and thickness render the FGs uncomfortable and reduce the field of vision of the athlete, thus hindering their performance. Therefore, thin and lightweight FGs are required. We fabricated FGs using commercial glass fiber-reinforced thermoplastic (GFRTP) and carbon fiber-reinforced thermoplastic (CFRTP) resins to achieve these requirements and investigated their shock absorption abilities through impact testing. The results showed that an FG composed of CFRTP is thinner and lighter than a conventional FG and has sufficient shock absorption ability. The fabrication method of an FG comprising CFRTP is similar to the conventional method. FGs composed of commercial FRTPs exhibit adequate shock absorption abilities and are thinner and lower in weight as compared to conventional FGs.
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Affiliation(s)
- Takahiro Wada
- Department of Advanced Biomaterials, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (M.Y.); (M.U.)
- Correspondence: ; Tel.: +81-03-5803-5469
| | - Hiroshi Churei
- Department of Sports Medicine/Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan;
| | - Mako Yokose
- Department of Advanced Biomaterials, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (M.Y.); (M.U.)
| | - Naohiko Iwasaki
- Department of Oral Biomaterials Development Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (N.I.); (H.T.)
| | - Hidekazu Takahashi
- Department of Oral Biomaterials Development Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (N.I.); (H.T.)
| | - Motohiro Uo
- Department of Advanced Biomaterials, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (M.Y.); (M.U.)
- Department of Materials Engineering, Graduate School of Engineering, The University of Tokyo, 7‑3‑1 Hongo, Bunkyo‑ku, Tokyo 113-8656, Japan
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Ambroise B, Reboursière E, Drouet J, Corre P, Benateau H, Veyssière A. La prévention secondaire des fractures de la région nasale par un masque de protection faciale chez les sportifs – Étude rétrospective comparative à propos de 19 cas. Sci Sports 2020. [DOI: 10.1016/j.scispo.2020.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bojino A, Roccia F, Giaccone E, Cocis S. Comprehensive analyses of maxillofacial fractures due to non-professional sports activities in Italy. Dent Traumatol 2020; 36:632-640. [PMID: 32790896 DOI: 10.1111/edt.12586] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND/AIM Sports activities have become increasingly popular among amateurs and this has led to an increase in maxillofacial fractures. The aim of this study was to investigate the management of amateur sport-related maxillofacial fractures and appropriate preventive measures. METHODS A trauma database was used to analyze 3231 patients with maxillofacial fractures admitted to the Maxillofacial Surgery Division of Città della Salute e della Scienza Hospital, Turin, Italy, from January 2001 to December 2019. Only patients with non-professional sports-related maxillofacial fractures were included. The following data were collected: age, gender, type of sport, mechanisms of injury, sites of fracture, Facial Injury Severity Scale, associated injuries, month of trauma, time to treatment, treatment, length of stay, and interval before return to sport. RESULTS There were 432 patients, 378 males and 54 females, with a mean age of 29.2 (5-76 years). Sport-related maxillofacial fractures' relative percent ranged from 11.1% in 2001 to 17.5% in 2019. Soccer was the most common cause of sport-related maxillofacial fractures (54.2%), and impact with a player/opponent was the main mechanism of injury (72%). An intentional violent act (player hit by a fist) was the cause of fracture in 8.5% of the soccer-related injuries. Fractures of the middle third of the face occurred in 61.2% of patients. Maxillofacial fractures were treated within 24 h in 25% of patients. There were 343 out of 412 patients who received open reduction and internal fixation (mean length of hospital stay: 3.7 days). There was no contraindication to resuming sport activities at 30/40 days after treatment, except for combat sports. CONCLUSIONS This study provided further evidence of a relative increase in sports-related maxillofacial fractures. Soccer is related to the majority of sport maxillofacial fractures. Adherence to the rules is necessary to limit violent acts that cause such injuries. In non-professional players, resumption of the full activity is allowed after 40 days for non-combat sports.
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Affiliation(s)
- Alessandro Bojino
- Division of Maxillofacial Surgery (head: Prof. G. Ramieri), Surgical Science Department, Città della Salute e delle Scienze Hospital, University of Turin, Torino, Italy
| | - Fabio Roccia
- Division of Maxillofacial Surgery (head: Prof. G. Ramieri), Surgical Science Department, Città della Salute e delle Scienze Hospital, Turin, Italy
| | - Elena Giaccone
- Division of Maxillofacial Surgery (head: Prof. G. Ramieri), Surgical Science Department, Città della Salute e delle Scienze Hospital, University of Turin, Torino, Italy
| | - Stefan Cocis
- Division of Maxillofacial Surgery (head: Prof. G. Ramieri), Surgical Science Department, Città della Salute e delle Scienze Hospital, University of Turin, Torino, Italy
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Postoperative Management of Zygomatic Arch Fractures: In-House Rapid Prototyping System for the Manufacture of Protective Facial Shields. J Craniofac Surg 2019; 30:2057-2060. [PMID: 31568157 DOI: 10.1097/scs.0000000000005930] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Zygomatic fractures account for 10% to 15% of all facial fractures. The surgical management of isolated zygomatic arch fractures usually requires open reduction treatment without fixation through an intraoral access. Therefore, the main problem in the non-fixed treatment of zygomatic arch fractures is related to the difficulty in obtaining a stable reduction for a period long enough to guarantee the physiological bone healing process. We propose an innovative "in-house" rapid prototyping (RP) protocol for the 3D-zygoma mask manufacture of a patient-specific protective device to apply after zygomatic arch fracture reduction. Our study includes 16 consecutive patients who underwent surgical open reduction for an isolated zygoma fracture without fixation between January 2017 and February 2018. The patients received regular postoperative checks at weeks 1 and 2. Before the device was removed, a multiple choice questionnaire was administered to measure the degree of wearability of the mask. The estimated cost of the production is around &OV0556;5 per case and the construction time is around 90 minutes. Based on the encouraging results, obtained in our experience, we hope that other studies can be conducted to confirm our procedure and improve its functionality in the field of facial trauma.
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Ansari U, Wong E, Arvier J, Hyam D, Huang W. Early return to sport post maxillofacial fracture injury in the professional athlete: A systematic review. J Craniomaxillofac Surg 2019; 47:1323-1330. [PMID: 31377073 DOI: 10.1016/j.jcms.2019.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 04/15/2019] [Accepted: 06/02/2019] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION To summarize the current literature on return to sport times post-maxillofacial fracture injury in the professional athlete. MATERIALS AND METHODS A literature search on six databases for articles relating to maxillofacial fractures, professional athletes, and return to sport times. Study design, clinical data, and author recommendations were analysed. RESULTS 17 studies were retrieved. One prospective study returned 17 athletes to competitive rugby union and soccer at 3 weeks post injury without complication. Two large retrospective studies (n = 278) returned patients to sport at approximately 7 weeks without complication. 64% (n = 7) of patients from case based studies returned to sport at 3-14 days, 4 of which utilized protective facemasks. Athletes generally returned to competition earlier for lower grade (3-10 days) compared to higher grade contact sport (21 days at least). 2 articles recommended a 3 months recovery period for combat sports. 8 articles supported the utility of protective facemasks. CONCLUSION Early return to sport (<6 weeks) in the professional athlete post maxillofacial fracture injury is achievable. The optimal clinical approach may be to grade the sport according to its impact forces, discuss an early return with reference to the available literature, the potential utility of facemasks, risks of refracture and its operative implications.
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Affiliation(s)
- Umair Ansari
- Department of Oral & Maxillofacial Surgery, Westmead Public Hospital, Sydney, NSW, Australia.
| | - Eugene Wong
- Department of Otolaryngology, Westmead Public Hospital, Sydney, NSW, Australia.
| | | | - Dylan Hyam
- Maxillofacial Unit, The Canberra Hospital, Canberra, ACT, Australia.
| | - Weber Huang
- Department of Oral & Maxillofacial Surgery, Westmead Public Hospital, Sydney, NSW, Australia; School of Dentistry, Faculty of Medicine and Health, University of Sydney, NSW, Australia.
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Antunes LS, Torres AFC, Ferreira G, Prado R, Coto NP, Antunes LAA. Custom-made facemask as a coadjuvant in the postoperative treatment of sport-related facial trauma: Case report. Dent Traumatol 2018; 34:378-381. [PMID: 29999586 DOI: 10.1111/edt.12426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 07/05/2018] [Accepted: 07/06/2018] [Indexed: 11/29/2022]
Abstract
Maxillofacial injuries are a regular consequence of sport activities that can force athletes to take a long time off from training and competitions. One way to decrease the time that the athlete needs to get back to his or her training exercises after surgery is to use a custom facemask as a coadjuvant in the postoperative recovery phase. This case report describes the case of a 16-year-old male athlete who suffered facial trauma (orbitozygomatic fractures) during a soccer game. After surgery, a facemask was used during the postoperative phase. He returned to his regular physical activities only 3 weeks after surgery. This simple and very efficient procedure is a good option for athletes who suffer facial injuries.
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Affiliation(s)
- Leonardo Santos Antunes
- Postgraduate Program in Dentistry of Niterói Faculty of Dentisry, Federal Fluminense University (PPGO-FOUFF), Niterói, Rio de Janeiro, Brazil.,Department of Specific Formation, Health Institute of Nova Friburgo (ISNF), Laboratory of Sports Dentistry, School of Dentistry, Fluminense Federal University (UFF), Nova Friburgo, Rio de Janeiro, Brazil
| | - Ariane Ferraz Corrêa Torres
- Postgraduate Program in Dentistry of the Health Institute of Nova Friburgo (PPGO-ISNF), Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Gustavo Ferreira
- Postgraduate Program in Dentistry of Niterói Faculty of Dentisry, Federal Fluminense University (PPGO-FOUFF), Niterói, Rio de Janeiro, Brazil
| | - Roberto Prado
- Postgraduate program in Dentistry, School of Dentistry, Unigranrio, Rio de Janeiro, Brazil
| | - Neide Pena Coto
- Department of Maxillofacial Surgery, Prosthetics and Traumatology, Division of Maxillofacial Prosthesis/Sports Dentistry, School of Dentistry, University of São Paulo - FOUSP
| | - Lívia Azeredo Alves Antunes
- Postgraduate Program in Dentistry of Niterói Faculty of Dentisry, Federal Fluminense University (PPGO-FOUFF), Niterói, Rio de Janeiro, Brazil.,Department of Specific Formation, Health Institute of Nova Friburgo (ISNF), Laboratory of Sports Dentistry, School of Dentistry, Fluminense Federal University (UFF), Nova Friburgo, Rio de Janeiro, Brazil.,Postgraduate Program in Dentistry of the Health Institute of Nova Friburgo (PPGO-ISNF), Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
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Injury mechanism of midfacial fractures in football causes in over 40% typical neurological symptoms of minor brain injuries. Knee Surg Sports Traumatol Arthrosc 2018; 26:1295-1302. [PMID: 28180920 DOI: 10.1007/s00167-017-4431-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 01/13/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE The injury mechanisms of midfacial fractures may be typical causes of concussion, but hardly any scientific data on midfacial injuries sustained in football are available. Head and brain trauma represent frequent injuries in athletes of different sports that require appropriate treatment by sports and trauma physicians. This study investigated the management of midfacial fractures in football and the association of such fractures with concomitant brain injury. METHODS In a prospective cohort study lasting 24 months (2012 to 2013), midfacial injuries of football players were analysed with regard to the injury mechanisms, first aid procedures on the field, treatment and return-to-play. To analyse concomitant and potentially overlooked minor brain injuries due to the trauma, we retrospectively investigated the neurological symptoms of the study population. RESULTS The study included 132 football players (37 semi-professionals and 95 amateurs) with midfacial fractures. The main injury mechanisms were head-to-head and head-to-elbow trauma. The mean period of return-to-play after trauma was 33.5 days, which was significantly shortened if a protective face mask was worn (mean 10.4 days earlier, p = 0.0006). Semi-professional football players returned to play earlier (p = 0.009) and more often used protective face masks (p = 0.001). 55 players (41.6%) had neurological symptoms immediately after trauma as a possible sign of concomitant minor brain injury. 5 of 132 players with concussion had been hospitalised for 24 h, but no persistent neurological symptoms were detected. CONCLUSION In football, midfacial fractures represent moderate-to-severe injuries with time away from sports of more than 4 weeks. Over 40% of athletes with a midfacial fracture showed concomitant neurological symptoms as a sign of minor brain injury. Therefore, sports physicians and other staff supervising athletes in daily practice should be aware of the presence of neurological symptoms. LEVEL OF EVIDENCE Level III.
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Improvement of the Shock Absorption Ability of a Face Guard by Incorporating a Glass-Fiber-Reinforced Thermoplastic and Buffering Space. BIOMED RESEARCH INTERNATIONAL 2018; 2018:6503568. [PMID: 29854774 PMCID: PMC5964619 DOI: 10.1155/2018/6503568] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 01/01/2018] [Indexed: 11/25/2022]
Abstract
This study aimed to evaluate the shock absorption ability of trial face guards (FGs) incorporating a glass-fiber-reinforced thermoplastic (GF) and buffering space. The mechanical properties of 3.2 mm and 1.6 mm thick commercial medical splint materials (Aquaplast, AP) and experimental GF prepared from 1.6 mm thick AP and fiberglass cloth were determined by a three-point bending test. Shock absorption tests were conducted on APs with two different thicknesses and two types of experimental materials, both with a bottom material of 1.6 mm thick AP and a buffering space of 30 mm in diameter (APS) and with either (i) 1.6 mm thick AP (AP-APS) or (ii) 1.6 mm thick GF (GF-APS) covering the APS. The GF exhibited significantly higher flexural strength (64.4 MPa) and flexural modulus (7.53 GPa) than the commercial specimens. The maximum load of GF-APS was 75% that of 3.2 mm AP, which is widely used clinically. The maximum stress of the GF-APS only could not be determined as its maximum stress is below the limits of the analysis materials used (<0.5 MPa). Incorporating a GF and buffering space would enhance the shock absorption ability; thus, the shock absorption ability increased while the total thickness and weight decreased.
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Security "high-tech" individual extra-light device mask 2.0: CAD/CAM evolution. Br J Oral Maxillofac Surg 2017; 55:e27-e28. [PMID: 28408058 DOI: 10.1016/j.bjoms.2017.03.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 03/27/2017] [Indexed: 11/21/2022]
Abstract
In 2008, we presented our security "high-tech" individual extra-light device mask (SHIELD), a protective shield based on the face cast of an injured soccer player that can be customised. It allows a shortened convalescent period, is comfortable, fits well, and allows the patient to continue to play at a professional level in their chosen sport or activity in the shortest time possible. It has been used often in both amateur and professional categories of many sports, and we now present an update.
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Bobian MR, Hanba CJ, Svider PF, Hojjat H, Folbe AJ, Eloy JA, Shkoukani MA. Soccer-Related Facial Trauma: A Nationwide Perspective. Ann Otol Rhinol Laryngol 2016; 125:992-996. [PMID: 27620669 DOI: 10.1177/0003489416668195] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Soccer participation continues to increase among all ages in the US. Our objective was to analyze trends in soccer-related facial injury epidemiology, demographics, and mechanisms of injury. MATERIALS AND METHODS The National Electronic Injury Surveillance System was evaluated for soccer-related facial injuries from 2010 through 2014. Results for product code "soccer" were filtered for injures to the face. Number of injuries was extrapolated, and data were analyzed for age, sex, specific injury diagnoses, locations, and mechanisms. RESULTS In all, 2054 soccer-related facial trauma entries were analyzed. During this time, the number of injures remained relatively stable. Lacerations were the most common diagnosis (44.2%), followed by contusions and fractures. The most common sites of fracture were the nose (75.1%). Of fractures with a reported mechanism of injury, the most common was head-to-head collisions (39.0%). Patients <19 years accounted for 66.9% of injuries, and athletes over 18 years old had a higher risk of fractures. CONCLUSIONS The incidence of soccer-related facial trauma has remained stable, but the severity of such injuries remain a danger. Facial protection in soccer is virtually absent, and our findings reinforce the need to educate athletes, families, and physicians on injury awareness and prevention.
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Affiliation(s)
- Michael R Bobian
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Curtis J Hanba
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Peter F Svider
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Houmehr Hojjat
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Adam J Folbe
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Newark, New Jersey, USA.,Department of Opthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Mahdi A Shkoukani
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.,Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA
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Abstract
BACKGROUND Sports-related maxillofacial injuries contribute a significant proportion of the workload in a maxillofacial unit. The aim of this study was to identify the incidence of maxillofacial sports-related injuries, treatments required, and assess the impact of the injury on future sport participation. METHOD A retrospective review was carried out on all maxillofacial trauma referrals from September 1, 2009 to August 31, 2010. Patient records were reviewed and the following variables were recorded: age, sex, sport involved, injury sustained, mechanism of injury, treatment, subsequent participation, and interval before return to sport. RESULTS The study population included 162 patients with sports-related facial injuries. The most common sporting injuries were as follows: Gaelic football 35.3% (N = 57), soccer 22.3% (N = 36), rugby 12.4% (N = 20), and equine sports 12.4% (N = 20). The most common injury sustained was zygomatic complex fracture 36.4% (N = 59). Mandibular fracture occurred in 20% (N = 33), orbit fracture in 14.2% (N = 23), and nasal bone fracture in 12.3% (N = 20). The most common mechanism of injury was from a clash of heads (23.4%) followed by an elbow to the face (17.2%). The majority of patients (84%) resumed participation in their chosen sport at mean interval of 7.3 weeks (range 1-18 weeks). CONCLUSIONS This study identified a significant number of sporting facial injuries, which presented over 1 year. In total, 113 patients underwent a surgical procedure for the management of their injuries. This study highlights the need to educate all players regarding use of personal protective equipment and adherence to the rules of sports.
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Gandy JR, Fossett L, Wong BJF. Face masks and basketball: NCAA division I consumer trends and a review of over-the-counter face masks. Laryngoscope 2015; 126:1054-60. [PMID: 26344194 DOI: 10.1002/lary.25584] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS This study aims to: 1) determine the current consumer trends of over-the-counter (OTC) and custom-made face mask usage among National Collegiate Athletic Association (NCAA) Division I athletic programs; and 2) provide a literature review of OTC face guards and a classified database. STUDY DESIGN Literature review and survey. METHODS Consumer trends were obtained by contacting all 352 NCAA Division I programs. Athletic trainers present in the office when called answered the following questions: 1) "When an athlete breaks his or her nose, is a custom or generic face guard used?" and 2) "What brand is the generic face guard that is used?" Data was analyzed to determine trends among athletic programs. Also, a database of OTC devices available was generated using PubMed, Google, and manufacturer Web sites. RESULTS Among the 352 NCAA Division I athletic programs, 254 programs participated in the survey (72% response rate). The majority preferred custom-made guards (46%). Disadvantages included high cost and slow manufacture turnaround time. Only 20% of the programs strictly used generic brands. For the face mask database, 10 OTC products were identified and classified into four categories based on design, with pricing ranging between $35.99 and $69.95. CONCLUSION Only a handful of face masks exist for U.S. consumers, but none of them have been reviewed or classified by product design, sport application, price, and collegiate consumer use. This project details usage trends among NCAA Division I athletic programs and provides a list of available devices that can be purchased to protect the nose and face during sports. LEVEL OF EVIDENCE NA. Laryngoscope, 126:1054-1060, 2016.
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Affiliation(s)
- Jessica R Gandy
- School of Medicine.,the Beckman Laser Institute and Medical Clinic
| | - Lela Fossett
- the Beckman Laser Institute and Medical Clinic.,the Francisco J. Ayala School of Biological Sciences
| | - Brian J F Wong
- School of Medicine.,the Beckman Laser Institute and Medical Clinic.,the Department of Biomedical Engineering, University of California-Irvine, Irvine.,Department of Otolaryngology, Head and Neck Surgery, University of California-Irvine, Orange, California, U.S.A
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Abe K, Takahashi H, Churei H, Iwasaki N, Ueno T. Flexural properties and shock-absorbing capabilities of new face guard materials reinforced with fiberglass cloth. Dent Traumatol 2012; 29:23-8. [DOI: 10.1111/j.1600-9657.2012.01135.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Design and manufacture of customised protective facial sports splints. Br J Oral Maxillofac Surg 2011; 50:264-5. [PMID: 21684050 DOI: 10.1016/j.bjoms.2011.03.266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Accepted: 03/21/2011] [Indexed: 11/20/2022]
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