Craniofacial Injuries Research Articles

Craniofacial Injuries Resulting from Polytrauma: Mechanisms, Imaging, and Complications

Purpose: This literature review aims to identify and analyse the most common mechanisms causing injuries in the craniofacial region their diagnosis and possible sequelae. Methods: The study analysed publications from the Medline database made available in PubMed and Google Scholar considering the following keywords "maxillofacial injuries" and/or "maxillofacial trauma" and/or "maxillofacial fractures". Results: Craniofacial injuries in polytrauma patients are often complicated by their heterogeneous nature and coexistence with other injuries. Their incidence and mechanisms vary depending on the country of investigation. Diagnosis includes advanced imaging techniques such as CT scans. Treatment often requires multidisciplinary collaboration. Conclusions: Craniofacial injuries in polytraumatic patients require a complex diagnostic and therapeutic approach. Interdisciplinary collaboration is crucial to achieve the best clinical outcome. The most common causes include road traffic collisions, assaults, falls and sports-related injuries. Despite properly applied treatment protocols, they generate changes in the stomatognathic system, sensory disturbances, blindness and, in extreme cases, can lead to death

Plastic Surgery Contributions to the World Wars: Historical Foundations for Modern Craniofacial Techniques.

Plastic surgery played a crucial role during the World Wars. Surgeons dedicated their careers to reconstructing facial injuries and residual deformities incurred during combat. Times of unprecedented trauma led to rapid innovation in plastic surgery, with invaluable impact on practice today. Pioneers such as Harold Gillies are well-known for their work. There are numerous additional contributors who deserve wider recognition. A literature review was performed to identify key surgeons who treated soldiers' craniofacial injuries during World Wars I and II. Biographical information, country of practice, and technical contributions to plastic surgery were compiled. Nineteen plastic surgeons were identified who contributed significantly to craniofacial surgery during the World Wars. These surgeons were: Albéric Pont, Archibald Mcindoe, Arthur Mowlem, Harold Gillies, Hippolyte Morestin, James Barrett Brown, Jaques Joseph, Johannes Esser, John Staige Davis, John Reese, Otto Lanz, Paul Tessier, Robert Ivy, Suzanne Blanche Gros Noël, Thomas Kilner, William Kelsy Fry, Varaztad H. Kazanjian, Vilray P. Blair, and Vladimir Petrovich Filatov. Fourteen were active during WWI. Nine were active during WWII. Notable technical developments were made in maxillofacial fracture fixation, bone grafting, rhinoplasty, dental prosthetics, flap-based coverage, skin grafting, and burn reconstruction. Plastic surgeons played an unheralded role in managing the disfiguring craniofacial injuries of World Wars I and II. By treating tens of thousands of war victims, these surgeons contributed not only to the rehabilitation of soldiers but also to the advancement of craniofacial surgery and the establishment of plastic surgery as a distinct subspecialty.

A 14-Year-Old Child with Craniofacial Injuries Caused by Traumatic Gunshot

Ballistic trauma is an injury resulting from the impact of a projectile on the body. Gunshot wounds to the head are among the most lethal. Although they were rare in civilian practice, their incidence has increased in recent years in the civilian population due to the resurgence of armed conflicts and terrorism. Severe firearm-related head injuries in children are very rare and poorly studied; they are most often due to suicide attempts. CT is the imaging modality of choice. It aids in initial management, monitors progression. We present the case of a 14-year-old child admitted for a gunshot injury. The patient was initially hospitalized in the intensive care unit before undergoing initial imaging in our department.

FEATURES OF FUNCTIONAL DIAGNOSTICS OF OPTIC NERVE DAMAGE IN CASE OF HEAD INJURY

Introduction. Traumatic optic nerve damage is a rare complication of a head injury. Symptoms of primary damage appear at the time of first diagnostic in the early period and mask TON’s signs. Understanding of visual disturbances for the patient comes in a later period, when recovery is limited due to the irreversibility of the received injuries. Difficulties of early diagnosis of optic nerve damage in case of head trauma encourage the search for new, more informative methods. The aim of the study was to analyze the functional manifestations of the optic nerve damage in case of head injuries with different localization. Materials and methods. 366 cases (732 eyes) of patients with traumatic optic neuropathy (TON) were studied according to archival data in the period from 2014 to 2019. The control group consisted of 58 practically healthy persons (116 eyes). All patients were divided into three groups: A group - patients with traumatic brain injury (TBI) was 120 persons, B group - patients with craniofacial injury (CFI) - 118 persons and C group - with combined injuries - 128 injured. The degree of optic nerve damage was assessed using visometry, pupillometry, and perimetry. Results. In case of craniocerebral injury, decrease of visual acuity with an average value of 0.92±0.06 corresponded to degrees 0 (93%) and I (7%). In the case of craniofacial trauma, according to the research, visual acuity decreased to 0.76±0.13 (by 0.24, 24% compared to the control group, p<0.05). The first degree (23%) and the second degree (7%) were determined. With a combined primary head injury, visual acuity decreased to 0.42±0.21 (by 0.58, 58%, compared to the control group, p<0.05). One third were patients with I, II and III degrees of visual impairment. The use of static perimetry made it possible to detect damage to the optic nerve in patients with 0 degrees of reduced visual acuity. At the same time, 88% of patients of A group (n=120) had 0A class, 23% of B group (n=118) had 0B class, and in C group (n=122) there was almost no. The relative afferent pupillary defect’s test was negative at 0A group of vision loss, but the pupil cycle speed (PSC) was reduced in all patients. This confirms damage to the optic nerve in patients with high visual acuity This study showed that patients with TBI had high visual acuity in 93% of cases, The visual acuity was around 0.5-1.0, but sensitivity in the central part of the visual field decreased by 12 times, and the pupil reaction rate decreased by 55% compared to the control group. In case of craniofacial trauma (B group), visual acuity decreased to 0.76±0.13 (by 0.24, 24% compared to the control group, p<0.05). I degree (23%) and II degree (7%) decrease of visual acuity was determined. As for the sensitivity in the central part of the visual field, it was 46.59% lower than in the A group. In patients with a combined injury of the head and face, a third of the injured had visual acuity less than 0.1, which is not found in other variants of injury. Conclusions. Analysis showed that severity of optic nerve damage depends on localization of the head injury. The use of static perimetry and pupillometry is important for the early diagnosis of TON in conditions with high visual acuity when other symptoms are weak or not amenable to examination.

Pacifiers and Teething Devices: A Risk for Craniofacial Injury in Children Under 2 Years Old.

Pacifiers and teething devices are commonly introduced during infancy to soothe and comfort. This study aimed to investigate the incidence of emergency room visits for pediatric craniofacial injuries associated with pacifiers and teething devices. All craniofacial injuries due to "Pacifiers or Teething Rings" in children less than 2 years old were retrieved from the National Electronic Injury Surveillance System (NEISS). Age, sex, race, context of injury, cause of injury, and patient disposition were collected. Query revealed an estimated nationwide incidence of 5424 injuries from the years 2012 to 2021, with a mean age of 12.1 months at the time of injury. Most injuries occurred at home (70.2%), often resulting from falls while using the pacifier/teething device (71.0%). An estimated 97.6% of patients were released after emergency room treatment. Education regarding abstaining from pacifier and teething device use during activity may reduce the incidence of these injuries.

Study of Pattern of Craniofacial Injuries in Road Traffic Accident Cases Autopsied in Midnapore Medical College

Background: The objective of this study was to investigate the pattern of craniofacial injuries in victims of fatal road traffic accidents, observed through autopsies conducted at Midnapore Medical College, West Midnapore from January 2021 to December 2023. Methods: It is a retrospective, cross- sectional observational study. Data was collected by thorough analysis of the injuries documented in post-mortem reports of all the alleged road traffic accident cases where victim sustained Cranio- facial injuries within a time span of 3 years, from 1st January 2021 to 31st December, 2023. Data was analysed using Microsoft Excel. Conclusion: The study highlights the necessity of context-specific interventions to address the unique injury patterns observed in West Midnapore's road traffic accidents. Improving road infrastructure, raising traffic safety awareness, and promoting protective measures like seat belts and helmets can reduce severe craniofacial injuries. The prevalence of maxillofacial fractures underscores the face's vulnerability, with long-term physical and psychological impacts. Effective prevention strategies, such as strict traffic regulations and awareness campaigns on the dangers of distracted or impaired driving, are essential. Despite limitations, the study provides valuable insights into craniofacial injury patterns in fatal accidents, stressing the need for enhanced road safety, stronger traffic laws, and better post-accident care. Interdisciplinary collaboration among healthcare professionals, law enforcement, and policymakers is crucial for developing comprehensive strategies to manage and prevent these injuries. By examining regional injury characteristics and comparing them with other studies, this research contributes to the broader understanding of craniofacial trauma, offering significant implications for improving road safety, trauma care, and forensic practices.

Epidemiology of craniofacial and spinal injuries in French Rugby union: A report including medical, social, and professional consequences

ObjectivesFirst, to investigate the medico-socio-professional repercussions of non-fatal cranioencephalic and spinal injuries occurring across all levels of play in male and female Rugby Union in France. Second, to determine whether an association existed between the severity of injuries and the circumstances of their occurrence and/or the profiles of the injured players. Third, to gather new epidemiological data regarding the severity and long-term consequences of these injuries in the sport. DesignNational retrospective observational open cohort study conducted using medical expertise files on all injuries registered by the insurer affiliated to the French Rugby Federation. MethodsWe analysed the medical reports of spinal, craniofacial or radicular trauma occurred from 26/08/2011 to 31/01/2018. Data relating to the severity and the circumstances of the injury, and its medical and socio-professional consequences (e.g., ability of players to continue playing rugby and/or professional/scholastic activity, receiving or not financial compensation) were extracted. Results199 cases were identified. The overall incidence rate of injuries was 10.57/100,000 person-years. The median PMI value after consolidation was 6 %. Five cases had a PMI value equivalent or higher than 50 %. 85 % of players were able to return to work/studies whilst 47 % returned to rugby overall. Injury severity did not differ between age groups, genders, performance levels, training/match-play or according to the game situation. ConclusionsAlthough rare, craniofacial and spinal injuries in rugby can leave sequelae with substantial repercussions on personal, professional/scholastic and sporting life. Further research into their potential causes and targeted prevention strategies is warranted.

Моделирование краниофациальных повреждений, анализ сроков регенерации и показаний к хирургической коррекции

The purpose of the experiment. Experimental modeling of craniofacial injuries, analysis of oculomotor function and regeneration in the post-traumatic period. Materials and methods. In the experiment, 48 sexually mature males of the Wistar breed were hit with a blunt hammer on a pre-determined area on the muzzle. According to the MS CT data, the nature of the displacement of bone fragments and the presence of muscle interposition were visualized. In the post-traumatic period, behavioral activity in the Actimeter device was analyzed. Results and discussion. Taking into account the thickness of the bone, the localization of the buttress at the place of applied force in the rodent, the hypothesis of energy absorption with its propagation through the bone structures of the orbits, and their subsequent displacement, was confirmed. Conclusions. In 38% of animals (groups 2 and 4), after impact to the postero lateral segment of the lower wall of the orbit, type 2 fracture of the cheekbone-orbital complex was recorded. In the posttraumatic period, a violation of behavioral activity was registered, which required prompt correction of displaced fragments. Upon impact to the central segment, in 50% of cases, 1 type of fracture was formed, without deviations in behavioral activity and without the need for surgical treatment.

Case Report: Multidisciplinary management of severe blast-related craniofacial and ocular injuries at artisanal gold mining sites in Niger: An unusual case report and comprehensive literature review

Blast-related craniofacial and ocular injuries have traditionally been associated with battlefields. In civilian populations, these injuries were infrequent, primarily arising from accidental explosions or terrorism incidents. Explosions can inflict severe damage to the neurological, ocular, and auditory systems through blast waves, high-velocity foreign bodies, and thermal radiation. The pathophysiology of blast-related craniofacial injuries is specific and complex, with severe cases often involving both penetrating and blunt trauma, leading to high mortality and morbidity rates. These injuries necessitate multidisciplinary management and can be defined as intracranial polytrauma. Recently, Niger has seen a surge in blast injuries, predominantly due to the increase in clandestine artisanal gold mining. Managing these injuries in resource-limited settings poses significant challenge. Comprehensive national data on these injuries are sparse due to high pre-hospital mortality rates and their infrequent occurrence, resulting in limited experience among our local physicians in their management. We present a rare case involving an artisanal gold miner with a history of smoking and previous concussions from explosion exposures. The patient was transferred to our hospital following severe craniofacial and ocular injuries caused by an accidental dynamite explosion at a mining site. On admission, the patient presented altered consciousness, agitation, unstable vital signs, multiple craniofacial wounds, including a large frontal wound with brain substance extrusion, diffuse facial burns, left globe rupture, and rhinorrhagia. After resuscitation and stabilization, brain imaging revealed multiple complex craniofacial fractures with foreign bodies. The patient underwent multidisciplinary surgical management. However, the postoperative course was complicated by post-concussive syndrome, and infection of the surgical wounds, necessitating surgical revision. Following the second surgery, the postoperative course was uneventful, although the patient experienced reduced visual acuity. This case highlights the management challenges in Niger and underscores the urgent need for clinical studies and training for gold miners to enhance safety practices in their activities.

Pediatric Facial Fracture Associated Craniofacial and Cervical Spine Injury

Management of pediatric facial fractures depends on location and severity, age, and associated injuries. Accurate diagnosis of associated injuries is crucial for effective treatment. This study evaluates the incidence of associated injuries and seeks to determine the influencing factors to provide imaging guidance. A retrospective review of pediatric facial fractures from the American College of Surgeons National Trauma Data Bank from 2017 to 2021 was completed. Associated cervical spine (c-spine), skull fracture, traumatic brain injury (TBI), and intracranial bleeding were evaluated. Demographics, fracture patterns, mechanisms, protective devices, and the Glasgow Coma Scale (GCS) were reviewed. A total of 44,781 pediatric patients with 65,613 facial fractures were identified. Of the total, 5.47% had a c-spine injury, 21.86% had a skull fracture, 18.82% had TBI, and 5.76% had intracranial bleeding. Multiple fractures significantly increased the rate of all associated cranial and c-spine injuries. Single midface fractures had the highest c-spine, TBI, and intracranial bleeding rates. With increasing age, there was a significant increase in c-spine injury and TBI, while there was a decrease in skull fractures. Motor vehicle accidents and GCS <13 were associated with significantly increased rates of all injuries. Among pediatric patients with facial fractures, 5.47% had a c-spine injury, 21.86% had a skull fracture, 18.82% had TBI, and 5.76% had intracranial bleeding. The authors’ findings recommend c-spine imaging in older age and cranial imaging in younger patients. Multiple facial fractures, fractures of the midface, decreased GCS, and motor vehicle accidents increase the need for both c-spine and cranial imaging.

PEDIATRIC OCULAR TRAUMA MANAGEMENT: A CASE STUDY OF EFFECTIVE INTRA-ORBITAL FOREIGN BODY IOFB EXTRACTION

Highlights: The rare nature of Orbitocranial Injury with Intraorbital Foreign Body (IOFB). Utilizing a 3D Head CT Scan to ascertain the precise location of the IOFB and its impact on anatomical structures is pivotal in shaping immediate treatment strategies, thereby reducing the potential for complications. Abstract: Introduction: Penetrating intraorbital foreign body (IOFB) injuries are a rare form of traumatic injury. Recognized as a surgical emergency, meticulous history-taking and a thorough examination are essential for determining the trauma's mechanism and cause, facilitating accurate diagnosis and effective disease management. Case Illustration: In the emergency room, a 5-year-old female patient was presented with a craniofacial injury resulting from an IOFB. An evacuation procedure, conducted through a subsidiary incision, was performed to extract the foreign body. Interestingly, the object removed from the orbital cavity was a plastic foreign body, initially suspected to be a fractured orbital bone. Discussion: The clinical presentation, management, and outcomes of orbital foreign body injuries can differ based on the material composition of the foreign body. In cases of intraorbital foreign body trauma, the primary treatment goal is foreign body removal. Conclusion: Precise and accurate initial management in the emergency department is crucial. Early diagnosis, aided by a 3D head CT scan, is instrumental in locating the IOFB and identifying the involved anatomical structures. This, in turn, enables timely treatment decisions to minimize the risk of complications.

Rodent Model of Masseter Volumetric Muscle Loss for Studying Bioengineering Materials.

Craniofacial volumetric muscle loss (VML) injuries can occur as a result of severe trauma, surgical excision, inflammation, and congenital or other acquired conditions. Treatment of craniofacial VML involves surgical, functional muscle transfer. However, these procedures are unable to restore normal function, sensation, or expression, and more commonly, these conditions go untreated. Very little research has been conducted on skeletal muscle regeneration in animal models of craniofacial VML. This manuscript describes a rat model for the study of craniofacial VML injury and a protocol for the histological evaluation of biomaterials in the treatment of these injuries. Liquid hydrogel and freeze-dried scaffolds are applied at the time of surgical VML creation, and masseters are excised at terminal time points up to 12 weeks with high retention rates and negligible complications. Hematoxylin and eosin (HE), Masson's Trichrome, and immunohistochemical analysis are used to evaluate parameters of skeletal muscle regeneration as well as biocompatibility and immunomodulation. While we demonstrate the study of a hyaluronic-acid-based hydrogel, this model provides a means for evaluating subsequent iterations of materials in VML injuries.

Assessing the COVID-19 pandemic's impact on pediatric baseball and basketball-related craniofacial and neck injuries treated in United States emergency departments, 2003-2022.

A large proportion of United States (U.S.) youth play basketball, baseball, softball, or T-ball. Each of the activities poses a documented risk of craniofacial and neck injuries. However, few studies have assessed the national prevalence of pediatric craniofacial and neck injuries in this population, particularly following the COVID-19 pandemic. The National Electronic Injury Surveillance System (NEISS) dataset was used to identify pediatric craniofacial and neck injuries associated with basketball, baseball, softball, or T-ball from 2003-2022 in a cross-sectional study. The annual number of injuries before and after the onset of the COVID-19 pandemic with 95% confidence intervals were calculated. Interrupted time series analysis (ITSA) was used to estimate the pandemic's impact on the monthly number of injuries incurred nationally. Both overall and stratified by sport involvement, the annual number and rate of injuries identified in NEISS decreased significantly after the COVID-19 pandemic. ITSA demonstrated that the monthly number of injuries decreased -4094.4 (95% CI = -5100, -3088.7) immediately after the beginning of the pandemic. The number of injuries began increasing towards pre-pandemic levels at a rate of 110.6 (95% CI = 64, 157.2) injuries per month after the initial plunge. Prior to the-pandemic, there was a steady decline in craniofacial and neck injuries due to basketball, baseball, softball and T-ball among children, aged <18 years. The shutdown during the initial months of the COVID-19 pandemic resulted in a precipitous drop in such injuries. Current rates are approaching pre-pandemic levels and may exceed them. Continued efforts are needed to keep the pre-pandemic progress.

Yard Work and Gardening: A Pastime with Potential for Craniofacial Injury.

Yard and garden tools are increasingly used by Americans. Despite the growing popularity of gardening as a leisure activity, the rate of injury associated with these tools remains remarkedly high. Previous research has highlighted the risks associated with improper handling of tools and associated potential long-term consequences. This retrospective study aims to provide a comprehensive analysis of the craniofacial injuries caused by yard and garden equipment. The investigation will emphasize the need for improved safety measures and regulations. Publicly available data from the National Electronic Injury Surveillance System (NEISS) database were utilized to identify craniofacial injuries related to yard and garden tool handling during a 10-year period (2013-2022). Study population included patients aged 1 to 85+ years who visited emergency departments secondary to these injuries. Data analysis involved queries for specific products and diagnostic codes related to craniofacial injuries. Over the study period, a total of 588,384 craniofacial injuries associated with yard and garden tools were recorded, averaging 58,838 injuries annually. Men accounted for a significantly higher proportion of injuries (69.2%) compared to women (30.8%). Elderly population, particularly those aged 60 to 64 years, experienced the highest incidence of craniofacial injuries. Cranium was the most commonly affected anatomical location, comprising 34% of all injuries. Lacerations and contusions were the most frequent injury diagnoses. Greenhouse or gardening supplies and lawnmowers are the most common causative agents, respectively. Our study highlights the persistent incidence of craniofacial injuries associated with yard and garden tool handling emphasizing the need for standardized safety regulations and guidelines. Sociological and demographic factors, such as differences in gardening habits and behavioral patterns between genders, contribute to the observed disparities in injury rates. Understanding the underlying factors contributing to these craniofacial injuries is crucial to promoting safer practices and reducing the overall burden associated with yard and garden tools.

Complex-Type Foreign Body Penetrating Injuries of the Craniofacial Region and Surgical Management: A Report of Three Cases.

Craniofacial penetrating injuries are not a rare sight in the career of oral and maxillofacial surgeons and trainees, but bizarre craniomaxillofacial sharp injuries caused by peculiar foreign bodies to the head and neck region, complicating and obscuring the vital structures, are seldomfound. Foreign bodies such as lunch boxes, wooden branches or twigs are peculiarly associated with penetrating/perforating craniofacial severe impaled injuries with dramatic consequences. Three cases are reported, with elaborate descriptions of the site, kind, and severity of the injuries. Cases 1 and 3, wooden impalement injuries into the neck region and sensitive orbital region, respectively, necessitating immediate surgical retrieval as in both cases. In case 2, 4-year old sustained an injury with a sharp rim of the lunch box, obscuring the entire craniofacial region and impeding the primary care and assessment.Cases represent the peculiarity of the injuries caused by unusual foreign bodies and how their uniqueness demanded a different surgical intervention.The need for a multidisciplinary approach is crucial to managing these injuries in areas with a high degree of specialization overlap, such as the craniofacial region. We give an overview of the diagnosis and treatment of penetrating foreign body trauma encountered in our department. Every foreign bodypenetrating trauma demands a formulation of a different surgical plan and stands as a challenge for the treating surgeons. Adequate radiology knowledge, detection, vigilant clinical assessment, and tension-free closure are a few of the important aspects for the ideal management of penetrating foreign body trauma.

Epidemiology of Craniofacial Injuries from Exercise and Weightlifting: A 10-Year Analysis.

Exercise is the cornerstone of a healthy lifestyle. It is recognized for enhancing cardiovascular health and bolstering mental well-being. While the fitness industry grows, the incidence of exercise-related injuries continues to rise. This study examines craniofacial injuries resulting from exercise and weightlifting over the past decade. The goal is to uncover trends, demographics, diagnoses, and patient dispositions. A retrospective review was conducted using the National Electronic Injury Surveillance System database. Emergency department visits for craniofacial injuries associated with exercise and weightlifting between 2013 and 2022 were analyzed. One-sample t-tests and the Mann-Kendall test were used to evaluate injury prevalence and significant trends. Over the past decade, 582,972 craniofacial injuries related to exercise and weightlifting were documented. Men accounted for 55.7% of cases. Annual incidence increased by 32.7% between 2013 and 2022. It was statistically significant. Adolescents aged 15 to 19 displayed the highest injury rate. Head injuries were most common (45%), followed by face (26%), neck (21%), mouth (4%), eye (3%), and ear (1%). Diagnoses included internal injury (25.2%), laceration (24.8%), contusions/abrasions (12.9%), and strain/sprain (11.9%). Hospitalization was required for only 8.5% of patients. This study elucidates the need for injury prevention strategies. Vulnerable subgroups such as males, adolescents, and the elderly demand targeted prevention efforts. Future research should explore specific mechanisms of injury to identify high-risk exercise. This study promotes the need for safe exercise practices and increases awareness of craniofacial injury risks associated with physical activity.

Epidemiology of Craniofacial Soft Tissue Injury in a Western Chinese Population.

Craniofacial soft tissue injuries represent a serious public health problem and their epidemiology is extremely variable. The objective of the present study was to analyze and discuss the epidemiological characteristics of 12,816 patients with craniofacial skin soft tissue injuries over a 3-year period. This retrospective study was conducted in emergency departments of plastic surgery at Xijing Hospitals from 2020 to 2022. Data were collected for the cause of injury, age and gender distribution, localization and frequency of soft tissue injuries, visit time, facial bone fractures, nerve injury, and treatment protocols. All the data were analyzed and performed including descriptive analysis, chi-square test, and logistic regression analyses. A total of 13,574 soft tissue injuries were seen in 12,816 patients. A total to 94.67% (12,133) were single-site injuries, and 5.33% (683) were multiple-site injuries. The male-to-female ratio of 1.62:1. The age group 0 to 9 years accounted is the largest subgroup. The most common etiology of the trauma was collisions, accounted for 51.89%. The forehead (23.54%) was the most common site by the cheeks (14.36%). Two hundred three patients (1.58%) had associated bone fractures. May month had the highest incidence of trauma and February month had the lowest incidence. There are more visits on weekends than on weekdays. 18:00 to 24:00 is the time with the largest number of visits, but there is no statistically significant difference from other time periods. The average time interval between the accident and treatment was 6.8 hours, and the median time was 6 hours. The incidence of craniofacial soft tissue injuries is related to gender, age, and the cause of trauma. Children between 0 and 9 are the most likely group. Collisions is the main cause of craniofacial soft tissue injuries.

Baseball Injury Prevention Through a Community Outreach Initiative.

Sports-related craniofacial injuries account for 10% to 42% of facial fractures in the US pediatric population, with the incidence of injury peaking at ages 6 to 7 and 12 to 14. The National Survey of Children's Health reported ~5.6 million children between the ages of 6 and 17 participated in baseball in 2021. National Electronic Injury Surveillance System reported 861,456 injuries resulting from baseball and 511,117 injuries resulting from softball in 2021, with ~500,000 of those injuries being to the face/head/neck. While participation in baseball and other youth sports has tremendous physical and mental health benefits, facial and other athletic injuries are concerning beyond the pain and disability caused by the incident itself. Severe injury can result in lost time from school as well as other social activities. Players and their families often experience financial strain as a result of physical trauma as well. The use of protective equipment has decreased the incidence of emergency department visits due to baseball-related trauma, especially mouthguards. However, adherence to using mouthguards is relatively low in baseball, with over 80% of players reporting not being told by a coach to wear mouthpieces. Youth from low-income areas often lack financial means to provide protective equipment and health insurance in the case of injury. The authors, along with the University of Miami Miller School of Medicine Division of Plastic and Reconstructive Surgery and Miami Marlins RBI Program, created an outreach program by which over 400 mouthguards were given to players and caretakers at inner-city baseball and softball programs. Two community outreach events took place in South Florida. One event was held at a University of Miami Men's Baseball Game, and another was held on the opening day of the Miami Marlins RBI Program youth baseball league. In addition to handing out protective equipment and informational pamphlets, a question and answers session was held to discuss injury prevention. In conclusion, our community safety initiative created an interactive dialogue and message to hundreds of youth baseball players about the importance of protective gear to prevent injuries.

Craniofacial Injury in a Child by Agricultural Fan Blade: A Case Report

AbstractFarm machine-related injuries in children are common modality of head injury. We describe here a case of threshing fan blade injury to head and its successful management. A 10-year-old male was brought to the emergency department of All India Institute of Medical Sciences (AIIMS) Patna with the complains of accidental fall on the fan blade of the thresher machine. On arrival he had a Glasgow Coma Scale of E1VTM5 status, bilateral pupil mid-dilated and sluggish reaction to light. On secondary survey, he had a lacerated wound of size 15 × 4 × 2 cm extending from left side forehead to right temporal region exposing bone and brain parenchyma herniation through the wound. A noncontrast computed tomography head showed B/L frontal contusion with gross edema, subarachnoid hemorrhage, and intraventricular hemorrhage. There was fracture of bilateral frontal bone extending to right parietotemporal bone. Patient was taken to operating room, where after painting and draping, the wound was irrigated with normal saline. The herniated brain was removed, securing hemostasis with surgical and Bovie cautery. He underwent a prolonged neurorehabilitation and made a complete recovery after 3 months of injury. Bihar is an eastern part of India where agriculture plays a major role in rural livelihood. Winnowing fan machines are used to separate the grain from the husk. Children have peculiar behavior to inspect things and this curious behavior leads to coming in contacts with the open blade. Falling on even a stationary blade can sometimes lead to head injury. Early surgery with meticulous wound debridement and closure of dura is required. Covering the fan blade as well as careful parenting of children will prevent further injuries.

Prevalence of Craniofacial Injuries in the Elderly Population.

Recognizing and understanding risk factors for craniofacial injury in the elderly is of paramount importance in prevention. This research aims to investigate the prevalence of craniofacial injuries in connection with extrinsic preventable factors, particularly identifying common household products that pose the greatest risk for such injuries. This study was done with the utilization of the 2013 to 2022 National Electronic Injury Surveillance System (NEISS). Data gathered included patient age, injury type, cause of injury, and year of incidence. "Elderly" was defined as an individual of 65 years of age or older. There was a total of 9,703,688 estimated national cases of elderly craniofacial injury from 2013 to 2022. In all, 5,888,112 (60.68%) of these occurred in females. In descending order, the 5 most common items responsible for craniofacial injury in the elderly are floors/flooring Materials (3,741,706, 30.92%), beds/bed frames (1,250,396, 10.33%), stairs/steps (907,92, 7.50%), chairs (546,697, 4.52%), and tables (453,989, 3.75%). These top 5 account for roughly 57% of all cases. The 5 most common presenting diagnoses were internal injury (2,957,095, 40.21%), lacerations (1,435,926, 19.53%), ABR (1,191,008, 16.20%), fracture (568,842, 7.74%), and hematoma (355,871, 4.84%). Out of the roughly 10 million cases of craniofacial injury in the last decade, ~three-fifths have happened to women. The majority of injuries occur in a home setting. The overwhelming majority of cases were related to the product code 1807-floors or flooring materials, and the largest diagnosis was internal injury by a wide margin. Evidently, there is a large population of elderly patients who suffer from craniofacial injuries related to objects and items that permeate within their living residences. The elimination of excess elderly craniofacial injury can be achieved by reducing fall risk factors in the immediate vicinity of the elderly.