Pattern Of Trauma Research Articles

Prevalence, pattern and etiology of maxillofacial injury in chengalpattu india: a retrospective study

Introduction: Maxillofacial injures are affected by population, social and financial conditions. Increased and up-to-date knowledge about maxillofacial trauma may aid in the implementation of preventive strategies to reduce maxillofacial trauma. Aim: The objective of this research was to evaluate the prevalence, pattern, and etiology of maxillofacial trauma in patients treated at Chengalpattu Medical College and Hospital. Materials and methods: This retrospective study was conducted in the Department of Dental Surgery. Information on age and gender, etiology and mechanisms of trauma and facial bone fractures have been collected and analysed retrospectively to determine the prevalence, pattern and etiology of maxillofacial trauma. Results: This study included a total of 854 maxillofacial trauma patients. 90.3 percent of the overall trauma was attributed to maxillofacial fractures. There is a statistically significant association between gender and the etiology of study subjects with maxillofacial trauma. Fractures of the mandible (42.6 %) were significantly more frequent than malar and maxillary bone fractures (35.7%). Conclusions: It can be concluded that maxillofacial injuries occur mainly as a result of road traffic accidents with male predominance and that there is a significant association between gender and mechanisms of trauma in the prevalence of maxillofacial trauma.

The Pattern, Management and Outcome of Genitourinary Trauma in Ghana

Objectives: This is to review the pattern of causes, management and outcome of genitourinary(GU) injuries managed at the Korle Bu and the 37 Military Teaching Hospitals from 1978 to 2010.
 Patients and Methods: Prospectively cases of genitourinary trauma from 1978 to 2010 were studied at the Korle Bu and 37 Military Teaching Hospitals. Patient history and clinical examination was taken and classified into haemodynamically stable or unstable condition. Stable patients were admitted and investigated whilst unstable patients were stabilised and operated. Investigations were based on the injuries sustained and included a full blood count , plain and contrast radiological investigations and computerised tomography .
 Results: A total of 523 cases (460 cases from Korle Bu teaching hospital from 1978 to 2001 and 63 cases from 37 Military Hospital from 2001 to 2010) were managed made up of 412 males (78.8%) and 111 females (21.2%) with a male to female ratio of 4 to 1. The youngest was 4 years and the oldest was 64 years. Sites affected included 38 renal (7.3%), 63 ureteral (12.1%), 109 bladder (20.8%), 233 urethral (44.6%) and 54 external genital (10.3%). Causes included road traffic accidents (49.5%), industrial accidents (0.77%), falls (16.8%), high (1.15%) and low (2.7%) velocity injuries, bites (0.57%), iatrogenic (23.71%) and idiopathic (0.2%). Presentation included haematuria (80%), urinary retention (8%), anuria plus abdominal pain /peritonitis (10%) and 2% with peritonitis. Management was 57 (10.8%) conservative and 466 (89.2%) operative. Outcome was 462 (88.3%) recovery, 47 (8.9%) with complications and 14 (2.64%) deaths. 
 Conclusion: Commonest causes of Genitourinary injuries in Ghana include Road traffic accidents 259(49.5%), Iatrogenic causes 124 (23.7%) and Falls 88 (16.8%). Early intervention in unstable patients prevents mortality .

Adverse Childhood Experiences, Domestic Violence and Substance Misuse: An Action Research Study on Routine Enquiry and Practice Responses.

The long-term impacts of Adverse Childhood Experiences (ACEs) are of increasing interest to researchers and practitioners, including the effectiveness of screening for ACEs to improve health and social outcomes. Despite a focus on implementing such practices, there has been little focus on ACEs experiences for women experiencing domestic violence and substance use, or consideration of practice responses around ACEs routine enquiry for domestic violence and related services. The Irish study discussed in this paper used an action research approach to implement ACEs routine enquiry within a domestic violence service for women accessing the service (n = 60), while also utilizing co-operative inquiry groups for practitioners both within the organization (n = 10) and with those working in associated fields of infant mental health, child protection, substance misuse and welfare and community support (n = 7). Of the 60 women who completed the ACEs routine enquiry in the study, over one-half (58 per cent) reported experiencing at least two ACEs in their childhood, including one-third of all respondents reporting experiencing four or more; service users reported significant levels of overlap between direct child maltreatment and adverse home environments. Reported parental substance misuse with the home environment was substantially higher than in general population studies. These findings offered early indications of both ACEs prevalence as well the types of ACEs that most define the experiences of the women presenting to a domestic violence service that supports women with substance misuse and other related issues. This paper discusses the ways in which the co-operative inquiry groups used this information and other processes to enhance practitioner, organizational, and inter-agency understanding and service responses. The practitioners felt that this form of ACEs routine enquiry, while not an end in itself, was a useful tool to engage women in conversations about trauma and intergenerational patterns and a basis for developing trauma-informed interventions. We conclude with discussion about: considerations of the risks of “individualizing” women's traumatic experiences; skills and supports for practitioners; and resource implications.

Changing Patterns of Pediatric Trauma During the COVID-19 Pandemic.

The implementation of lockdown and social distancing policies at the beginning of the coronavirus disease 2019 (COVID-19) pandemic changed both the nature of pediatric traumatic injuries and how those injuries were managed by pediatric trauma centers. At the start of the pandemic, the number of injured children evaluated at trauma centers decreased. Trauma volumes have since rebounded, and a concerning increase in abuse-related injuries has been seen. Pediatric trauma systems responded to the pandemic with new approaches to protect health care providers, conserve critical resources, and assist adult trauma systems overburdened by patients with COVID-19. The widespread effect of COVID-19 continues to have significant repercussions on children's health, but the lessons learned and gaps exposed by the pandemic may be an opportunity to positively transform injury prevention and health care delivery. [Pediatr Ann. 2022;51(7):e286-e290.].

A Study of Trauma Patients in the Emergency Department of a Tertiary Care Hospital in Nepal during Lockdown in COVID-19 Pandemic

Background The nationwide lockdown was imposed upon by the Government of Nepal with regards to the COVID-19 pandemic. Even during times of limited mobility and travel, trauma cases were presenting to the hospital.
 Objective To assess trauma patterns among patients presented to the Emergency department in Dhulikhel hospital during the lockdown period. The assessment of the burden of trauma during the pandemic could aid in planning allocation of resources and improving trauma care.
 Method A retrospective cross-sectional study design was used to assess all patients with a history of trauma during the period of lockdown announced by the Government of Nepal for COVID-19 from March 24 to June 14, 2020.
 Result Among 2097 patients that visited the emergency department, 23% were trauma cases. In comparison to the corresponding time-period in 2019, trauma cases reduced by more than half (54.5%). The majority of patients utilized ambulances as a means of transportation; a few patients utilized Dhulikhel emergency medical services. The most common mechanism of injury was fall injury, followed by motor vehicle accident and physical assault. Traumatic brain injury occurred in 30% of patients. Of all patients, 71% were discharged after initial treatment, 26% were admitted to different wards and 3% were referred to other health centres.
 Conclusion Fall injury is a crucial public health concern followed by motor vehicle accident among trauma patients even during the pandemic condition. Thus, emergency rooms should aid in planning for preparedness, mitigation of trauma during situations like these, in planning the allocation of resources and improving trauma care.

Understanding the pattern and volume of various orthopaedic disorders observed at a tertiary care hospital, before and during the COVID-19 pandemic

<p><strong>Background:</strong> The COVID-19 pandemic has lead to a huge loss of life and disruption of lifestyle. The pandemic has also led to disruption in the health sector, as significant changes in the pattern of hospital admissions, medical care and variations in disorders have been observed especially in the orthopaedics department. To assess the change in pattern and volume of trauma in our region, we evaluated data from our center for the pandemic period and compared it with the previous years’ data (pre-pandemic period).</p><p><strong>Methods:</strong> Comparison of orthopaedic in-patient records was carried out of the pre-pandemic and during the COVID-19 period, to assess the effect of COVID-19 on the orthopaedic in-patient load and prevailing diseases. Medical records of the patients were analyzed and the data collected were subjected to statistical analysis using IBM SPSS software version 1.0.</p><p><strong>Results:</strong> Significant reduction in patient load was observed during the pandemic period. Cases of various types of fractures were observed to be high in number, followed by arthritis. The only disorder that was observed to be highly prevalent in both the periods is proximal femur fractures.</p><p><strong>Conclusions:</strong> A high variation was observed in both the volume and nature of trauma presentations during the COVID-19 lockdown. A significant decrease in overall admissions was observed, this could be related to the period of societal restrictions and nationwide lockdown.</p><p><strong> </strong></p>

Differences in Trauma Injury Patterns and Severity Between Intentional and Accidental Falls From a Height: A Japanese Nationwide Trauma Database Study.

BackgroundFall from a height is a common cause of trauma requiring emergency care; in many cases, the trauma team needs to urgently develop the initial treatment strategy. The mechanism of injury (intentional or accidental) is an important factor in predicting trauma patterns and severity. We aimed to describe how the severity of injuries in each body region contributes to overall trauma severity and skeletal trauma patterns in intentional and accidental falls.MethodsData accumulated between January 1, 2004 and May 31, 2019 were obtained from a nationwide trauma database. Patients aged ≥18 years and injured by falls from a height were included. The median Abbreviated Injury Scale (AIS) score for the Injury Severity Score (ISS) for each body region (region 1: head, face, and neck; region 2: thorax; region 3: abdomen; region 4: lower extremity and pelvis; and region 5: upper extremity) was investigated. Skeletal injury patterns were classified into four groups: group I (intentional/severe), group II (accidental/severe), group III (intentional/not severe), and group IV (accidental/not severe). Severe trauma was defined as a trauma with an ISS of 16 or more. The groups were compared using the chi-square test and Mann-Whitney U test.ResultsAmong the 342,263 patients enrolled in the database, 28,409 met the inclusion criteria: 6,812 in group I, 11,754 in group II, 2,384 in group III, and 7,459 in group IV. The intentional fall group showed an increase in the AIS score for region 4 as the ISS increased, whereas the accidental fall group showed an increase in the AIS score for region 1. Both groups showed an increase in the AIS score for region 2 as the ISS increased. The intentional fall group had a higher proportion of fractures in the lower extremities and pelvis than the accidental fall group.ConclusionsThere were differences in trauma patterns and trauma severity levels between patients who experienced intentional and accidental falls from a height. Our findings provide a comprehensive understanding of this topic. Further studies are required to assess the usefulness of our findings for the development of initial treatment strategies at the ED.

Clinical application of automated virtual orbital reconstruction for orbital fracture management with patient-specific implants: A prospective comparative study

The aim of the study was to compare automated and manually conducted (slice-by-slice) virtual orbital wall reconstruction in terms of PSI design, manufacture, and clinical application for orbital fracture management.Patients with orbital wall fractures were evaluated for the potential for treatment with PSI, based on automated virtual wall reconstruction; these formed the main group. The surgical outcomes of these main-group patients' treatments were compared with those of the control group, which comprised patients randomly selected for this study, each of whom had the same orbital trauma patterns and were also managed with PSI. However, the control group patients were treated using ‘slice-by-slice’ virtual orbital reconstruction.Mean volume differences between the intact and reconstructed orbit were 0.65 ± 0.26 cm3 in the main group (n = 23) and 0.57 ± 0.23 cm3 in the control (n = 27; p = 0.837). In both groups, no cases of implant malposition or enophthalmos were detected after surgery. Orbital shape difference was similar for the main group and the control, at −3.3 ± 3.5% and 3.25 ± 2.5%, respectively (p = 0.929). Diplopia was diagnosed at the 3-month follow-up in 13.0% of the main group and in 11.1% of the control (p = 0.651). The average times spent on computer-aided design (CAD) procedures, including segmentation, virtual orbital reconstruction, and PSI design, were 36.7 ± 6.9 min in the main group and 72.9 ± 7.7 min in the control group (p < 0.001).Within the limitations of the study it seems that PSI based on automated virtual reconstruction is a relevant alternative treatment option for orbital fractures because of its clinical efficacy that is similar to PSI based on a ‘slice-by-slice’ CAD protocol.

Maximal Sensitivity to Child Maltreatment at the Ages of 6 and 11 Years is Associated with the Risk of Bipolar Disorder.

Adverse childhood experiences, including child maltreatment (CM), are relevant environmental risk factors for bipolar disorder (BD). However, little is known about the interaction of the type, duration and frequency of abuse with the timing of abuse in BD. The aim of this study was to investigate the different patterns of childhood trauma (frequency, type and chronology) between BD patients and healthy controls (HCs) and to identify BD-sensitive periods of exposure to CM that could influence functioning outcomes. The Maltreatment and Abuse Chronology Exposure (MACE) scale was used to evaluate the importance of the type and timing of maltreatment in a sample of 60 patients diagnosed with euthymic BD. Additionally, 76 HCs were recruited for comparison. All participants were of European-Caucasian origin and were assessed in the 2016-2019 period. To identify the variables that maximally differentiated the type and timing of exposure to CM between the BD and HC groups, a linear mixed effects model and random forest (RF) analyses were applied. We showed that multiplicity and severity, nonverbal emotional abuse, witnessing interparental violence and emotional neglect were the main factors associated with BD. In addition, regarding the occurrence of maltreatment in BD patients, we identified two sensitive periods with a principal peak at the age of 6 and a secondary peak at the age of 11. Functionality at the assessment time was associated with CM in adolescence for both HC and BD participants. Although the sample size and retrospective nature of the MACE instrument were the main limitations of our study, we were unable to explore the role of variables such as sex or socioeconomic status. We concluded that the multiplicity and sensitivity of CM exposure, mainly of the emotional type, during middle childhood are important risk factors for BD, at least in the European-Caucasian cultural setting.

Effect of COVID-19 Lockdown on Small Animal Trauma Patterns in Australia: A Multicentre Study.

ObjectiveTo determine whether patterns of trauma changed following the start of local lockdowns due to COVID-19.DesignMulti-institutional retrospective study assessing patients presenting within 2 years prior to local lockdown due to COVID-19 and 1 year following lockdown inclusive.SettingTwo university teaching hospitals and one private referral center in Australia.AnimalsDogs and cats with a presenting complaint of known or suspected trauma.InterventionsPatient signalment, date of presentation, trauma type, treatment interventions and patient outcome (survival to discharge, cardiopulmonary arrest, or euthanasia) were recorded in a web-based data capture system (REDCap).Measurements and Main ResultsThree thousand one hundred eighty-nine patients (682 cats and 2,507 dogs) were included in the study. Overall trauma prevalence was 2.9% with pre-lockdown prevalence of 2.8% and post-lockdown prevalence of 3.1% (p < 0.001). Cats had higher rates of blunt trauma while penetrating trauma was more prevalent in dogs (p < 0.001). Juvenile patients were also more likely to have blunt trauma when compared to adult patients (p < 0.001). Patient age and sex characteristics did not differ when comparing the 2 time periods. Compared to pre-lockdown, blunt and penetrating trauma patterns changed post-lockdown in dogs and cats (p < 0.001 for both). Interventions were performed more frequently (p = 0.039) in the post-lockdown with surgical procedures having a significant increase (p = 0.015). Survival rates increased post-lockdown for both species (p < 0.001) with financially driven euthanasia being less common than in pre-lockdown for dogs (p = 0.02).ConclusionsTrauma patterns changed for cats and dogs in the post-lockdown period. Compared to pre-lockdown, trauma prevalence was higher with a decrease in mortality rate. No increase in juvenile patients was identified post-lockdown. A decrease in financially driven euthanasia and an increase in interventions suggest no negative financial effect from COVID-19 lockdown on trauma patient care in Australia.

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

Oral and maxillofacial trauma (OMFT) is a public health problem due to its high occurrence and demand for resources for its management and the financial and social impact of OMFT victims on the health system. The aim of this study was to conduct an 8-year prospective analysis of OMFT cases from an emergency service. A hospital-based 8-year prospective study on OMFT and associated factors was performed on data from December 2011 to December 2019. Data regarding sociodemographic (gender, age, and skin color) and socio-economic profiles (educational level, family income, and occupation), OMFT profile (etiology, OMFT type, and treatment), associated factors [alcohol consumption and personal protective equipment (PPE) use], OMFT occurrence (injury day and hour), length of hospital stay, and cost were collected. Descriptive and inferential analyses of data were performed. Most OMFT cases involved men with low schooling and family income, resulting from traffic accidents. OMFT severity was associated with longer hospital stay, higher hospital costs and nonuse of PPE, midface fractures (mainly orbital-zygomatic fractures), closed reduction, and open reduction/internal fixation. Traffic accidents were the main cause of longer hospital stays for victims aged 41-60 years with better socio-economic status compared with cases that had higher hospital costs. In general, higher hospital costs were associated with victims of violence under 40 years of age, with low schooling and farmers. Alcohol consumption and non-use of PPE also contributed to increasing the length of hospital stay. Oral and maxillofacial trauma severity was associated with longer hospital stay and higher hospital costs. Associated factors such as alcohol consumption and non-use of PPE contributed to increase the length of hospital stay and OMFT severity.

Update in combined musculoskeletal and vascular injuries of the extremities.

Combined musculoskeletal and vascular injuries of the extremities are conditions in which a multidisciplinary approach is a sine qua non to ensure life initially and limb viability secondarily. Vascular injuries as part of musculoskeletal trauma are usually the result of the release of a high energy load in the wound site so that the prognosis is determined by the degree of soft-tissue damage, duration of limb ischemia, patient’s medical status and presence of associated injuries. The management of these injuries is challenging and requires a specific algorithm of action, because they are usually characterized by increased morbidity, amputation rate, infection, neurological and functional deficits, and they could be life threatening. Although vascular injuries are rare and occur either isolated or in the context of major combined musculoskeletal trauma, the high index of suspicion, imaging control, and timely referral of the patient to organized trauma centers ensure the best functional outcome of the extremity in such challenging cases. Even after a successful initial treatment of a combined trauma pattern, long-term follow-up is crucial to prevent and detect early possible complications. The purpose of this manuscript is to provide an update on diagnosis and treatment of combined musculoskeletal and vascular injuries of the extremities, from an orthopedic point of view.

More than they could chew: Activity‐induced dental modifications in a Portuguese medieval–modern rural population

AbstractNon‐masticatory dental lesions (e.g., notching, interproximal grooving, polished surfaces, lingual tilting, and dental trauma) may help evaluate the impact that dietary, individual, or social‐cultural habits had on ancient populations. Thus, this study aims to describe and discuss possible causes for dental wear and trauma recorded in 1206 commingled teeth recovered from a medieval‐modern ossuary in Miranda do Corvo (Coimbra, Portugal). All teeth were observed macroscopically under good light conditions. Dental wear and traumatic injuries were recorded according to their location. Atypical wear was divided into five categories—notches and grooves, polished surfaces, oblique wear plane, interproximal grooves, and lingual tilting. Higher mean values of occlusal dental wear were found in the anterior dentition (3.03 ± 1.457; n = 396), being the central incisors the more worn out (3.19 ± 1.28; n = 102). In all, 11.0% of the observed teeth presented atypical wear (130/1185), being anterior teeth (26.7%; 112/419) more affected than posterior (17.0%; 128/765). The most common alterations were notches/grooves (50.0% of the teeth with atypical wear; 65/130) and dental microtrauma (20.3% of the observed teeth; 240/1184). Furthermore, teeth presenting microtrauma were more affected by atypical wear, affecting 38.9% (48/130) of the worn teeth. An association between chipping and notches and/or grooves (62.5%; 30/48) was also noted. The obtained results, namely, the morphology and distribution of the “incisor‐dominant” dental wear and dental trauma patterns, suggest that many individuals of this population may have used their teeth as a “third hand” in routine practices. However, some types of atypical wear, namely, polished lingual surfaces of anterior teeth, may have had other causes, such as malocclusion. This study provides new insights into how ancient populations used their dentitions, even when the osteological remains are recovered from a commingled context.

World Oral and Maxillofacial Trauma (WORMAT) project: A multicenter prospective analysis of epidemiology and patterns of maxillofacial trauma around the world.

The World Oral Maxillofacial Trauma (WORMAT) project was performed to analyze the causes and characteristics of maxillofacial fractures managed in 14 maxillofacial surgery divisions over a 1-year period. The following data were collected: age, sex, cause and mechanism of maxillofacial fracture, alcohol and/or drug abuse at the time of trauma, fracture site, Facial Injury Severity Scale score (FISS), associated injury, day of trauma, timing and type of treatment, and length of hospitalization. Statistical analyses were performed using SPSS software. Between 30 September 2019 and 4 October 2020, 2,387 patients (1,825 males and 562 females [ratio 3.2:1], 47.6% aged 20-39 years [mean age 37.2 years, median 33.0 years]) were hospitalised. The main cause of maxillofacial fracture was road traffic accidents (RTA), which were statistically associated with male adults as like as assault, sport, and work (p<0,05). Half of the fractures involved the middle third of the face, statistically associated with fall and assault (p<0.05). Trauma in multiple locations was significantly associated with longer hospital stay (p<0.05). The mean length of hospitalization was 3.9 days (95% Confidence Interval 3.7-4.2). This prospective, multicenter epidemiological study confirmed that young adult males were the ones most commonly affected by maxillofacial fracture. RTAs and assaults are statistically associated with the adult population, while falls are associated with females and older population.

Ontogenetic patterns in human frontal sinus shape: A longitudinal study using elliptical Fourier analysis.

Frontal sinus morphology is highly variable across individuals, but little is known regarding how or at what age that variation is reached. Existing ontogenetic studies are conflicting and often cross-sectional in nature, limiting understanding of individualistic growth. Studies investigating sinus growth with longitudinal series often focus on lateral cephalograms and consequently do not capture the sinus morphological features that are most relevant to clinical and medicolegal settings (e.g., arcade/scalloping, width-to-height dimensions, asymmetry). Longitudinal analysis of sinus morphology from frontal radiographs is important to understand when sinus morphology stabilizes. The purpose of this study was to investigate at what age the frontal sinus attains its final shape, and whether sex-based differences in ontogeny are evident, using a longitudinal sample of posterior-anterior (PA) frontal radiographs from the AAOF Legacy Collection. Frontal sinus outlines were manually traced in 935 radiographs from 111 individuals (55F/56M) spanning 8-29 years of age. Outlines were subjected to elliptical Fourier analysis (EFA) and underwent principal components analysis (PCA). PC1 (51.02% of variation) appears to represent the relative height and breadth of the sinus, PC2 (11.73%) and PC3 (10.03%) captures the degree of relative complexity in the outlines. Individual PC scores were plotted against age-in-months with individual Loess growth curves. Overall, younger individuals typically display relatively shorter, flatter sinuses, increasing in vertical complexity with age. Mixed-effect models on PC1 indicate significant effects for the repeated measure of years (p < 0.001). Within individuals, Euclidean distances of PCs between each sinus outline and their oldest-age outline (i.e., final morphology) were calculated and plotted against age-in-months with Loess growth curves. The results indicate that final frontal sinus morphology is mostly attained by 20 yoa regardless of sex. There is sexual dimorphism in ontogenetic trajectories: females attain frontal sinus shape earlier than males. Specifically, Loess growth curves of the Euclidean distances to final sinus shape indicate that female shape shows decreased development at 14-16 yoa, with males approaching stabilization at 18-20 yoa. These trends were supported by paired t-tests on PC1 between each year and the oldest age, whereby significant differences end for females starting at 15 and 18 yoa for males. The timing of shape-stabilization in the current study closely aligns with previous studies on linear and size dimensions, indicating a close relationship between the ontogeny of frontal sinus shape and size. This research has several implications in diverse fields. Documenting ontogenetic patterns in modern humans could lead to more accurate interpretations of frontal sinus variation in hominin lineages. Understanding the age at which frontal sinus shape and size stabilizes in pediatric populations has important clinical implications, with future studies needed to investigate if/how sinus development directly relates to sinonasal disease susceptibility (e.g., sinusitis), surgical complications, and/or expected trauma patterns. For forensic practitioners utilizing frontal sinus comparisons for decedent identifications, it is important to know at what age these features stabilize to understand how much change may be expected between antemortem and postmortem radiographs.

Assessment of Mandibular Trauma Sustained in Motorcycle Accidents at Liaquat University Hospital Hyderabad

Background: Motorcycle accidents regularly impact the maxillofacial structures, with the mandible being one of the most usually shattered bones. Helmets have been found to have a preventive effect in avoiding maxillofacial injuries, although their impact on the likelihood of mandibular fractures is unknown. Objective: To assess the pattern of mandibular trauma among the motorcycle accidents reported at Liaquat university hospital Hyderabad. Subject and Methods: A total of 150 patients having mandibular fracture were selected. Patient’s data including age, gender, use or no use of a protective helmet at the time of trauma, type and site of fracture, speed limit and collision pattern weren recorded on a prescribed design Performa. Diagnosis of the trauma was carried out on the basis of clinical and radiographic evaluation (PA view of face, Orthopantomogram). Results: Males were predominantly affected as compared to females. Mean age in male was 29.5 and in females 33. 96 subjects were not using helmets during trauma. Most of the patients were having compound fracture. Collision with car was mostly seen as etiology. Parasymhysis with condyle was most common site involved followed by isolated parasymphysis and symphysis. Conclusion: To reduce the amount of face injuries in such incidents, educational programmes, defensive driving, and the usage of appropriate helmets are required. Keywords: Mandibular trauma, Motorcycle Accident, Helmet, Compound Fracture

Patterns and Outcomes of Patients with Abdominal Trauma

Aim: To determine the patterns and outcomes of patients with abdominal trauma. Study Design: Prospective cross sectional study Place and duration of study: Department of Surgery, DHQ Hospital Abbottabad from 1st June 2016 to 30th June 2021. Methodology: One hundred and twenty three abdominal trauma male and female patients having age between 18-45 years. Patients with conservative management and failing to provide history of trauma were excluded from the study. We studied the patterns of abdominal trauma and its outcomes in terms of surgical site infection, anemia, mortality and hospital stay. Results: Majority of the patients were male as compared to females (83.7% vs 16.3%). The most effected age group was 21 to 40 years (56.9%). Road traffic accident was the major cause of injury (59.3%). The most common pattern of injury was blunt force trauma (77.2%). Majority of the patients had &lt; 10 days of hospital stay. Surgical site infection was the most common postoperative complication (36.6%). Mortality rate was 11.4%. Conclusion: Blunt force trauma was the most common pattern of injury. Young patients (21-40 years) were more prone to abdominal injuries. Surgical site infection seems to the most common postoperative complication. Key words: Abdonimal trauma, Pattern, Outcome, Blunt force trauma

Patterns of maxillofacial trauma in helmet vs. non helmet wearing two wheeler drivers in a tertiary care center.

The frequency and patterns of maxillofacial fractures vary by country, based on demographic, socioeconomic, cultural and environmental factors. Wearing a helmet is an efficient form of head protection for two-wheeler drivers and is now required in the vast majority of countries. The aim of this study was to compare the patterns of maxillofacial trauma in patients who wore helmets and those who did not. The data were gathered from clinical records of patients presenting with maxillofacial trauma between January 2019 and February 2022. The inclusion criteria were met by subjects involved in two-wheeler accidents with comprehensive case records and radiological investigations. A total of 177 people presented following maxillofacial trauma. The mean age was 34.2 ± 12.7 years. There were 151 (85.3%) males and 26 (14.6%) females. One hundred and two patients had not been wearing a helmet, while 75 patients were wearing a helmet at the time of the accident. Mandible fractures were the most common injury in both groups, followed by zygomatic arch fractures (which were more common in non-helmet users) and dentoalveolar fractures in helmet users. There was a significant difference in the pattern and severity of maxillofacial trauma in helmet users and non-helmet users.

Injury patterns of equine-related trauma: A fifteen-year review of hospital admissions to a level 1 trauma center

ABSTRACT Objective Little information exists about horse-related injury admissions to Level 1 trauma centers in the Western United States. This study describes injury patterns in this population, to reveal potential areas for injury prevention initiatives. Methods A retrospective database review of 512 non-fatal equine-related injuries over a 15-year period was conducted, using a Level 1 hospital trauma registry. To determine patterns of injury, patients injured by riding or being near a horse were classified according to age, sex, helmet use, abbreviated injury score, anatomical region injured, and length of stay. Results Equine-related injury was more frequent among females than males, the anatomical region most at risk among adults was the lower extremity (including pelvis), and among children and youth, the head. 75% of head-injured patients were not wearing a helmet at the time of injury and those with the most severe head injuries were least likely to be wearing a helmet. Conclusion Preventable equine-related injuries occur across all ages, are more frequent among females, and affect all regions of the body. Despite head-injury risks associated with horse activities, helmet use was not common among most of the injured. Decreasing the risk of these injuries requires use of appropriate protective equipment and enhanced education campaigns aimed at those in the horse industry and the general public.

Single Institute Audit of Maxillofacial Trauma Cases Before and During COVID-19 Pandemic.

In the year 2020, we saw the emergence of severe acute respiratory syndrome coronavirus 2 causing COVID-19 into a full blown pandemic. This resulted in constraints on healthcare resources, and the attention was shifted to reduce cross contamination and prevent spreader events. Maxillofacial trauma care was also affected similarly, and most of the cases were managed by closed reduction whenever possible. A retrospective study was conducted to document our experience in treating maxillofacial trauma cases before and after nationwide lockdown due to COVID-19 pandemic in India. The objective of the study was to compare the effect of pandemic in reported pattern of mandibular trauma and the result of closed reduction procedures in the management of single or multiple fractures in mandible during this time period. The study was conducted in the Department of Oral and Maxillofacial Surgery, Maulana Azad institute of Dental Sciences, Delhi, for a period of 20 months, that is, 10 months before and after nationwide lock down which was effective from 23rd March 2020 due to COVID-19 pandemic. The cases were grouped into Group A (those reporting from 1st June 2019 to 31st March 2020) and Group B (those reporting from 1st April 2020 to 31st January 2021). Primary objectives were assessed and compared according to etiology, gender, location of the mandibular fractures, and treatment provided. Quality of life (QoL) associated with the treatment outcome by closed reduction was assessed after 2 months as a secondary objective using General Oral Health Assessment Index (GOHAI) in Group B. A total of 798 patients sought treatment for mandibular fractures and included 476 patients in Group A and 322 in Group B. The groups showed similar age and male: female ratio. Cases showed a steep fall during first wave of pandemic, and most of the cases occurred as result of RTA followed by fall and assault. The fractures due to fall and assault showed an obvious rise during the lockdown period. There were 718 (89.97%) patients having exclusive mandibular fractures and 80 (10.03%) patients having involvement of both mandible and maxilla. Single fractures of mandible constituted 110 (23.11%) and 58 (18.01%) in Group A and B, respectively. 324 patients (68.07%) and 226 patients (70.19%) had multiple fractures involving mandible in respective groups. Parasymphysis of mandible was most commonly involved (24.31%) followed closely by unilateral condyle (23.48%) then Angle and Ramus of mandible (20.71%) with coronoid being the least fractured. During the initial 6 months after lockdown, all the cases were treated successfully using closed reduction. GOHAI QoL assessment conducted in cases having exclusive mandibular fracture (210 Multiple, 48 Single) showed favorable results with significant (P < .05) difference between the single and multiple fractures. After one and half years and recovering from the second wave of pandemic that hit the country, we have come to understand COVID-19 better and embraced better management protocol. The study reveals that IMF remains the gold standard for the management of most of the facial fractures in pandemic situations. It was evident from the QoL data that most of the patients were able to carry out their day-to-day functions adequately. As the country prepares for a third wave of pandemic, management of maxillofacial trauma by closed reduction will remain the norm for most unless indicated otherwise.