Ruslin, M.; Boffano, P.; ten Brincke, Y.J.D.; Forouzanfar, T.; Brand, H.S.
Sports and exercise are important causes of maxillofacial injuries. Different types of sports might differ in frequency and type of fractures. The aim of the present study was to explore the possible relation between the types of sport practiced and the frequency and nature of the facial bone
Shirani, Gholamreza; Kalantar Motamedi, Mohammad Hosein; Ashuri, Alireza; Eshkevari, Pooyan Sadr
This study was designed to assess the prevalence, distribution, and patterns of injury among athletes engaged in combat sports and compare the prevalence, pattern, and types of oral and maxillofacial trauma in these athletes. A total of 120 male athletes engaged in four combat sports (boxing, taekwondo, kickboxing, and Muay Thai) who had sustained bodily trauma were studied; 95 subjects with at least one traumatic injury to the face requiring treatment were referred to us by the physician team. The type of injury (facial laceration, facial fractures, jaw dislocation, etc.), site of facial injury (jaw, nose, malar bone, teeth, etc.), dental injuries (tooth fracture, displacement, luxation, and avulsion), causative sport (boxing, taekwondo, kickboxing, and Muay Thai) as well as demographic data were recorded. Injuries were examined clinically and radiographically, and treated accordingly by a specialist. Treatment data and demographics were recorded for each subject. Recorded data were assessed, and χ(2), ANOVA, and Kruskal-Wallis tests were used to statistically analyze and compare the data. Of 120 subjects, 95 male subjects (79.2%), aged 18-25 years (avg. 20 years), had at least one traumatic injury to the face requiring medical treatment. These injuries included facial laceration, bone fractures (nose, mandible, and zygoma), dental injuries (displacement, luxation, fracture, and avulsion), and mandibular dislocation which were recorded in 83 (69.2%), 55 (45.1%), 53 (44.2%), and 8 (6.7%) cases respectively. Statistically significant differences were encountered among various injuries and the sports; kickboxing caused the most maxillofacial injuries and was identified as more injurious. Tooth fractures (59.7%) were the most common dental injuries, and the nose (84.7%) was the most frequently fractured facial bone. Lacerations were more common in Thai-boxers (93.3%). Injuries were significantly greater in professional rather than amateur athletes. In this study
Full Text Available Aim: This study was designed to assess the prevalence, distribution, and patterns of injury among athletes engaged in combat sports and compare the prevalence, pattern, and types of oral and maxillofacial trauma in these athletes. Materials and Methods: A total of 120 male athletes engaged in four combat sports (boxing, taekwondo, kickboxing, and Muay Thai who had sustained bodily trauma were studied; 95 subjects with at least one traumatic injury to the face requiring treatment were referred to us by the physician team. The type of injury (facial laceration, facial fractures, jaw dislocation, etc., site of facial injury (jaw, nose, malar bone, teeth, etc., dental injuries (tooth fracture, displacement, luxation, and avulsion, causative sport (boxing, taekwondo, kickboxing, and Muay Thai as well as demographic data were recorded. Injuries were examined clinically and radiographically, and treated accordingly by a specialist. Treatment data and demographics were recorded for each subject. Recorded data were assessed, and c2 , ANOVA, and Kruskal-Wallis tests were used to statistically analyze and compare the data. Results: Of 120 subjects, 95 male subjects (79.2%, aged 18-25 years (avg. 20 years, had at least one traumatic injury to the face requiring medical treatment. These injuries included facial laceration, bone fractures (nose, mandible, and zygoma, dental injuries (displacement, luxation, fracture, and avulsion, and mandibular dislocation which were recorded in 83 (69.2%, 55 (45.1%, 53 (44.2%, and 8 (6.7% cases respectively. Statistically significant differences were encountered among various injuries and the sports; kickboxing caused the most maxillofacial injuries and was identified as more injurious. Tooth fractures (59.7% were the most common dental injuries, and the nose (84.7% was the most frequently fractured facial bone. Lacerations were more common in Thai-boxers (93.3%. Injuries were significantly greater in professional rather
Objective: To profile the patients with sports related fractures. Patients and methods: This was a retrospective study of patients sustaining a sport related fracture between January 2000 and December 2006. The medical records including the demographic data, type of sport, mechanism and location of injury, and treatment ...
Shirani, Gholamreza; Kalantar Motamedi, Mohammad Hosein; Ashuri, Alireza; Eshkevari, Pooyan Sadr
Aim: This study was designed to assess the prevalence, distribution, and patterns of injury among athletes engaged in combat sports and compare the prevalence, pattern, and types of oral and maxillofacial trauma in these athletes. Materials and Methods: A total of 120 male athletes engaged in four combat sports (boxing, taekwondo, kickboxing, and Muay Thai) who had sustained bodily trauma were studied; 95 subjects with at least one traumatic injury to the face requiring treatment were referre...
Lock, Jing Zhan; Hegde, Raghuraj; Young, Stephanie; Lim, Thiam Chye; Amrith, Shantha; Sundar, Gangadhara
With an increased popularity of sport and active living worldwide, our study aims to explore the incidence and features of sports-related orbital fractures in Singapore. 1421 computer tomography (CT) imaging scans of the face and orbits done at the National University Hospital over a 24-month period from January 2013 and December 2014 were reviewed retrospectively for orbital fractures. We identified 483 orbital fractures of which sports injury was the fourth most common etiology (n = 65; 13.5%) after road traffic accident (n = 131; 27.1%), geriatric fall (n = 81; 16.8%) and workplace injury (n = 67; 13.9%). The three most common sport in orbital fractures were soccer (n = 20; 30.8%), bicycling (n = 11; 16.9%) and jogging (n = 8; 12.3%). The three most common fracture patterns were zygomatico-maxillary complex fractures (n = 24; 36.9%), isolated one wall blowout fractures (n = 19; 29.2%) and naso-orbito-ethmoid fractures (n = 7; 10.8%). Sports-related orbital fractures were associated with a low mean age of patients (45.9 years, range, 14-79 years), a higher proportion of males (n = 58; 89.2%) than that from geriatric falls (n = 37, 45.6%) (P Sports-related orbital fractures are the fourth most common cause of orbital fractures. Though commonly seen in young male adults, in view of the aging population and people exercising more regularly, education of safety measures among sports users is paramount to preventing sports-related orbital fractures.
Hwang, Kun; You, Sun Hye; Lee, Hong Sik
In this paper, we report a retrospective study of 236 patients with facial bone fractures from various sports who were treated at the Department of Plastic and Reconstructive Surgery, Inha University Hospital, Incheon, South Korea, between February 1996 and April 2007. The medical records of these patients were reviewed and analyzed to determine the clinical characteristics and treatment of the sports-related facial bone fractures. The highest frequency of sports-related facial bone fractures was in the age group 11 to 20 years (40.3%); there was a significant male predominance in all age groups (13.75:1). The most common causes of the injury were soccer (38.1%), baseball (16.1%), basketball (12.7%), martial arts (6.4%), and skiing or snowboarding (11%). Fractures of the nasal bone were the most common in all sports; mandible fractures were common in soccer and martial arts, orbital bone fractures were common in baseball, basketball, and ice sports, and fractures of the zygoma were frequently seen in soccer and martial arts. The main causes of the sports injuries were direct body contact (50.8%), and the most commonly associated soft tissue injuries were found in the head and neck regions (92.3%). Nasal bone fractures were the most common (54.2%), and tripod fractures were the most common type of complex injuries (4.2%). The complication rate was 3.0%. Long-term epidemiological data regarding the natural history of sports-related facial bone fractures are important for the evaluation of existing preventative measures and for the development of new methods of injury prevention and treatment.
Objective: To determine the pattern of occurrence, types, and treatment and prognosis of patients with maxillofacial fractures at the dental school of the Muhimbili University College of Health SciencesNational Hospital, Dar es Salaam, Tanzania. Methodology: All patients with maxillofacial fractures who presented from ...
Kumar, G B Ananth; Dhupar, Vikas; Akkara, Francis; Kumar, S Praveen
The maxillofacial skeleton is commonly fractured due to its prominent position. The pattern of maxillofacial fractures varies from one country to another. The aim of this retrospective study was to analyze the patterns of maxillofacial injuries in the state of Goa and compare the results with similar studies in India and rest of the world. The data were collected from the records of the patients who reported to the Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital between 2005 and 2010. The site of fracture, age of patient, etiology of trauma, daily and monthly variation of the fractures was analysed. Records of 2,731 patients sustaining maxillofacial injury were examined. The most commonly fractured facial bone was the mandible followed by zygomaticomaxillary complex. Most fractures occurred in the third and fourth decade of life with male and female ratio of 6:1. Main etiology was road traffic accidents. Despite strict traffic legislation, road traffic accidents are the main cause of maxillofacial injuries.
Schortinghuis, J; Bos, RRM; Vissink, A
Purpose: The aim of this retrospective study was to evaluate the complications of open reduction and internal fixation of maxillofacial fractures with microplates. Patients and Methods: In 44 patients with maxillofacial trauma, fractures of the maxillofacial skeleton were treated by open reduction
Constantinou, Demitri; Kastanos, Konstantinos
Stress fractures are relatively uncommon sports injuries and when they do occur, are mostly found in the lower limb. Stress fractures of the clavicle are particularly rare, having been described in a number of non-sport related pathologies, such as nervous tics and post radical neck dissection. In sport, there have only been seven cases reported in the literature. We report on a clavicle stress fracture in a 47-year-old male, partaking in recreational weight lifting activities. This is the first reported case of a non-union stress fracture of the clavicle. The patient underwent an open reduction and internal fixation and made a full recovery. PMID:21264151
Ruslin, M.; Wolff, J.; Boffano, P.; Brand, H.S.; Forouzanfar, T.
Aim: The aim of this study was to retrospectively investigate the incidence and associated factors of dental trauma in patients with maxillofacial fractures at the VU Medical Center in Amsterdam. Material and methods: Data from 707 patients who were treated surgically for maxillofacial fractures
Ruslin, M.; Wolff, J.; Boffano, P.; Brand, H.S.; Forouzanfar, T.
Aim The aim of this study was to retrospectively investigate the incidence and associated factors of dental trauma in patients with maxillofacial fractures at the VU Medical Center in Amsterdam. Material and methods Data from 707 patients who were treated surgically for maxillofacial fractures were
Method: A retrospective study of patients with maxillofacial fractures seen and treated at the Oral and Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria between January 1993 to January 2003. Data extracted from the patients' records include aetiology, age, sex, types and sites of fractures, ...
Loxha, Mergime Prekazi; Sejfija, Osman; Salihu, Sami; Gjinolli, Fellanza; Agani, Zana; Hamiti, Vjosa; Rexhepi, Aida Namani; Gecaj-Gashi, Agreta
The aim: The aim of this study was to analyze maxillofacial region fractures during the past 20 years in the Department of Maxillofacial Surgery in Prishtina. Methods: We have analyzed the histories of all patients with trauma who were hospitalized in the Department of Maxillofacial Surgery in Prishtina since the opening of the clinic in 1983 through 2005. Narrowing the subject of our research, we concentrated on fractures of the maxillofacial region treated at the Clinic of Maxillofacial Surgery for the period 2001–2005. We have analyzed those fractures and compared them with the period from 1983 to 2005 only when it was reasonable. Results: During this period, 1,945 patients were treated for trauma in the maxillofacial region by the Department of Maxillofacial Surgery. This group included 19.8% females and 80.2% males. The largest age group were those between 20 and 20 years of age. Causes of trauma for both periods were predominantly traffic accidents; however, during the period 2001-2005, interpersonal conflicts were increasingly the cause of fractures. Conclusion: Interpersonal conflict as a cause of maxillofacial trauma has risen in recent years. With this increase the methods of treating fractures in this region are also changing. PMID:24167433
A multi-disciplinary team approach for the management of maxillofacial fractures in patients undergoing orthodontic treatment with fixed appliances is suggested. Orthodontic treatment with surgical involvement has been found to improve both facial aesthetics and occlusal function. Key words: Maxillofacial, trauma, ...
Full Text Available Background: Maxillofacial injuries make up a large proportion of reported cases of trauma. The rise in the number of complex and high-energy injuries encountered among patients make it inevitable for one to be on the lookout for associated maxillofacial injuries. Aim: The aim of this study was to determine the pattern of maxillofacial fracture in patients who presented at the University of Uyo Teaching Hospital, Uyo, Nigeria. Methods: A 4-year retrospective review of maxillofacial fractures, from October 2008 to September 2012 in the University of Uyo Teaching Hospital, Uyo, Southern Nigeria is presented. Results: A total of 215 patients were seen in the period under review. 66.67% were males and 33.03% females, giving a male to female ratio of 2:1. The age of patients varied between 10 and 70 years. 67.9% of the patients were in the age bracket of 21-40 years, and the mean age of patients was 30 years. Road traffic accidents were responsible for the fractures in 80% of cases while 9% of fractures were due to falls. 66% of patients had mandibular fractures, with fractures of the body of the mandible accounting for 41.67% of mandibular fractures. 34% of the patients had maxillary fractures. Zygomatic fractures were the most common maxillary fractures accounting for 45% while Le Fort III fractures accounted for 2.82% of maxillary fractures. Conclusion: This study shows that road traffic injuries are the most common causes of facial fractures in our setting. Majority of the fractures in maxillofacial injury were found in the mandible (66% followed by maxilla (44%.
Pham-Dang, Nathalie; Barthélémy, Isabelle; Orliaguet, Thierry; Artola, Alain; Mondié, Jean-Michel; Dallel, Radhouane
This study evaluated the trends and factors associated with maxillofacial fractures treated from 1997 to 2007 in the Oral and Maxillofacial Surgery Department of the Clermont-Ferrand University Hospital. This study included 364 patients of which 82% were men and 45%, 20-29-years old. The etiology, anatomical distribution, treatment modality and complications of maxillofacial fractures were examined. Overall, interpersonal violence, traffic accidents and falls were the most common mechanisms of injury. There was a decreasing trend in traffic accidents and increasing one in falls as a cause of fracture over the 11-years period of this study. Young male patients were preferentially victim of interpersonal violence and traffic accidents, while middle-aged ones were of falls and work-related accidents. Middle-aged female patients were preferentially victim of traffic accidents and interpersonal violence, while older ones were of falls. And the number of fractures per patient varied according to the mechanism of injury: low after work-related accidents and high after traffic accidents. About two-third of fractures involved the mandible. Most of these mandibular fractures were treated by osteosynthesis with or without intermaxillary fixation, with the proportion of the latter increasing over time. There were very few postoperative infections and only in mandible. Maxillofacial fractures predominantly occur in young men, due to interpersonal violence. There is nevertheless an increasing trend in falls as a cause of fracture, especially in female patients, consistent with the increasing trend in presentation of older people. Most maxillofacial fractures involve the mandible and there is an increasing trend in treating these fractures by osteosynthesis without intermaxillary fixation. Antibiotic prophylaxis associated with dental hygiene care can be indicated to prevent postoperative infections.
Arzi, Boaz; Verstraete, Frank J M
To describe internal fixation for maxillofacial fractures using titanium miniplates and report outcome in 7 dogs. Prospective case series. Skeletally mature dogs (n = 7) with maxillofacial fractures. After CT evaluation of fracture configuration, using a combination of extraoral and intraoral approaches as needed, non-locking titanium miniplates were contoured to match the normal anatomy of the fractured bones. Plates were secured using non-locking titanium screws and then covered with a soft-tissue envelope followed by routine intraoral and extraoral closure. Fractures healed rapidly after reconstruction with immediate return to normal function and occlusion. Follow-up time of up to 94 months indicated excellent long-term function and general lack of complications. One dog developed nasal aspergillosis 1.5 years after surgery and the miniplates were removed without adverse consequences. Internal fixation for maxillofacial reconstruction using titanium miniplates is an excellent solution for the treatment of comminuted and displaced maxillofacial fractures in dogs. © Copyright 2014 by The American College of Veterinary Surgeons.
Nakamura, Yoshiki; Ogino, Tomoko Kuroiwa; Hirashita, Ayao
We present the orthodontic treatment of a patient with occlusal dysfunction after plastic surgery for multiple maxillofacial bone fractures caused by a traffic accident. The patient had mandibular deviation to the right because of inappropriate repositioning and fixation of the fractured bone and complete avulsion of both mandibular central incisors. The bilateral mandibular incisors, canines, and premolars were also suspected of partial avulsion or alveolar bone fracture. Several tests, including percussion and dental computed tomography, were performed on these teeth to rule out ankylosis and confirm tooth movement. Camouflage orthodontic treatment was carried out with expansion of the maxillary arch, alignment of both arches, and space closure between the mandibular lateral incisors to improve the occlusion. Good occlusion and interdigitation were obtained. Orthodontic treatment is useful for the rehabilitation of occlusal dysfunction caused by multiple maxillofacial bone fractures.
Dec 31, 2014 ... whereas interpersonal violence remains the leading ... abuse, accounting for 75.0% and 1.0% respectively of all the cases seen. .... Soghier A, Al-Shnwani A. Patterns and aetiology of maxillofacial fractures in Riyadh. City, Saudi Arabia. Saudi Dent Journ. 2003;25:33-38. 3. Rana ZA, Khoso NA, Arshad O,.
Ali, Ibrahim K; Sansare, Kaustubh; Karjodkar, Freny R; Salve, Prashant; Vanga, Kavita; Pawar, Ajinkya M
There is a paucity of literature on external auditory canal (EAC) fractures secondary to maxillofacial trauma, with most of the literature on EAC fractures consisting of isolated case reports. To the authors' best knowledge, this is the first study to use cone beam computed tomography to evaluate the EAC region. The aim of this study was to assess the prevalence of external auditory canal (EAC) fracture following maxillofacial trauma and to evaluate the association between EAC fracture and other maxillofacial fractures and the region of trauma. One hundred patients were prospectively evaluated over 6 months from February to August 2016. The patients were referred for CBCT regarding temporomandibular joint or condylar fractures following maxillofacial trauma. Two observers (both experienced radiologists) assessed the EAC and associated fractures in the maxillofacial region. External auditory canal (EAC) fracture was confirmed in 32% of the patients. Of the EAC fractures, 68.75% and 31.25% were associated with mandibular fractures and non-mandibular fractures, respectively. Of the EAC fractures, 68.75% were single fractures and 31.25% of patients had multiple comminuted fractures. Significant association was observed on cross-tabulation of the fractured region and region of trauma with the presence of EAC fracture using chi-square test. External auditory canal (EAC) fracture is associated with maxillofacial fractures with increased incidence in mandibular fractures compared to non-mandibular fractures. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Full Text Available Introduction: Technologic improvement and increased production of car and motorcycle have led to the increased incidence of maxillofacial trauma all around the world. Injuries of maxillofacial region include fractures of mandible, maxilla, zygoma, orbit and nasal bone, which is due to different etiologic factors such as motor vehicle accidents, quarreling, fall, and sport-related and work- related accidents. The Purpose of this study was to evaluate the frequency of maxillofacial fracture in CT-scan radiographs in Shahid Sadoghi and Shahid Rahnemon emergency departments in Yazd from 2007 till 2010. Methods: In this retrospective study we assessed the medical files of all patients with maxillofacial traumawho were admitted at Shahid Sadoughi and Shahid Rahnemoun hospitals in ENT and surgery wards during a 4-year period. The information from patients' medical file and CT scan radiographs were recorded. At last 372 patients were evaluated. Results: In this study the age of patients showed to be between 20 and 29. Eighty six and fourteen percent of patients were males and females, respectively. Among all fractures, mandible fracture was the most frequent one (50.8%. The most frequent etiologic factor was accident (59% and the most frequent outcome was partial recovery (46.4% and death was observed in 0.8% of individuals. Conclusion: Results of this study showed that the most frequent etiologic factor of trauma to maxillofacial region is motor vehicle accident similar to other developing countries.
Swenson, David M; Henke, Natalie M; Collins, Christy L; Fields, Sarah K; Comstock, R Dawn
High school athletes sustain millions of injuries annually, many of which are fractures. Fractures can severely affect athletes physically, emotionally, and financially and should be targeted with focused prevention methods. Patterns and primary mechanisms of fractures differ by sport and gender. Descriptive epidemiology study. High school sports-related injury data were collected from academic years 2008-09 to 2010-11 for 18 sports and from 2009-10 to 2010-11 for 2 additional sports. We used linear regression to describe annual fracture rate trends and calculated fractures rates, rate ratios (RRs), and injury proportion ratios (IPRs). From 2008-09 to 2010-11, certified athletic trainers reported a total of 21,251 injuries during 11,544,455 athlete exposures (AEs), of which 2103 (9.9%) were fractures, with an overall rate of 1.82 fractures per 10,000 AEs. Fracture rates were highest in football (4.37 per 10,000 AE), boys' ice hockey (3.08), and boys' lacrosse (2.59). Boys sustained 79.1% of all fractures, and the overall rates of fractures were greater in boys' sports than in girls' sports for competition (RR, 2.82; 95% CI, 2.45-3.24) and practice (RR, 2.43; 95% CI, 2.07-2.86). The most commonly fractured body sites were the hand/finger (32.1%), lower leg (10.1%), and wrist (9.5%). Overall, 17.2% of fractures required surgery, which was higher than for all other injuries combined (IPR, 3.14; 95% CI, 2.81-3.52). The most common mechanism of fracture involved contact with another player (45.5%). Using linear regression, we found the proportion of all injuries that were fractures was inversely correlated with the athlete's age (P = .02) but was not correlated with the athletes' age- and gender-adjusted body mass index. Fractures are a significant problem for high school athletes. Targeted preventive interventions should be implemented to reduce the burdens these injuries cause the athletes.
Conclusion: According to our result, most sites of fractures were in nasal bone. The main cause of maxillofacial fractures was motorcycle accident. However, in each age range the most common cause of accident was different.
Zhou, Hai-Hua; Liu, Qi; Yang, Rong-Tao; Li, Zhi; Li, Zu-Bing
The purpose of this study was to evaluate and compare the demographic characteristics of maxillofacial fractures between women and men in China. The sample was composed of all patients who sustained maxillofacial fractures during a 10-year period (2000 through 2009). Incidences, age distributions, etiologies, fracture patterns, associated injuries, and occupation distributions were recorded and analyzed. Data analysis included the χ(2) test, the Fisher exact test, and the t test. A P value less than .05 was considered significant. There were 1,131 patients (881 male and 250 female) who sustained maxillofacial fractures, with a male-to-female ratio of 3.5:1. Male patients sustained injuries most frequently during the autumn (P = .048), whereas female patients sustained more maxillofacial injuries during the summer (P = .006). Men sustained motorcycle (P = .023) and assault-related accidents (P = .036) more frequently than women, whereas women were more frequently injured in bicycle-related accidents (P maxillofacial fractures more frequently than female workers (P maxillofacial fractures than their male counterparts (P = .010, P = .004, and P = .044 respectively). The demographic characteristics of maxillofacial fractures in female patients considerably differ from those in male patients. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Esses, Diego-Felipe-Silveira; Sá, Carlos-Diego-Lopes; Silva, Paulo-Goberlânio-de Barros; Bezerra, Thâmara-Manoela-Marinho; Carvalho, Francisco-Samuel-Rodrigues; de Medeiros, José-Rômulo; Soares, Eduardo-Costa-Studart
Background To investigate the occupational profile, educational level, marital status and deleterious habits to the health of patients with maxillofacial fractures of a population of northeastern Brazil. Material and Methods A retrospective study of patients records admitted to the Division of Oral and Maxillofacial Surgery at the Walter Cantídio University Hospital (Fortaleza, Brazil) who sustained maxillofacial fractures was conducted in the period between 2006 and 2015. Results A total of 338 patients rendered 355 fractures. Males were the most affected (pmaxillofacial fractures in a Brazilian population during the study period. Key words:Epidemiological studies, trauma, facial bones. PMID:29274150
Arangio, Paolo; Vellone, Valentino; Torre, Umberto; Calafati, Vincenzo; Capriotti, Marco; Cascone, Piero
A retrospective study was performed to assess maxillofacial fractures in patients treated at the public "S.M. Goretti Hospital" hospital from 2011 to 31/8/2012. Data were prospectively recorded including age and sex, cause and mechanisms of injury, soft tissue injuries, dentoalveolar trauma, facial bone fractures and type of treatment. The pre-surgical and post-surgical hospitalization days were also analysed. Causes were grouped into five categories: road traffic collision, sports accidents, occupational accidents, assaults and domestic accidents. The analyses involved descriptive statistics. Records from 83 patient sustaining 95 maxillofacial fractures were evaluated. The zygoma was the most fractured anatomical site in both males and females, accounting for 32% of injuries, followed by isolated fracture of the orbital floor (blow-out and blow-in) with 11%. The age group between 18 and 39 years showed the highest rate of incidence of maxillofacial fractures. Men were more involved than women in all cases with a male:female ratio of 5,4:1. Accidents were the most frequent cause of maxillofacial fractures in the age group between 18 and 39 years and interpersonal violence was the most frequent cause of maxillofacial fractures in the age group between 40 and 59 years. Facial fractures occurred primarily among men under 30 years of age, and the most common sites of fractures in the face were the mandible and the zygomatic complex. Road traffic collisions were the main aetiologic factor associated with maxillofacial trauma. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Zeng, Wei; Lian, Xiaotian; Chen, Gang; Ju, Rui; Tian, Weidong; Tang, Wei
The purpose of this study was to evaluate the accuracy of the digital diagnosis and treatment program for maxillofacial fractures. The data of 626 patients with maxillofacial fractures were analyzed retrospectively from January 2010 to August 2016. These patients were divided into 2 groups. In the experimental group, preoperative planning was conducted and transferred to patients with guiding templates and navigation according to the digital diagnosis and treatment program for maxillofacial fractures. In the control group, postsurgical planning was performed instead of preoperative planning. To assess the accuracy of the digital diagnosis and treatment program for maxillofacial fractures, preoperative planning and postoperative computed tomographic models were superimposed and imported to dedicated software (Geomagic Studio 13.0, Geomagic, Inc, Research Triangle Park, NC) to calculate the difference between the 2 models in the 2 groups. Results of the experimental set showed that the mean error between the preoperative planning model and the postoperative model ranged from 0.65 to 0.97 mm (average, 0.89 mm). For the control group, the mean error was 0.78 to 1.45 mm (average, 1.01 mm). Thus, the mean error of the experimental group was statistically lower than that of the control group (P maxillofacial fractures was more accurate. Aided by the digital diagnosis and treatment program, the accuracy for maxillofacial fractures was notably improved. To facilitate the application and promotion of digital technology, further modification of the complete digital diagnosis and treatment pathway for maxillofacial fractures is highly desired. Copyright © 2017. Published by Elsevier Inc.
Maximiana Cristina de Souza Maliska
Full Text Available A retrospective study was performed to assess maxillofacial fractures in patients treated at a public hospital from 2002 to 2006. The data collected included age, gender, etiology, type of injury, treatment modalities and period of treatment. Causes were grouped into seven categories: road traffic collisions, sports accidents, occupational accidents, gunshot fractures, falls, violence and other causes. The analyses involved descriptive statistics, the Chi-squared Test and the Fisher Exact Test. Records from 132 patients sustaining 185 maxillofacial fractures were evaluated. The mandible (54.6% was the most commonly fractured bone in the facial skeleton, followed by the zygoma (27.6%. The mean age of the patients was 37.7 years, and the male:female ratio was 4.3:1. Most fractures occurred in adults with ages ranging from 18 to 39 years. A significant statistical relation was found between the age and the etiology of the trauma (p < 0.05, and between the number of fractured sites and the age of the patient (p < 0.05. Considering the age groups, accidents were the most frequent cause of maxillofacial fractures in the age group between 18 to 39 years, and interpersonal violence was the most frequent cause of maxillofacial fractures in the age group between 40 to 59 years. Treatment was performed on the same day as the diagnosis in 44.7% of the patients. Open surgery with internal stable fixation was indicated for most of the patients. Facial fractures occurred primarily among men under 30 years of age, and the most common sites of fractures in the face were the mandible and the zygomatic complex. Traffic road collisions were the main etiologic factor associated with maxillofacial trauma.
Samieirad, Sahand; Aboutorabzade, Mohammad-Reza; Tohidi, Elahe; Shaban, Baratollah; Khalife, Hussein; Salami, Hamid-Reza
Background The epidemiology of facial injuries varies based on lifestyle, cultural background and socioeconomic status in different countries and geographic zones. This study evaluated the epidemiology of maxillofacial fractures and treatment plans in hospitalized patients in Northeast of Iran (2015-2016). Material and Methods In this retrospective study, the medical records of 502 hospitalized patients were evaluated in the Department of Maxillofacial Surgery in Kamyab Hospital in Mashhad, Iran. The type and cause of fractures and treatment plans were recorded in a checklist. Data were analyzed with Mann–Whitney test, chi-squared test and Fisher’s exact test, using SPSS 21. Results The majority of patients were male (80.3%). Most subjects were in 20-30-year age range (43.2%). The fractures were mostly caused by accidents, particularly motorcycle accidents (MCAs), and the most common site of involvement was the body of the mandible. There was a significant association between the type of treatment and age. In fact, the age range of 16-59 years underwent open reduction internal fixation (ORIF) more than other age ranges (P=0.001). Also, there was a significant association between gender and fractures (P=0.002). Conclusions It was concluded that patient age and gender and trauma significantly affected the prevalence of maxillofacial traumas, fracture types and treatment plans. This information would be useful for making better health policy strategies. Key words:Epidemiology, treatment, facial injuries, maxillofacial fractures, trauma. PMID:28809369
Full Text Available Objectives: In several epidemiological studies of maxillofacial trauma, falls were one of the most frequent causes of facial injury. The aim of this study is to analyse the patterns of fall-related maxillofacial injuries based on the height of the fall. Material and Methods: Using a systematic computer-assisted database of patients hospitalised with maxillofacial fractures, only those with fall-related injuries were considered. The falls were divided into four groups: falls from slipping, tripping or stumbling (STSF, loss of consciousness (LOCF, stairs (SAF, and height (HF. Data on the age, gender, fracture site, Facial Injury Severity Scale (FISS, facial lacerations, associated lesions, type of treatment, and length of hospital stay were also analysed. Results: This study included 557 patients (338 males, 219 females; average age 51.5 years [range 4 - 99 years]. In the over 60 age group, females were more prevalent in STSF than males. According to aetiology, STSF was the most frequent cause of maxillofacial fractures (315 patients; 56.5% followed by LOCF (157; 28.2%, HF (55; 9.9%, and SAF (30; 5.4%. The middle third of the face was affected most frequently. After LOCF, however, the inferior third was prevalently involved. The majority of associated fractures, as well as the most severe injuries and greatest rate of facial lacerations, occurred secondary to HF. Conclusions: This study showed that fracture severity and site are influenced not only by patient age, but also by the nature of the fall.
Obimakinde, Obitade Sunday; Ogundipe, Kolawole Olubunmi; Rabiu, Taopheeq Bamidele; Okoje, Victoria Nwebuni
Previous reports indicated that there is geographic and sociodemographic variation in the epidemiology of maxillofacial fractures. Audit of maxillofacial injuries managed at any institution is therefore necessary to understand the trends and proffer strategies for prevention. We therefore embarked on this study to determine the pattern of maxillofacial fractures and concomitant injuries in our institution. We carried out a retrospective review of information on demography, aetiology and type of maxillofacial fracture, patients' status, type of crash, level of consciousness and concomitant injuries. The data collected was analysed with SPSS Version 20. A total of 233 patients aged 2 to 66 years were reviewed. A higher male preponderance (M:F 3.4:1) was observed. Road traffic crashes (RTC) accounted for 78.5% of injuries. Motorcycle related crashes were responsible for 69.4% of RTC and 54.5% of all fractures. Fracture of the mandible (63.2% n=172) was the most predominant skeletal injury and the body (25% n=43) was the most common site of fracture while the zygoma (29%) was predominantly affected in the midface. Ninety three patients (40%) suffered loss of consciousness. The relationship between aetiology of injuries and consciousness level of the patients was statistically significant (p=0.001). Of the 43 patients who had concomitant injuries, craniocerebral affectation (60.5%) was the commonest. RTC remains the major aetiology of maxillofacial fractures. The mandible was mostly affected and nearly half of the patients have associated loss of consciousness. There is need for continual advocacy and enforcement of laws on preventive measures among road users.
Angelova, I.; Yordanov, G.; Sirakov, V.; Velkova, K.
Computed tomography (CT) is the current method of study in maxillofacial region, which produces cross-sectional images of a specific area. There are still questions about methodology and radiation exposure. The aim of the present study is to evaluate the CT in diagnosis of fractures in maxillofacial region. 42 patients with traumatic injuries to the facial skeleton are examined. Fractures of maxilla are occurring in 14.6 % of patients with traumatic diseases. Fractures of maxilla and zygomatic bone are found in 29.3 percent of the traumatic event. Isolated nasal bone fracture is observed in 2.4% of ail fractures. Compound fractures constitute 17.1% of the tested fractures. This group of patients are positioned at second place in frequency. Mandibular fractures ranked first in frequency -36.6% of all traumatic lesions. The methods include: 1. Slice computed tomography in the axial and coronary projection 2. Spiral CT in axial projection and coronary one. 3. Cone Beam Computed Tomography. CT diagnosis is based on an analysis of all the images. It must comply with the data from other studies. When analyzing the results we found that the percentage of patients with primary diagnosis of fractured upper jaw is 11 %, while CT diagnosis of this percentage increases to 16%. The percentage of patients with primary diagnosis fracture of mandibula and CT diagnosis is almost identical. In the present study, 3D and CT have similar results in the detection of fractures. Three-dimensional images dearly show the spatial anatomy of the face, the presence of fragments, as well as monitoring of fracture lines. Key words; Fractures. Maxillofacial Area. CT
Samieirad, Sahand; Tohidi, Elahe; Shahidi-Payam, Akbar; Abedini, Ali
Background The epidemiology of facial injuries varies in different countries and geographic zones. Population concentration, lifestyle, cultural background, and socioeconomic status can affect the prevalence of maxillofacial injuries. Therefore, in this study, we evaluated the maxillofacial fractures epidemiology and treatment plans in hospitalized patients (2012-2014) which would be useful for better policy making strategies. Material and Methods In this retrospective study, the medical records of 386 hospitalized patients were evaluated from the department of maxillofacial surgery at Bahonar Hospital of Kerman, Iran. The type and cause of fractures and treatment plans were recorded in a checklist. For data analysis, ANOVA, t-test, Chi-square, and Fisher’s exact test were performed, using SPSS version 21. Results The majority of patients were male (76.5%). Most subjects were within the age range of 20-30 years. Fractures were mostly caused by accidents, particularly motorcycle accidents (MCAs), and the most common site of involvement was the mandible (parasymphysis). There was a significant association between the type of treatment and age. In fact, the age group of 16-59 years under went open reduction internal fixation (ORIF) more than other age groups (P=0.02). Also, a significant association was observed between gender and the occurrence of fractures (P=0.01). Conclusions Considering the geographic and cultural indices of the evaluated population, it can be concluded that patients age and gender and trauma causes significantly affect the prevalence of maxillofacial traumas and fracture kinds and treatment plans. Key words:Epidemiology, treatment, facial injuries, face fractures, maxillofacial trauma, trauma. PMID:26116845
Full Text Available Introduction: Because of its functional and cosmetic importance, facial injuries, especially bony fractures are clinically very significant. Missed and maltreated fractures might result in malocclusion and disfigurement of the face, thus making accurate diagnosis of the fracture very essential. In earlier times, conventional radiography along with clinical examination played a major role in diagnosis of maxillofacial fractures. However, it was noted that the overlapping nature of bones and the inability to visualise soft tissue swelling and fracture displacement, especially in face, makes radiography less reliable and useful. Computed tomography (CT, also called as X-ray computed radiography, has helped in solving this problem. This clinical study is to compare three-dimensional (3D CT reconstruction with conventional radiography in evaluating the maxillofacial fractures preoperatively and effecting the surgical management, accordingly. Materials and Methods: Fifty patients, with suspected maxillofacial fractures on clinical examination, were subjected to conventional radiography and CT face with 3D reconstruction. The number and site of fractures in zygoma, maxilla, mandible and nose, detected by both the methods, were enumerated and compared. The final bearing of these additional fractures, on the management protocol, was analysed. Results: CT proved superior to conventional radiography in diagnosing additional number of fractures in zygoma, maxilla, mandible (subcondylar and nasal bone. Coronal and axial images were found to be significantly more diagnostic in fracture sites such as zygomaticomaxillary complex, orbital floor, arch, lateral maxillary wall and anterior maxillary wall. Conclusion: 3D images gave an inside out picture of the actual sites of fractures. It acted as mind's eye for pre-operative planning and intra-operative execution of surgery. Better surgical treatment could be given to 33% of the cases because of better diagnostic
Shah, Sheerin; Uppal, Sanjeev K.; Mittal, Rajinder K.; Garg, Ramneesh; Saggar, Kavita; Dhawan, Rishi
Introduction: Because of its functional and cosmetic importance, facial injuries, especially bony fractures are clinically very significant. Missed and maltreated fractures might result in malocclusion and disfigurement of the face, thus making accurate diagnosis of the fracture very essential. In earlier times, conventional radiography along with clinical examination played a major role in diagnosis of maxillofacial fractures. However, it was noted that the overlapping nature of bones and the inability to visualise soft tissue swelling and fracture displacement, especially in face, makes radiography less reliable and useful. Computed tomography (CT), also called as X-ray computed radiography, has helped in solving this problem. This clinical study is to compare three-dimensional (3D) CT reconstruction with conventional radiography in evaluating the maxillofacial fractures preoperatively and effecting the surgical management, accordingly. Materials and Methods: Fifty patients, with suspected maxillofacial fractures on clinical examination, were subjected to conventional radiography and CT face with 3D reconstruction. The number and site of fractures in zygoma, maxilla, mandible and nose, detected by both the methods, were enumerated and compared. The final bearing of these additional fractures, on the management protocol, was analysed. Results: CT proved superior to conventional radiography in diagnosing additional number of fractures in zygoma, maxilla, mandible (subcondylar) and nasal bone. Coronal and axial images were found to be significantly more diagnostic in fracture sites such as zygomaticomaxillary complex, orbital floor, arch, lateral maxillary wall and anterior maxillary wall. Conclusion: 3D images gave an inside out picture of the actual sites of fractures. It acted as mind's eye for pre-operative planning and intra-operative execution of surgery. Better surgical treatment could be given to 33% of the cases because of better diagnostic ability of CT
Dettling, Samuel D; Morscher, Melanie A; Masin, Jeffrey S; Adamczyk, Mark J
Jefferson (C1) fractures are rare cervical spine injuries that usually do not result in cranial nerve (CN) impairment. However, case reports of Collet-Sicard syndrome (impairment of CNs IX-XII) and impairment of CNs IX, X, and XII have been reported. All reported cases involved adult patients in high-impact collisions, such as motor vehicle accidents or falls. To our knowledge, a Jefferson fracture with selective CN impairment due to a low-energy, sports-related injury in a pediatric patient has not been reported. Chart and radiographic data for a single case were reviewed and reported in a retrospective study approved by the Institutional Review Board of the participating hospital. A 16-year-old male was diagnosed with a Jefferson fracture after a head-to-chest football collision. On computed tomography, the distance between the atlas transverse process and styloid process of the skull was 5 mm right and 10 mm left. Before halo fixation, the patient had vague complaints of dysphagia. These complaints worsened which led to the diagnosis of CN IX and X impairment and placement of a feeding tube. The fracture healed uneventfully, the dysphagia symptoms resolved, and the halo fixation and feeding tube were removed. The patient returned to all activities, but was instructed to avoid participation in contact sports. This was the first report of selective CN impairment in a pediatric patient with a Jefferson fracture resulting from a low-impact sports-related injury. Careful monitoring of the patient complaints led to appropriate treatment. Further studies into the spatial relationship between the transverse process of the atlas in relation to the styloid process of the skull may be warranted. Level V, case report.
Hassanein, Ahmed Gaber; Abdel Mabood, Ahmed M A
During surgery for major maxillofacial fractures, orotracheal intubation can interfere with some surgical procedures and nasal intubation can be contraindicated or impossible. That is why tracheotomy is presented as a solution, although it carries a relatively high incidence of complications. In this study, the use of submandibular tracheal intubation is basically evaluated as an alternative to tracheotomy in such circumstances. This prospective study was performed in patients undergoing surgery for major maxillofacial fractures in which oral intubation and/or nasal intubation have been unsuitable, impossible, or contraindicated. The technique of submandibular intubation was assessed intraoperatively and in the postoperative period. The outcomes and complications are presented. The study included 26 patients aged between 14 and 57 years. All patients had mandibular fractures, with 19 midface fractures (73.1%), 11 nasal bone fractures (42.3%), 10 zygomatic bone fractures (38.5%), 9 naso-orbito-ethmoidal fractures (34.6%), and 9 frontobasilar fractures (34.6%). The procedure time ranged from 5 to 12 minutes (mean, 7 minutes 4.6 seconds). Delayed extubation was performed in 15 cases (57.7%) in which the tube was left in place for a period ranging from 8 to 50 hours (mean, 30 hours 24 minutes). The technique has proved to be straightforward and satisfactory. A postoperative superficial infection occurred in 2 patients, whereas hypertrophic scars occurred in another 2 patients. Submandibular endotracheal intubation is straightforward, safe, and quick to carry out. It can be an alternative to tracheotomy as it allows operative techniques and postoperative airway protection without the risks and side effects of tracheotomy. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Falci, Saulo Gabriel; Douglas de Oliveira, Dhelfeson Willya; Stella, Paulo Eduardo Melo; Rocha dos Santos, Cássio Roberto
Background Intermaxillary fixation is used to achieve proper occlusion during and after oral and maxillofacial fracture surgery. The aim of this systematic review was to compare Erich arch bar fixation with other intermaxillary fixation methods in terms of the operating time, safety during installation, oral health maintenance and occlusal stability. Material and Methods An electronic online search was conducted of the Scirus, PubMed, Ovid, Cochrane Library and VHL databases. A clinical trial...
Yamamoto, Kazuhiko; Matsusue, Yumiko; Horita, Satoshi; Murakami, Kazuhiro; Sugiura, Tsutomu; Kirita, Tadaaki
Sports activity increases the risk of maxillofacial fractures. The aim of this study was to analyze trends and characteristics of maxillofacial fractures sustained during sports activity to develop more effective treatments and possibly to prevent injury. Data of 248 patients with maxillofacial fractures sustained during sports activity were retrospectively analyzed based on their clinical records and radiographs. The patients were 226 males (91.1%) and 22 females (8.9%). Their ages ranged from 6 to 70 years and the majority were in their second decade. The fractures were sustained in various sports which included baseball in 85 patients (34.3%), rugby in 40 (16.1%), soccer in 30 (12.1%), softball in 22 (8.9%), golf in 10 (4.0%), hockey in 8 (3.2%), combat sports in 28 (11.3%), and others in 29 (11.7%). The cause of injuries was collision with another player in 97 patients (39.1%), hit by a ball in 89 (35.9%), intended attack in 20 (8.1%), hit by equipment of another player in 15 (6.0%), a fall in 14 (5.6%), and collision with ground equipment in 13 (5.2%). The site of fractures was the mandible in 145 patients (58.5%), midface in 100 (40.3%), and both in 3 (1.2%). Among 210 fracture sites in the mandible, 77 (36.6%) were in the angle, 68 (32.4%) in the symphysis, and 65 (30.9%) in others. Among 103 fractures in the midface, 58 (56.3%) were in the zygoma, 26 (25.2%) in alveolar bone, and 19 (18.4%) in others. Treatment was observation in 67 patients (27.0%), maxillomandibular fixation in 64 (25.8%), open reduction and internal fixation in 63 (25.4%), intramaxillary splinting in 40 (16.1%), transcutaneous reduction in 10 (4.0%), and other procedures in 4 (1.6%). Maxillofacial fractures sustained during sports activity showed characteristic features dependent on the type of sport and cause of injury. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Mabrouk, Amr; Helal, Hesham; Mohamed, Abdel Rahman; Mahmoud, Nada
Although there is a worldwide increase in maxillofacial trauma incidence; the pattern and etiology of these injuries varies from one country to another depending on socioeconomic, cultural, and environmental factors. This study aims to realize the epidemiological characteristics of maxillofacial fractures in our department. A retrospective cross-sectional study of all facial trauma patients admitted to our department during 2009 to 2012. Patients' data including gender, age, etiology of trauma, the pattern and demographic distribution of fractures of maxillofacial skeleton, and associated injuries were analyzed and compared with previously published data. The chi-square test was used with a p value of less than 0.05, which was considered statistically significant. There is a significant increase in maxillofacial fractures incidence in the past 2 years than former ones. There is a male predominance with highest incidence in the age group of 20 to 40 years. Road traffic accident is the most common etiological factor followed by violence. There is increase in mandibular fracture incidence compared with midface. The significant increased incidence of maxillofacial fracture due to motor car accidents and assaults in the past 2 years reflects a behavioral change within the community.
Objectives The facial bones are the most noticeable area in the human body, and facial injuries can cause significant functional, aesthetic, and psychological complications. Continuous study of the patterns of facial bone fractures and changes in trends is helpful in the prevention and treatment of maxillofacial fractures. The purpose of the current clinico-statistical study is to investigate the pattern of facial fractures over a 4-year period. Materials and Methods A retrospective analysis of 1,824 fracture sites was carried out in 1,284 patients admitted to SMG-SNU Boramae Medical Center for facial bone fracture from January 2010 to December 2013. We evaluated the distributions of age/gender/season, fracture site, cause of injury, duration from injury to treatment, hospitalization period, and postoperative complications. Results The ratio of men to women was 3.2:1. Most fractures occurred in individuals aged between teens to 40s and were most prevalent at the middle and end of the month. Fractures occurred in the nasal bone (65.0%), orbital wall (29.2%), maxillary wall (15.3%), zygomatic arch (13.2%), zygomaticomaxillary complex (9.8%), mandibular symphysis (6.5%), mandibular angle (5.9%), mandibular condyle (4.9%), and mandibular body (1.9%). The most common etiologies were fall (32.5%) and assault (26.0%). The average duration of injury to treatment was 6 days, and the average hospitalization period was 5 days. Eighteen postoperative complications were observed in 17 patients, mainly infection and malocclusion in the mandible. Conclusion This study reflects the tendency for trauma in the Seoul metropolitan region because it analyzes all facial fracture patients who visited our hospital regardless of the specific department. Distinctively, in this study, midfacial fractures had a much higher incidence than mandible fractures. PMID:26734557
Osinaike, Babatunde Babasola; Gbolahan, Olalere O; Olusanya, Adeola A
Despite advancements in airway management, treatment of fractures in the maxillofacial region under general anesthesia remains a unique anesthetic challenge. We reviewed the pattern of airway management in patients with maxillofacial fractures and assessed those challenges associated with the different airway management techniques employed. The anesthetic chart, theatre and maxillofacial operations records of patients who had reduction and immobilization of various maxillofacial fractures over a 2-year period were reviewed. Information obtained included the patient demographics, mechanisms of injury, types of fractures and details about airway management. Statistical Package for Social Sciences, SPSS version 17.0 was utilized for all data analysis. Fifty-one patients were recruited during the 2-year study period. Mask ventilation was easy in 80-90% of the patients, 80% had Mallampati three or four, while 4 (7.8%) had laryngoscopy grading of 4. There was no statistically significant difference between the fracture groups in terms of the laryngoscopy grading (P = 0.153) but there was statistical significant difference in the technique of airway management (P = 0.0001). Nasal intubation following direct laryngoscopy was employed in 64.7% of the patients, fiber-optic guided nasal intubation was utilized in only 7.8%. None of the patients had tracheostomy either before or during operative management. Laryngoscopic grading and not adequacy of mouth opening predicted difficult intubation in this group of patients in the immediate preoperative period. Despite the distortions in the anatomy of the upper airway that may result from maxillofacial fractures, nasal intubation following direct laryngoscopy may be possible in many patients with maxillofacial fractures.
Full Text Available BACKGROUND: There are only few studies regarding the pattern and causes of maxillofacial fractures till date in Nepal and no such study in western and central Nepalese population has been conducted. The purpose of this study, therefore, was to describe the causes and the pattern of maxillofacial fractures in western and central part of Nepal over the period of 5 years. MATERIAL AND METHODS A retrospective analysis of maxillofacial fractures was conducted on 328 patients who were treated in the department of maxillofacial surgery. Data was extracted and analyzed based on age, sex, cause of injury and anatomic location. RESULT Young males of 3rd decade of life most commonly sustained the maxillofacial trauma. The commonest site involved was the zygomatic complex (42% when only mid face fractures was considered and parasymphysis (32% when only mandible was considered.The most common cause of injuries was road traffic accidents (289 patients; 88.1% followed by interpersonal violence (25 patients; 7.6 % and falls accounting for 4.2% of the all injuries. CONCLUSION The findings of this study suggest the need for expansion of the motorway network, ensuring compliance of strict traffic rules and regulations, replacing old vehicles without safety measures and implement school education in alcohol abuse.DOI: http://dx.doi.org/10.3126/jcmsn.v10i3.12771 Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-3, 8-13
Ianof, Jéssica Natuline; Freire, Fabio Rios; Calado, Vanessa Tomé Gonçalves; Lacerda, Juliana Rhein; Coelho, Fernanda; Veitzman, Silvia; Schmidt, Magali Taino; Machado, Sergio; Velasques, Bruna; Ribeiro, Pedro; Basile, Luis Fernando Hindi; Paiva, Wellingson Silva; Amorim, Robson; Anghinah, Renato
ABSTRACT Traumatic brain injury (TBI) is a major cause of lifelong disability and death worldwide. Sport-related traumatic brain injury is an important public health concern. The purpose of this review was to highlight the importance of sport-related concussions. Concussion refers to a transient alteration in consciousness induced by external biomechanical forces transmitted directly or indirectly to the brain. It is a common, although most likely underreported, condition. Contact sports such...
Thorén, H; Numminen, L; Snäll, J; Kormi, E; Lindqvist, C; Iizuka, T; Törnwall, J
The aim of this retrospective study was to clarify the occurrence and types of dental injuries in 389 patients who had been diagnosed with facial fractures, and to analyze whether the occurrence of dental injury correlates to gender, age, trauma mechanism and type of facial fracture. Dental injuries were observed in 62 patients (16%). The most common type of injury was a crown fracture (48%). Dental injuries were multiple in most patients (63%). Almost half (48%) of all injured teeth were severely injured. Most injured teeth (61%) were in the maxilla. The incisor region was the most prevalent site in both the mandible (45%) and the maxilla (56%). The occurrence of dental injury correlated significantly with trauma mechanism and fracture type: motor vehicle accidents and mandibular fracture were significant predictors for dental trauma. The notable rate of dental injury observed in the present study emphasizes the importance of a thorough examination of the oral cavity in all patients who have sustained facial fracture. Referral to a dental practice for further treatment and follow up as soon as possible after discharge from hospital is fundamental. Copyright 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Motamedi, Mohammad Hosein Kalantar; Dadgar, Esmaeel; Ebrahimi, Ali; Shirani, Gholamreza; Haghighat, Abbas; Jamalpour, Mohammad Reza
This multicenter study assessed the demographics, prevalence, causes, types, treatment, and complications of maxillofacial (MF) fractures managed by MF surgeons nationwide. This 5-year retrospective descriptive analytical chart study evaluated 8,818 patients treated for MF fractures from 2007 to 2012 at 11 medical centers. Parameters, including age, sex, cause of injury, site of injury, type of injury, fracture patterns, treatment modalities, and complications, were evaluated from patient charts and radiographs. Collected data were analyzed via t test or χ test using SPSS 20 (Chicago, IL). A p value of less than 0.05 was considered statistically significant. This retrospective chart study was exempt from institutional review board approval. There were 7,369 male patients (83.6%), 1,376 female patients (15.7%), and 73 patients (0.8%) of unknown sex (aged 6 months to 112 years); 39.54% (3,457 patients) were in the 21-year to 30-year age group (mean, 28.18 years). We found 5,737 mandibular fractures (65.1%); mandible fracture was the most common (p patterns can provide insight to prevention protocols, this study shows that, despite better law enforcement of traffic regulations, better roads, better automobiles, and the like, the pattern of MF fractures in Iran has not changed significantly during the past 10 years. Epidemiologic study, level IV.
Douglas-de-Oliveira, Dhelfeson-Willya; Stella, Paulo-Eduardo-Melo; Rocha-dos Santos, Cássio-Roberto
Background Intermaxillary fixation is used to achieve proper occlusion during and after oral and maxillofacial fracture surgery. The aim of this systematic review was to compare Erich arch bar fixation with other intermaxillary fixation methods in terms of the operating time, safety during installation, oral health maintenance and occlusal stability. Material and Methods An electronic online search was conducted of the Scirus, PubMed, Ovid, Cochrane Library and VHL databases. A clinical trial dating from the inception of the data bases until August 2013 was selected. Studies that compared Erich arch bars with other intermaxillary fixation methods in patients older than 18 years-old were included. The studies were assessed by two independent reviewers. The methodological quality of each article was analyzed. Results Nine hundred and twenty-five manuscripts were found. Seven relevant articles were analyzed in this review. The risk of bias was considered moderate for four studies and high for three clinical trials. Conclusions There is not enough evidence to conclude that the Erich arch bar is the best intermaxillary fixation method in cases of oral and maxillofacial fractures. Key words: Facial injuries, jaw fixation techniques, mandible, maxilla. PMID:26034929
Jéssica Natuline Ianof
Full Text Available ABSTRACT Traumatic brain injury (TBI is a major cause of lifelong disability and death worldwide. Sport-related traumatic brain injury is an important public health concern. The purpose of this review was to highlight the importance of sport-related concussions. Concussion refers to a transient alteration in consciousness induced by external biomechanical forces transmitted directly or indirectly to the brain. It is a common, although most likely underreported, condition. Contact sports such as American football, rugby, soccer, boxing, basketball and hockey are associated with a relatively high prevalence of concussion. Various factors may be associated with a greater risk of sport-related concussion, such as age, sex, sport played, level of sport played and equipment used. Physical complaints (headache, fatigue, dizziness, behavioral changes (depression, anxiety, irritability and cognitive impairment are very common after a concussion. The risk of premature return to activities includes the prolongation of post-concussive symptoms and increased risk of concussion recurrence.
The history of maxillofacial and oral injuries, including mandibular fractures, from 1650 BC to the present, is the topic of two publications.1,2 To summarise: the Greek. 'Father of Medicine' Hippocrates was the first to describe fracture treatment – he recommended bandages and single jaw fixation. Celsus, a Roman (30 BC ...
Brady, Don; Brady, Flo
Sport-related concussions (SRC) are not limited to specific age ranges, professional athletes, or gender. The primary focus of much of SRC research pertains to the assessment, management, and return to play (RTP) of the concussed athlete. This article highlights some major issues of SRC along with some controversies that presently exist within the…
Conder, Robert L; Conder, Alanna A
Concussions are an inherent part of collision sports such as football and soccer. As a subset of traumatic brain injury, concussions are neurometabolic events that cause transient neurologic dysfunction. Following a concussion, some athletes require longer neurologic recovery than others. Education and intervention aimed at prevention and management can minimize the long-term sequelae of sports-related concussions.
Bonavolontà, Paola; Dell'aversana Orabona, Giovanni; Abbate, Vincenzo; Vaira, Luigi Angelo; Lo Faro, Carmelo; Petrocelli, Marzia; Attanasi, Federica; De Riu, Giacomo; Iaconetta, Giorgio; Califano, Luigi
Maxillofacial fractures represent a serious public health problem. Their epidemiology is extremely variable, and its analysis is crucial to establish effective treatment and prevention of these injuries. However only two works have been published about maxillofacial fracture epidemiology in Italy. The records of 1720 patients diagnosed with maxillofacial fractures in a 15-years period (2001-2015) in our department were retrospectively reviewed. A total of 1108 male and 612 female patients were included in the study. The most frequent aetiology of fracture was road traffic injuries (57.1%), followed by assault (21.7%), falls (14.2%), work accidents (3.5%), sport accidents (3.3%) and other causes (0.2%). Significant variations of aetiology were detected between males and females and between Italians and individuals from other countries. The most frequently observed fracture involved the mandible (861 cases, 36%), followed by zygoma (489 cases, 20.4%), orbital walls (386 cases, 16.1%) and maxilla (282 cases, 11.8%). Road traffic legislation enforcement and continuous public education regarding the use of security devices remain an ongoing problem in our region and should be encouraged. In the same way, as migration flows influence and change the epidemiology of facial traumas, it is crucial to establish social support programs that avoid these disadvantaged categories of victims of violence and crime. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Burt, C W; Overpeck, M D
We sought to estimate the effect and magnitude of patients with sports-related injuries presenting to hospital emergency departments in the United States and to examine differences in patient and visit characteristics between sports- and nonsports-related injuries. Data from the 1997 and 1998 National Hospital Ambulatory Medical Care Survey, a national probabilistic sample of 496 US hospital EDs, were combined to examine emergency visits for sports-related injuries. Data from 16,997 sample ED encounter records for injuries that included narrative cause of injury text were analyzed. Narrative text entries were coded to 1 of 84 sport and recreational activity codes. Sample weights were applied to provide annual national estimates. Estimates of sports-related injury visits were based on 1,775 records with an assigned sports-related activity code. There were an average annual estimated 2.6 million emergency visits for sports-related injuries by persons between the ages of 5 and 24 years. They accounted for over 68% of the total 3.7 million sport injuries presented to the ED by persons of all ages. As a proportion of all kinds of injuries presenting to the ED, sports-related injuries accounted for more than one fifth of the visits by persons 5 to 24 years old. The use rate was 33.9 ED visits per 1,000 persons in this age group (95% confidence interval 30.3 to 37.5). The sports-related injury visit rate for male patients was more than double the rate for female patients (48.2 versus 19.2 per 1,000 persons between 5 and 24 years of age). Visits from sports-related activities for this age group were more frequent for basketball and cycling compared with other categories (eg, baseball, skateboarding, gymnastics). Compared with nonsports-related injuries for this age group, sports-related injuries were more likely to be to the brain or skull and upper and lower extremities. Patients with sports-related injuries were more likely to have a diagnosis of fracture and sprain or
Full Text Available Introduction: This study was conducted to determine the pattern of maxillofacial fractures in three age groups of adults, adolescents, and children, using CT scan images. Methods: In this cross-sectional study, CT scan images of 230 patients with maxillofacial trauma during one year were examined in terms of the number and site of fractures. The patients were divided into three age groups, children (0-14 years, adolescents (14-17 years, and adults (>17 years. The data collected from this group were analyzed using, Chi-square, independent t-test and ANOVA statistical tests. Results: The analysis showed that 85% of maxillofacial fractures occur in adults, 7% in adolescents, and 8% in children. The most prevalent causes of fractures in adults were accidents (70% and fallings (16%. Accidents (73% and quarrels (13% were the most prevalent causes of fractures in adolescents. In children, falling (60% as the most prevalent cause of fracture was significantly higher than that in other groups (P-value=0.001. The most prevalent sites of maxillofacial fracture in adults were nasal bones and zygomaticomaxillary complex. Nasal and orbital fractures in adolescents comprised the most prevalent sites of fracture. Mandibular bone was the most prevalent site of fracture in children. The variations in prevalent sites of fracture among the three groups were significant (P-value=0.002. Conclusion: Car accidents are the main risk factor for maxillofacial fractures. The prevalent causes and sites of maxillofacial fractures in adults, adolescents, and children are different from one another.
Hong Bae Jeon
Full Text Available BackgroundBioabsorbable plates and screws are commonly used to reduce maxillofacial bones, particularly in pediatric patients because they degrade completely without complications after bone healing. In this study, we encountered eight cases of a delayed foreign body reaction after surgical fixation with bioabsorbable plates and screws.MethodsA total of 234 patients with a maxillofacial fracture underwent surgical treatment from March 2006 to October 2013, in which rigid fixation was achieved with the Inion CPS (Inion, Tampere, Finland plating system in 173 patients and Rapidsorb (Synthes, West Chester, PA, USA in 61 patients. Their mean age was 35.2 years (range, 15-84 years. Most patients were stabilized with two- or three-point fixation at the frontozygomatic suture, infraorbital rim, and anterior wall of the maxilla.ResultsComplications occurred in eight (3.4% of 234 patients, including palpable, fixed masses in six patients and focal swelling in two patients. The period from surgical fixation to the onset of symptoms was 9-23 months. Six patients with a mass underwent secondary surgery for mass removal. The masses contained fibrous tissue with a yellow, grainy, cloudy fluid and remnants of an incompletely degraded bioabsorbable plate and screws. Their histological findings demonstrated a foreign body reaction.ConclusionsInadequate degradation of bioabsorbable plates caused a delayed inflammatory foreign body reaction requiring secondary surgery. Therefore, it is prudent to consider the possibility of delayed complications when using bioabsorbable plates and surgeons must conduct longer and closer follow-up observations.
Tomich, G.; Baigorria, P.; Orlando, N.; Mejico, M.; Costamagna, C.; Villavicencio, R.
Introduction: Maxillofacial trauma (MFT) is a common reason for attendance at Emergency Departments. The complex anatomy of the facial bones requires multiplanar imaging techniques for a proper evaluation. Objectives. To describe frequency and types of fractures in a series of patients with MFT evaluated by multi-slice computed tomography (MDCT) with multiplanar and 3D reconstructions. Materials and Methods: Facial bone CTs ordered for MFT by the Emergency Department from June 2008 to December 2009 were retrospectively reviewed. The following data were obtained: age, gender, cause of trauma, presence and type of fractures. Patients were evaluated with an 8-channel MDCT. Multiplanar reconstructions were performed in all cases using high resolution bone window and soft tissue window, as well as 3D reconstructions. Results: One-hundred and thirty-seven CTs were performed for MFT: 78 (57%) showed 131 fractures. Of these 78 patients, 52 (66%) were males and 26 (34%) were females; mean age 33 years old (range: 14-90 yrs.). Causes: 58 % were injuries from traffic accidents; 24% were injuries from fights; 13% were sport injuries; and 7% were due to miscellaneous etiologies. Type and frequency of fractures: 18.3% were orbital floor fractures, 16% were maxillary sinus fractures, 15.3% were nasal fractures, 13% were jaw fractures, 9.2% were orbital fractures, and 12.3% were fractures of the zygomatic-malar complex; two cases of Le Fort II-III fractures were also observed. Conclusions: Fractures were more common in males, in the age range from 15 to 35 years old. Most fractures, and the most complex ones, were caused by traffic accidents. The most common fracture, either isolated or associated with other fractures, was the orbital floor fracture. (authors)
Szpilman, David; Orlowski, James P
Aquatic sports are included in the top list of risky practices as the environment per se carries a possibility of death by drowning if not rescued in time. Not only are aquatic sports related to a high risk of death, but also all sports practiced on the water, over the water and on ice. Whatever the reason a person is in the water, drowning carries a higher possibility of death if the individual is unable to cope with the water situation, which may simply be caused by an inability to stay afloat and get out of the water or by an injury or disease that may lead to physical inability or unconsciousness. The competitive nature of sports is a common pathway that leads the sports person to exceed their ability to cope with the environment or simply misjudge their physical capability. Drowning involves some principles and medical interventions that are rarely found in other medical situations as it occurs in a deceptively hostile environment that may not seem dangerous. Therefore, it is essential that health professionals are aware of the complete sequence of action in drowning. This article focuses on the pulmonary injury in sports and recreational activities where drowning plays the major role. Copyright ©ERS 2016.
Laker, Scott R
Sports-related concussions (SRC) are common in all ages and occur in all sports. The diagnosis based on clinical suspicion after more serious injury is ruled out. Symptoms of concussion are due to a temporary and reversible neurometabolic cascade resulting in blood flow changes, neuronal excitotoxicity, ionic shifts, and mitochondrial changes. Symptoms are nonspecific, and commonly include headache, cognitive complaints, photophobia, and phonophobia. Loss of consciousness is rare in SRC and has limited influence on recovery and prognosis. Imaging has a limited role in the management of concussion and should be used to evaluate for more serious intracranial pathology. Treatment is based on symptoms and an understanding of the typical, rapid (7-10 days) recovery. No athlete should return to play until their symptoms have resolved and they have completed a supervised, step-wise return to play protocol. The article covers the most recent literature on the diagnosis and management of SRC, including evidence-based recommendations and expert-based consensus opinion. The article will also discuss issues regarding medical retirement, legislation, and future concepts in concussion diagnosis and management.
Schneider, Daniel; Kämmerer, Peer W; Schön, Gerhard; Dinu, Christian; Radloff, Sarah; Bschorer, Reinhard
The aim of the present study was to illustrate the injury patterns and the etiology of accident victims with maxillofacial fractures in the state of Mecklenburg-Western Pomerania (M-P), Germany. Between 2010 and 2013, patients with maxillofacial fractures from the Department of Oral and Maxillofacial Surgery at the Helios Kliniken Schwerin, were evaluated with a specially constructed data set in a retrospective analysis. After review of the patient records, a case-related data collection was performed with the pre-set characteristics: age, gender, age group, maxillofacial fracture, and cause of injury. Of 409 patients, 79% (n = 323) were male and 21% (n = 86) were female. A fracture of the zygomaticomaxillary complex was most frequently observed (31%; n = 240). Midface fractures with orbital floor involvement were the most common fracture types (48.4%; n = 137). A significant percentage of the fractures (45.2%; n = 185) were caused by interpersonal violence; 70.8% (n = 131), and thus the majority of the patients who were treated due to a brutal offense, had consumed alcohol. Within this group, men in the age group of 20-29 years were most prevalent (38.7%; n = 125). Etiologically, 25.2% (n = 103) of fractures were caused by a fall. The regionalization of data on the distribution, emergence, and localization of maxillofacial fractures in M-P allows not only a national comparison but also an international comparison with areas that are in a similar strong socio-demographic change, as it applies to the East German population. This provides the opportunity to develop the global preventive measures and to apply suitable quality management. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Boffano, Paolo; Kommers, Sofie C; Karagozoglu, K Hakki; Forouzanfar, Tymour
The epidemiology of facial trauma may vary widely across countries (and even within the same country), and is dependent on several cultural and socioeconomic factors. We know of few reviews of published reports that have considered the sex distribution and aetiology of maxillofacial trauma throughout the world. The aim of this review was to discuss these aspects as they have been presented in papers published during the last 30 years. We made a systematic review of papers about the epidemiology of maxillofacial trauma that were published between January 1980 and December 2013 and identified 69 studies from Africa (n=9), North America and Brazil (n=6), Asia (n=36), Europe (n=16), and Oceania (n=2). In all the studies men outnumbered women, the ratio usually being more than 2:1. In American, African, and Asian studies road traffic crashes were the predominant cause. In European studies the aetiology varied, with assaults and road traffic crashes being the most important factors. In Oceania assaults were the most important. A comparison of the incidence of maxillofacial trauma of different countries together with a knowledge of different laws (seat belts for drivers, helmets for motocyclists, speed limits, and protection worn during sports and at work) is crucial to allow for improvement in several countries. To our knowledge this paper is the first attempt to study and compare the aetiologies of maxillofacial trauma. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
van den Bergh, B.; Goey, Y.; Forouzanfar, T.
The purpose of the present study was to investigate the necessity of routine postoperative radiographic analysis in patients with maxillofacial trauma. Between January 2000 and January 2010, 579 patients were treated surgically for 646 maxillofacial fractures including complex maxillofacial trauma.
van den Bergh, B.; Goey, Y.; Forouzanfar, T.
The purpose of the present study was to investigate the necessity of routine postoperative radiographic analysis in patients with maxillofacial trauma. Between January 2000 and January 2010, 579 patients were treated surgically for 646 maxillofacial fractures including complex maxillofacial trauma.
Arabion, Hr; Tabrizi, R; Aliabadi, E; Gholami, M; Zarei, K
Information about the etiology and incidence of maxillofacial trauma is important for prevention and appropriate treatments of such injuries. The purpose of this retrospective study was to conduct an analysis of maxillofacial injuries transferred and/or referred to the department of maxillofacial Surgery at Chamran emergency hospital, Shiraz, over a 6-year period with special reference to age, gender, occupation, date, type, site, etiology and clinical management. The data for this study were collected and reviewed retrospectively from the records and radiographs of 768 patients who were treated for maxillofacial trauma in the department of maxillofacial surgery at the Shiraz Chamran Emergency Hospital, Iran, between 2004 and 2010. A total of 730 of the subjects were the patients with fractures of the facial skeleton. The mean age was 26.6± 12.6 years, ranging from 2 to 81 years. Traffic accident was the most frequent etiological factor of maxillofacial fractures irrespective of gender (69.9% for men and 54.2% for women), whereas the second most frequent cause of injuries was falling down (9.8% for men and 21.5% for women) .The other etiologies were assaults (5.2%), sport related injuries (1.3%) and firearm injuries (1%). Regarding the head injuries in patients with maxillofacial fractures, brain contusion was seen in 227(29.6%) patients and 13.5% of patients had lacerations in the facial soft tissue. The monthly distribution peaked in October, with 81 cases (10.5%), which would be for the reason that schools open in this month. The next highest incidence was in December, with 80 cases (10.4%), probably because of the changing weather's effect on road traffic. Isolated mandibular fracture due to the road traffic accident was the most common type of maxillofacial injuries in the city of Shiraz.
Ivan Onone Gialain
Full Text Available Current study analyzes the characteristics and epidemiology of oral and nasal fractures and knowledge degree regarding the use of a mouthguard by an amateur university handball team inBrazil. A cross-sectional study comprised 138 students who practiced the sport. They were interviewed on dental and nasal fractures and on the need of mouthguards in games such as amateur handball. Data were processed by descriptive analysis. Results showed that 19.6% had suffered some type of dental injury during the practice of sports, namely 40 fractured teeth; 12% had fractured nasal bones; 57% underwent head and neck injuries; 32% were unaware of the need to use a mouthguard during sports; 68% had heard of mouthguards, but only 4.5% of the interviewees made use of this protection device. There was a high prevalence of nasal and dental fractures in the group under analysis. The upper central incisors were most susceptible to fracture. Even though most athletes knew a mouthguard was needed during sports activities, only 4.5% actually used one.
Emodi, Omri; Wolff, Amir; Srouji, Hanna; Bahouth, Hany; Noy, Dani; Abu El Naaj, Imad; Rachmiel, Adi
The aim of this study was to analyze the pattern and treatment of craniomaxillofacial injuries in the northern part of Israel, within a Jewish majority and large Arab minority population. A 5-year retrospective study evaluated patients treated for craniomaxillofacial fractures. Fracture cause, type, site, and patient demographics were evaluated. Patient age ranged from 1 to 94 years with an average age of 36.7 years; 52% of the victims were Jews and 48% Arabs. There was male predilection in both sectors (78.3% vs 21.7%). The main site of injury was the zygomatic bone (33.5%) followed by nasal bone, orbital, mandible, frontal sinus, and maxillary fractures. The main etiology of injuries was falls (45.4%) with significantly more falls reported by females (52.1% vs 43.2% in males). Motor vehicle accidents caused injuries more frequent in males. Arabs experienced CMF fractures at a younger age compared to Jews (27.8 and 44.8 average age, respectively). In the elderly, the trend reversed where Jews were more prone to craniomaxillofacial fractures. Compared to their weight in the population, the Arab sector experiences more craniomaxillofacial injuries. The Jewish elderly population tends to reside in nursing homes where they are more susceptible to accidental falls, whereas young Arab males are more exposed to motor vehicle accidents and interpersonal violence. Falls were the main cause of injuries particularly in women. This may reflect the women's fear of reporting domestic violence. We believe that increased government investments in infrastructures and education will lower the incidence of craniomaxillofacial trauma and balance the gap between both sectors and sexes.
The changing complexity of maxillofacial fractures in recent years has created a situation where classical systems of classification of maxillofacial injuries fall short of defining trauma particularly that observed with high-velocity collisions where more than one region of the maxillofacial skeleton is affected. Trauma scoring systems designed specifically for the maxillofacial region are aimed to provide a more accurate assessment of the injury, its prognosis, the possible treatment outcomes, economics, length of hospital stay, and triage. The evolution and logic of such systems along with their merits and demerits are discussed. The author also proposes a new system to aid users in quickly and methodically choosing the system best suited to their needs without having to study a plethora of literature available in order to isolate their choice. Copyright © 2016 Elsevier Ltd. All rights reserved.
Prevalence evaluation of ocular injuries of different kinds as zygomatic fractures consequences in patients referring to department of oral and maxillofacial surgery, Shariati Hospital (Oct 2004-Oct 2
Mahmood Hashemi H.
Full Text Available "nBackground and Aim: Zygomatic fractures are common among oral and maxillofacial problems and ocular injuries are of great importance, the prevalence of ocular problems following zygomatic fractures in Iran is not clear so we performed this study to evaluate this problem in patients referring to Shariati Hospital. "nMaterials and Methods: In this descriptive, cross-sectional study, we evaluated the patients who referred to department of oral and maxillofacial surgery of Shariati hospital for ocular complains following zygomatic fractures. The evaluation was performed both clinically and historically. "nResults: 115 patients were examined (87 males and 28 females with the mean age of 26 for males and 32 for females. The prevalence of ocular injuries were as follows: subconjunctival ecchymosis: 23.07% for males and 21.05% for females. Displacement of palpebral fissure: 26.5% for males and 27.6% for females. Unequal papillary levels: 18.37% for males and 15.78% for females. Diplopia: 8.9% for males and 10.5% for females. Enophthalmos: 23.1% for males and 25% for females. "nConclusion: It is strongly recommended to refer patients with zygomatic fracture for an ophthalmologic consultation.
Van Kampen, D.A.; Lovell, M.R.; Diercks, Ron
Sport related concussion is a hot item. The Health Council of the Netherlands published its report on concussions in 2003 and there is much concern about the negative health effects of sports related concussion. Neuropsychological testing has recently been endorsed as a 'cornerstone' of concussion
Khan, S.U.; Khan, M.; Khan, A.A.; Maqsood, A.; Ibrahim, W.; Wasim, A.
To determine the etiology and pattern of maxillofacial injuries in the Armed Forces of Pakistan in terms of anatomical distribution of injuries. Three hundred consecutive patients of Armed Forces of Pakistan with maxillofacial injuries reporting to AFID and admitted to the hospital or treated as out-patients in the oral surgery clinic, were included in this study. Isolated nasal bone and frontal sinus fractures were excluded from the study. Anatomical distribution, frequency and etiology of fractures, rank at job and occupational as well as personal hobbies were recorded. Descriptive analyses were used to determine mean, standard deviation, percentage and range values. The most frequent bone fractured was the mandible, which accounted for 159 cases (53%). The zygomatic complex was fractured in 51 cases (17%), the maxilla in 12 cases (4 %), and the alveolar process in 21 cases (7%). The most common cause was road traffic accident (168 cases; 56%), followed by accidental fall (69 cases; 23%), gunshot injuries (27 cases; 9%), sports related injuries (15 cases; 5%), and injury associated with a fight (12 cases; 4%); there were only 9 cases of animals related injuries (3%). In this series, mandible was the most commonly fractured facial bone, while road traffic accident was the most common etiological factor. Results could be influenced by the personal and working environment. (author)
Pohlenz, Philipp; Blake, Felix; Blessmann, Marco; Smeets, Ralf; Habermann, Christian; Begemann, Philipp; Schmelzle, Rainer; Heiland, Max
To describe the first clinical applications of intraoperative cone-beam computed tomography with an integrated flat-panel detector in oral and maxillofacial surgery after surgical treatment of zygomaticomaxillary complex fractures Nine cone-beam computed tomography datasets of patients with zygomaticomaxillary complex fractures were intraoperatively acquired using a mobile isocentric C-arm (PowerMobil; Siemens Medical Solutions, Erlangen, Germany), including a flat-panel detector. Datasets based on 400, 200, and 100 fluoroscopic images were performed with different tube currents (4.6 mA, 3.3 mA, 2.3 mA, 1.2 mA, and 0.5 mA) and a current tube voltage of 100 kV. Postprocessing resulted in 15 different datasets available for comparison with corresponding preoperative computed tomography datasets. Four oral and maxillofacial surgeons and 2 experienced radiologists evaluated each dataset regarding noise, transition, and the delimitation of landmarks. All examinations were successfully performed. Reconstructed datasets showed high-resolution images of all midfacial osseous structures in near-computed tomography quality. Regarding high-contrast structures, detailed analyses of datasets acquired in this study suggest that the parameters 400 projections, 1.2 mA, and 100 kV are sufficient. In terms of soft-tissue visualization, a higher level of mA seems preferable. The tested prototype predicts a new era in cone-beam computed tomography imaging. The integration of a flat-panel detector will overcome the limitations of current available systems. The size of the field of view is increased allowing regularly the visualization of the whole facial skeleton. Particularly in cases of open reduction of unilateral fractures, the assessment of symmetry is of clinical value.
Donker, E.L.; Barel, J.C.; Mulder, J.J.S.; Barkhuysen, R.; Bronkhorst, M.A.; Damme, P.A. van
Mandibular fractures are among the most common facial bone injuries. Approximately 50% of the fractures occur in teeth bearing areas. Consequently, the likelihood that a tooth will be in the fracture line is substantial. A review of the literature reveals that there is not a clear guideline for
Schortinghuis, J; Stegenga, B; Raghoebar, GM; de Bont, LGM
A substantial part of the maxillofacial surgery practice deals with maxillofacial bone healing. In the past decades, low-intensity ultrasound treatment has been shown to reduce the healing time of fresh fractures of the extremities up to 38%, and to heal delayed and non-unions up to 90% and 83%,
Ford, Jessica L; Ildefonso, Kenneth; Jones, Megan L; Arvinen-Barrow, Monna
To date, much research has been devoted to understanding how anxiety can affect sport performance, both in practice and in competitive settings. It is well known that sport has the potential for high levels of stress and anxiety, and that practicing and employing a range of psychological strategies can be beneficial in anxiety management. Equally, growing evidence also suggests that anxiety can play a role in sport injury prevention, occurrence, rehabilitation, and the return to sport process. The purpose of this paper is to provide current insights into sport-related anxiety. More specifically, it will provide the reader with definitions and theoretical conceptualizations of sport-related anxiety. This will be followed by making a case for considering the term "performance" to be broader than activities associated with sport-related performance in practice and competition, by including performance activities associated with sport injury prevention, rehabilitation, and the return to sport process. The paper will then highlight the importance of recognizing early signs and symptoms of anxiety, and the potential need for referral. Finally, the conclusions will emphasize the need for appropriate, client-specific, and practitioner competent care for athletes experiencing sport-related anxiety.
Full Text Available Jessica L Ford, Kenneth Ildefonso, Megan L Jones, Monna Arvinen-Barrow Department of Kinesiology, Integrative Health Care & Performance Unit, University of Wisconsin-Milwaukee, Milwaukee, WI, USA Abstract: To date, much research has been devoted to understanding how anxiety can affect sport performance, both in practice and in competitive settings. It is well known that sport has the potential for high levels of stress and anxiety, and that practicing and employing a range of psychological strategies can be beneficial in anxiety management. Equally, growing evidence also suggests that anxiety can play a role in sport injury prevention, occurrence, rehabilitation, and the return to sport process. The purpose of this paper is to provide current insights into sport-related anxiety. More specifically, it will provide the reader with definitions and theoretical conceptualizations of sport-related anxiety. This will be followed by making a case for considering the term "performance" to be broader than activities associated with sport-related performance in practice and competition, by including performance activities associated with sport injury prevention, rehabilitation, and the return to sport process. The paper will then highlight the importance of recognizing early signs and symptoms of anxiety, and the potential need for referral. Finally, the conclusions will emphasize the need for appropriate, client-specific, and practitioner competent care for athletes experiencing sport-related anxiety. Keywords: anxiety, sport, performance, injury, sport medicine professional, sport psychology, mental health
Jones, G R; Newhouse, I
To present an overview and models of the potential causes and implications of sport-related hematuria in an athletic population as provided by a literature review. A total of 64 published scientific articles have been utilized to provide a review of sport-related hematuria. Reviewed studies were selected on the basis that they provided informative findings about the possible mechanisms of sport-related hematuria attributed to exercise duration and intensity. These studies used both normal adult and athletic populations. A review of the literature on the potential mechanisms of sport-related hematuria led to the classification of these mechanisms as either exercise duration related or exercise intensity related. Research has revealed an increased prevalence of hematuria in athletes. The mechanisms responsible may be traced to different sources or a combination thereof. Many explanations have been directed toward a potential cause; foot-strike hemolysis, renal ischemia, hypoxic damage to the kidney, the release of a hemolyzing factor, bladder and/or kidney trauma, nonsteroidal anti-inflammatory drugs, dehydration, increased circulation rate, myoglobinuria release, and the peroxidation of red blood cells. These mechanisms are presented in two models depicting the influence of either exercise intensity or exercise duration on sport-related hematuria. Athletes, coaches, and sports medicine professionals should be aware of this condition because frequent high-intensity and/or long-duration workouts and competitions may promote the symptoms. Repeated red blood cell loss through the urine may be a contributing factor toward promoting anemic conditions in competitive athletes. Recognition of the potential mechanisms can spare the time and expense of invasive testing.
Halil ibrahim Kisa
Full Text Available Maxillofacial injuries are most commonly associated with falls, motor and vehicle accidents, sports-related trauma, and interpersonel violence. The complexity of mandibular condyle region and its anatomic proximity to other craniofacial structures complicate diagnosis and treatment. Thus, treatment approaches of mandibular condyle fracture are still controversial. In the literature, different success rates are reported about observation versus treatment, closed reduction versus open reduction and fixation methods. In the present article, controversial issues related to mandibular condyle fractures were reviewed under the light of current literature. In conclusion, the simplest way that can be done with the least risk of complication should be chosen during treatment planning. In addition, current adjunctive treatment methods accelerating healing of fracture should be considered. [Archives Medical Review Journal 2014; 23(4.000: 658-671
Full Text Available PURPOSE To investigate the accuracy of MRI in evaluation of sports related knee injuries. MATERIALS AND METHODS From June 2015 to 1 st week of July 2016. Thirty patients referred for sports related knee pain have been included in this study. Patients were subjected to a dedicated MR knee study (GE HD XT 1.5T MR System and correlated knee arthroscopy and surgery. RESULTS The study included Thirty patients complaining of sports related knee pain, only 5 patients (16.67 % were with normal MRI findings and 25 patients (83.33% were with abnormal MRI findings. Among the 25 patients who had injuries of their knees, 15 patients (60% had ACL injuries, 6 patients (24% had PCL injuries, 10 patients (40% had meniscal injuries, 8 patients (32% had collateral ligament injuries, 5 patients (20% had bone injuries and 2 patients (8% had muscular injuries. Only 5 patients (20% were represented with isolated injury and 20 patients (80% were represented with combined injuries. In correlation with arthroscopies and surgeries, morphological analysis was true-positive in 23 (92% patients of the 25 injured patients, and true-negative in 1 (60% patient of the 2 normal patients. Morphological analysis revealed overall 92% sensitivity and 60% specificity. Regarding the 15 patients who had ACL injuries, 13 patients (86.6% were true-positive and 8 patients (80% of the 10 patients who had meniscal injuries were true-positive. CONCLUSION MRI represents the optimal imaging modalities in the evaluation of the sports related knee injuries, which has been shown to be an accurate and non-invasive method of diagnosing ligament, meniscal, cartilage and muscular knee injuries.
Soehardi, A.; Meijer, G.J.; Manders, R.; Stoelinga, P.J.W.
PURPOSE: The present study provides an inventory of the number of fractures that occurred in conjunction with implant placement in edentulous patients in the Dutch population from 1980 to 2007 and estimates the incidence with which this might occur. The study also sought to define the factors that
Baarveld, Frank; Visser, Chantal A. N.; Kollen, Boudewijn J.; Backx, Frank J. G.
Methods. Survey study conducted in 612 patients with sports-related injuries by 21 GP trainees in as many GP practices. Inclusion of study subjects took place between September 2007 and April 2009. Results. In total, 694 sports-related injuries were registered. The incidence of sports-related
José Luiz Rodrigues Leles
Full Text Available BACKGROUND: Maxillofacial injuries occur in a significant number of trauma patients. Epidemiological assessments are essential to reaffirm patterns, identify new trends and develop clinical and research priorities for effective treatment and prevention of these injuries. OBJECTIVE: The aim of this study was to identify the epidemiological profile and risk factors associated with maxillofacial trauma treated at a referral emergency hospital for the Public Health System in the State Capital of Goiás, Brazil. MATERIAL AND METHODS: A cross-sectional study was designed including 530 patients with maxillofacial trauma, 76% male, with a mean age of 25.5±15.0 years. Data were collected between May 2003 and August 2004 over weekly shift-working periods. RESULTS: The main causes of trauma were traffic accidents (45.7% and physical assaults (24.3%, and differences in etiological factors were identified according to gender (p<0.001. The distribution of patients according to age and etiology showed significant differences for traffic accidents (p<0.01, physical assaults (p<0.001, falls (p<0.001 and sport injuries (p<0.01. In the multinomial logistic regression analysis (R² = 0.233; p<0.05, age was associated with injury in traffic accidents and falls (p<0.01, sports-related accidents were associated with males (p<0.05, and alcohol consumption with assaults and traffic accidents (p<0.001. Facial soft tissue lesions were found in 98% of patients and facial fractures in 51%. CONCLUSIONS: The significant association of maxillofacial trauma with young males and alcohol consumption reinforces the need for educational strategies and the development of policies for the prevention and reduction of associated damage in this specific risk group.
Gosselin, Nadia; Lassonde, Maryse; Petit, Dominique; Leclerc, Suzanne; Mongrain, Valérie; Collie, Alex; Montplaisir, Jacques
Sleep and vigilance disorders are among the most commonly reported symptoms following a concussion. The aim of the study was thus to investigate the effects of sport-related concussions on subjective and objective sleep quality. Ten concussed athletes and 11 non-concussed athletes were included. Concussed athletes had a history of 4.6+/-2.1 concussions with at least one concussion during the last year. They were recorded for two consecutive nights in the laboratory and during a 10-min period of wakefulness. They completed questionnaires related to sleep quality and symptoms as well as neuropsychological tests and the CogSport computer battery. Concussed athletes reported more symptoms and worse sleep quality than control athletes, but no between-group differences were found on polysomnographic variables or on REM and NREM sleep quantitative EEG variables. However, concussed athletes showed significantly more delta activity and less alpha activity during wakefulness than did control athletes. In spite of the subjective complaints in sleep quality of concussed athletes, no change was observed in objective sleep characteristics. However, concussions were associated with an increase in delta and a reduction in alpha power in the waking EEG. Sport-related concussions are thus associated with wakefulness problems rather than sleep disturbances.
Hobbs, Jonathan G; Young, Jacob S; Bailes, Julian E
Sports-related concussions (SRCs) are traumatic events that affect up to 3.8 million athletes per year. The initial diagnosis and management is often instituted on the field of play by coaches, athletic trainers, and team physicians. SRCs are usually transient episodes of neurological dysfunction following a traumatic impact, with most symptoms resolving in 7-10 days; however, a small percentage of patients will suffer protracted symptoms for years after the event and may develop chronic neurodegenerative disease. Rarely, SRCs are associated with complications, such as skull fractures, epidural or subdural hematomas, and edema requiring neurosurgical evaluation. Current standards of care are based on a paradigm of rest and gradual return to play, with decisions driven by subjective and objective information gleaned from a detailed history and physical examination. Advanced imaging techniques such as functional MRI, and detailed understanding of the complex pathophysiological process underlying SRCs and how they affect the athletes acutely and long-term, may change the way physicians treat athletes who suffer a concussion. It is hoped that these advances will allow a more accurate assessment of when an athlete is truly safe to return to play, decreasing the risk of secondary impact injuries, and provide avenues for therapeutic strategies targeting the complex biochemical cascade that results from a traumatic injury to the brain.
Mitchko, Jane; Huitric, Michele; Sarmiento, Kelly; Hayes, Gail; Pruzan, Marcia; Sawyer, Richard
Sports-related concussions can happen to any athlete in any sport. Each year in the United States, an estimated 1.6-3.8 million sports and recreation-related traumatic brain injuries (TBIs) occur, most of which can be classified as concussions. To help coaches prevent, recognize, and better manage sports-related concussions, the Centers for…
Macdonald, Ian; Hauber, Roxanne
Approximately 30 million children and adolescents in the United States participate in various forms of organized sports, and incidents of traumatic brain injuries in emergency departments have increased to 62% from 2001 to 2009. Knowledge, information, and preventive interventions appear to have been well disseminated among athletic personnel at the professional, collegiate, and high school levels. Research regarding parents' perceptions and knowledge of sports-related concussions (SRCs) however is lacking. This project aims to determine the impact of interventions designed to improve parental awareness of SRCs. The study used a demographic information sheet and a postintervention survey design. These surveys were to determine the impact of three distinct educational tools presented on the perceptions and knowledge of SRCs in a group of parents with children actively involved in sports. Forty-seven participants completed the demographic information sheet, most of them African American and have at least one child competing in high school contact sports. Furthermore, 85.1% of the parents felt that SRCs are a critical issue, although only 46.8% of the parents have ever sought out information to learn more about SRC. Twenty-nine individuals participated in the posteducational survey after the intervention, and most parents perceived that all three educational tools were written and presented in a fashion that changed their perception, awareness, and knowledge base of SRCs. These parents however stated that none of the interventions captured their attention enough to want to go to a professional for further information. Findings from this study suggest that parents know what educational approaches work best for them. However, it also suggests that a one-time educational intervention is not sufficient to move many parents to be proactive. The scarcity of published studies speaks to the need for further research to determine the most effective approaches to engage all
Three-Dimensional Planning in Maxillofacial Fracture Surgery: Computer-Aided Design/Computer-Aided Manufacture Surgical Splints by Integrating Cone Beam Computerized Tomography Images Into Multislice Computerized Tomography Images.
Ren, Jiayin; Zhou, Zhongwei; Li, Peng; Tang, Wei; Guo, Jixiang; Wang, Hu; Tian, Weidong
This study aimed to evaluate an innovative workflow for maxillofacial fracture surgery planning and surgical splint designing. The maxillofacial multislice computerized tomography (MSCT) data and dental cone beam computerized tomography (CBCT) data both were obtained from 40 normal adults and 58 adults who suffered fractures. The each part of the CBCT dentition image was registered into MSCT image by the use of the iterative closest point algorithm. Volume evaluation of the virtual splints that were designed by the registered MSCT images and MSCT images of the same object was performed. Eighteen patients (group 1) were operated without any splint. Twenty-one (group 2) and 19 patients (group 3) used the splints designed according to the MSCT images and registered MSCT images, respectively. The authors' results showed that the mean errors between the 2 models ranged from 0.53 to 0.92 mm and the RMS errors ranged from 0.38 to 0.69 mm in fracture patients. The mean errors between the 2 models ranged from 0.47 to 0.85 mm and the RMS errors ranged from 0.33 to 0.71 mm in normal adults. 72.22% patients in group 1 recovered occlusion. 85.71% patients in group 2, and 94.73% patients in group 3 reconstructed occlusion. There was a statistically significant difference between the MSCT images based splints' volume and the registered MSCT splints' volume in patients (P designing was feasible. The volume of the splints designed by MSCT images tended to be smaller than the splints designed by the integrated MSCT images. The patients operated with splints tended to regain occlusion. The patients who were operated with the splints which were designed according to registered MSCT images tended to get occlusal recovered.
Rajandram, Rama Krsna; Syed Omar, Syed Nabil; Rashdi, Muhd Fazly Nizam; Abdul Jabar, Mohd Nazimi
Maxillofacial injuries comprising hard tissue as well as soft tissue injuries can be associated with traumatic brain injuries due to the impact of forces transmitted through the head and neck. To date, the role of maxillofacial injury on brain injury has not been properly documented with some saying it has a protective function on the brain while others opposing this idea. This cross-sectional retrospective study evaluated all patients with maxillofacial injuries. The aim of the study was to analyze the occurrence and relationship of maxillofacial injuries with traumatic brain injuries. We retrospectively studied the hospital charts of all trauma patients seen at the accident and emergency department of UKM Medical Centre from November 2010 until November 2011. A detail analysis was then carried out on all patients who satisfied the inclusion and exclusion criteria. A total of 11294 patients were classified as trauma patients in which 176 patients had facial fractures and 292 did not have facial fractures. Middle face fractures was the most common pattern of facial fracture seen. Traumatic brain injury was present in 36.7% of maxillofacial cases. A significant association was found between facial fractures and traumatic brain injury (P maxillofacial injuries with or without facial fractures are at risk of acute or delayed traumatic brain injury. All patients should always have proper radiological investigations together with a proper observation and follow-up schedule. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Craig, J.G.; Holsbeek, M.T. van; Gauthier, T.P.; Cook, W.J.
Sports-related injuries of the musculoskeletal system affect millions of individuals every year. Integrating high-frequency Tissue Harmonic Imaging ultrasound with MRI and CT gives the greatest opportunity for diagnosing specific injuries. (orig.)
Ellis, Michael J; Leiter, Jeff; Hall, Thomas; McDonald, Patrick J; Sawyer, Scott; Silver, Norm; Bunge, Martin; Essig, Marco
The goal in this review was to summarize the results of clinical neuroimaging studies performed in patients with sports-related concussion (SRC) who were referred to a multidisciplinar ypediatric concussion program. The authors conducted a retrospective review of medical records and neuroimaging findings for all patients referred to a multidisciplinary pediatric concussion program between September 2013 and July 2014. Inclusion criteria were as follows: 1) age ≤ 19 years; and 2) physician-diagnosed SRC. All patients underwent evaluation and follow-up by the same neurosurgeon. The 2 outcomes examined in this review were the frequency of neuroimaging studies performed in this population (including CT and MRI) and the findings of those studies. Clinical indications for neuroimaging and the impact of neuroimaging findings on clinical decision making were summarized where available. This investigation was approved by the local institutional ethics review board. A total of 151 patients (mean age 14 years, 59% female) were included this study. Overall, 36 patients (24%) underwent neuroimaging studies, the results of which were normal in 78% of cases. Sixteen percent of patients underwent CT imaging; results were normal in 79% of cases. Abnormal CT findings included the following: arachnoid cyst (1 patient), skull fracture (2 patients), suspected intracranial hemorrhage (1 patient), and suspected hemorrhage into an arachnoid cyst (1 patient). Eleven percent of patients underwent MRI; results were normal in 75% of cases. Abnormal MRI findings included the following: intraparenchymal hemorrhage and sylvian fissure arachnoid cyst (1 patient); nonhemorrhagic contusion (1 patient); demyelinating disease (1 patient); and posterior fossa arachnoid cyst, cerebellar volume loss, and nonspecific white matter changes (1 patient). Results of clinical neuroimaging studies are normal in the majority of pediatric patients with SRC. However, in selected cases neuroimaging can provide
Baarveld, Frank; Visser, Chantal A N; Kollen, Boudewijn J; Backx, Frank J G
Introduction. Sports activities play an important role in today’s society. However, as more people become involved in these activities, the number of sports-related injuries also increases. In the Netherlands, 3.5 million sports injuries occur annually. Twenty per cent of these injuries are first seen by a GP. Little is known about the epidemiology of these injuries in general practice. This study has been conducted to determine the incidence and prevalence of sports-related injuries in gener...
Baarveld, Frank; Visser, Chantal A N; Kollen, Boudewijn J; Backx, Frank J G
Sports activities play an important role in today's society. However, as more people become involved in these activities, the number of sports-related injuries also increases. In the Netherlands, 3.5 million sports injuries occur annually. Twenty per cent of these injuries are first seen by a GP. Little is known about the epidemiology of these injuries in general practice. This study has been conducted to determine the incidence and prevalence of sports-related injuries in general practice and to provide information about the nature and treatment of these injuries. Survey study conducted in 612 patients with sports-related injuries by 21 GP trainees in as many GP practices. Inclusion of study subjects took place between September 2007 and April 2009. In total, 694 sports-related injuries were registered. The incidence of sports-related injuries was 23.7 in 1000 patients and prevalence 27.8 in 1000 patients. Soccer-related injuries are most prominent in this population, lower extremities being three times more often involved than upper extremities. GPs often (60.9%) used a symptom-based diagnosis. In 80% of the cases, no additional diagnostic testing took place, while in 36.5% of the cases, only explanation and advice sufficed. Few patients were referred to the hospital (6.6%). Patients with sports-related injuries regularly consult GPs (on average one to two times per week). GPs tend to use non-specific diagnoses in sports-related injuries. In part, this may be due to the lack of specific diagnoses available in the current registration system (International Classification of Primary Care). Most often these injuries require only explanation and medical advice from the GP. Usually, additional tests or hospital referrals are not necessary. Presumably, mostly patients with mild sports-related injuries consult the GP.
Baarveld, Frank; Visser, Chantal A N; Kollen, Boudewijn J; Backx, Frank J G
Introduction. Sports activities play an important role in today’s society. However, as more people become involved in these activities, the number of sports-related injuries also increases. In the Netherlands, 3.5 million sports injuries occur annually. Twenty per cent of these injuries are first seen by a GP. Little is known about the epidemiology of these injuries in general practice. This study has been conducted to determine the incidence and prevalence of sports-related injuries in general practice and to provide information about the nature and treatment of these injuries. Methods. Survey study conducted in 612 patients with sports-related injuries by 21 GP trainees in as many GP practices. Inclusion of study subjects took place between September 2007 and April 2009. Results. In total, 694 sports-related injuries were registered. The incidence of sports-related injuries was 23.7 in 1000 patients and prevalence 27.8 in 1000 patients. Soccer-related injuries are most prominent in this population, lower extremities being three times more often involved than upper extremities. GPs often (60.9%) used a symptom-based diagnosis. In 80% of the cases, no additional diagnostic testing took place, while in 36.5% of the cases, only explanation and advice sufficed. Few patients were referred to the hospital (6.6%). Discussion. Patients with sports-related injuries regularly consult GPs (on average one to two times per week). GPs tend to use non-specific diagnoses in sports-related injuries. In part, this may be due to the lack of specific diagnoses available in the current registration system (International Classification of Primary Care). Most often these injuries require only explanation and medical advice from the GP. Usually, additional tests or hospital referrals are not necessary. Presumably, mostly patients with mild sports-related injuries consult the GP. PMID:20923967
Comportamiento de las fracturas maxilofaciales atendidas en el Hospital Universitario de Maabar, República de Yemen Behavior of the maxillofacial fractures in the Maabar's University Hospital, Yemen Republic
Juan Carlos Quintana Díaz
Full Text Available Introducción: las fracturas maxilofaciales constituyen más del 50 % del total de fracturas, y en muchas ocasiones están asociadas a otras fracturas del cuerpo humano. Objetivos: estudiar el comportamiento de estas lesiones en el Hospital Universitario de Maabar, de la Universidad de Thamar (Yemen, determinar su relación con la edad, sexo, etiología y localización, y compararlo con los resultados de otros estudios realizados en Cuba y en otros países. Métodos: se realizó un estudio estadístico descriptivo retrospectivo de las fracturas maxilofaciales atendidas por la brigada de profesores cubanos en este hospital entre los años 2006 y 2009. Las variables estudiadas fueron: sexo, edad, causa de la fractura y región afectada, así como el tipo de fractura y los traumatismos asociados. Resultados: el sexo masculino fue mucho más afectado que el femenino. Los accidentes del tránsito fueron la causa más común (más del 50 % de los casos. La fractura nasal fue la más frecuente, y en más de 150 casos se detectaron traumatismos asociados, muchos muy graves, como fracturas de cráneo, de miembros y heridas de partes blandas. Conclusiones: se confirman los resultados que el sexo masculino es el más afectado, y que los accidentes del tránsito son la principal causa de fracturas en la cara. La fractura nasal es la más frecuente de todas las de los huesos faciales (más del 50 % de los casos, pero otros registran la mandíbula o la región zigomática como la zona más frecuente. Impresionaron las fracturas mandibulares en niños, lo cual no es frecuente en Cuba.Introduction: the maxillofacial fractures account for more than the 50 % of the total of fractures and often are associated with other fractures of the human body. Objectives: to study the behavior of these lesions in patients from the Maabar's University Hospital of the Thamar's University (Yemen, to determine its relation to age, sex, etiology and location and to compare it with
Mukherjee, S; Abhinav, K; Revington, P J
The aim of this study was to determine the incidence and patterns of cervical spine injury (CSI) associated with maxillofacial fractures at a UK trauma centre. A retrospective analysis was conducted of 714 maxillofacial fracture patients presenting to a single trauma centre between 2006 and 2012. Of the 714 maxillofacial fracture patients, 2.2% had associated CSI including a fracture, cord contusion or disc herniation. In comparison, 1.0% of patients without maxillofacial trauma sustained a CSI (odds ratio: 2.2, p=0.01). The majority (88%) of CSI cases of were caused by a road traffic accident (RTA) with the remainder due to falls. While 8.8% of RTA related maxillofacial trauma patients sustained a CSI, only 2.0% of fall related patients did (p=0.03, not significant). Most (70%) of the CSIs occurred at C1/C2 or C6/C7 levels. Overall, 455, 220 and 39 patients suffered non-mandibular, isolated mandibular and mixed mandibular/non-mandibular fractures respectively. Their respective incidences of CSI were 1.5%, 1.8% and 12.8% (p=0.005, significant). Twelve patients with concomitant CSI had their maxillofacial fractures treated within twenty-four hours and all were treated within four days. The presence of maxillofacial trauma mandates exclusion and prompt management of cervical spine injury, particularly in RTA and trauma cases involving combined facial fracture patterns. This approach will facilitate management of maxillofacial fractures within an optimum time period.
Kammerlander, Christian; Braito, Matthias; Kates, Stephen; Jeske, Christian; Roth, Tobias; Blauth, Michael; Dallapozza, Christian
The population is rapidly aging and remaining more active over the age of 65. An increasing number of sports related injuries in individuals 65 and older are thus anticipated. The aim of this study is to analyze the epidemiology of sports injuries in the age group aged 65 and older. Data from the medical records of adults aged 65 years and older who were treated for sports-related injuries at a level one trauma center between December 1994 and February 2008 was collected and statistically analyzed. A total of 2635 patients met our inclusion criteria. There were 1647 men (62.5%) and 988 women (37.5%) with a mean age of 70.9 years. The yearly number of injuries doubled during the study period (1996-2007). The most common mechanism of injury was a simple fall from standing height (69%). Nearly 75% of all injuries occurred during alpine skiing, cycling or mountain climbing. The median Injury Severity Score was 4. Minor injuries and wounds (40%) were recorded most commonly followed by fractures (27%), sprains, ligament injuries (19%) and injuries of muscles and tendons (6%). The most frequent diagnoses were minor injuries to the head and ligament injuries around the knee joint. Injuries to the upper extremities occurred in 33.7%, injuries to the lower extremities in 29.4% and injuries to the head occurred in 20% of the patients. Women sustained substantially more fractures than men. Adults aged 65 and older are remaining active in sports, which results in higher numbers of sports related injuries in this age group. Identification of type, mechanism and distribution of the injuries can help with the recognition of risk factors for injury. This may enable us to develop appropriate preventative measures to reduce the incidence, and morbidity of such injuries.
Reich, Waldemar; Surov, Alexey; Eckert, Alexander Walter
Undiagnosed cervical spine injury can have devastating results. The aim of this study was to analyse patients with primary maxillofacial trauma and a concomitant cervical spine injury. It is hypothetised that cervical spine injury is predictable in maxillofacial surgery. A monocentric clinical study was conducted over a 10-year period to analyse patients with primary maxillofacial and associated cervical spine injuries. Demographic data, mechanism of injury, specific trauma and treatments provided were reviewed. Additionally a search of relevant international literature was conducted in PubMed by terms "maxillofacial" AND "cervical spine" AND "injury". Of 3956 patients, n = 3732 (94.3%) suffered from craniomaxillofacial injuries only, n = 174 (4.4%) from cervical spine injuries only, and n = 50 (1.3%) from both craniomaxillofacial and cervical spine injuries. In this study cohort the most prevalent craniofacial injuries were: n = 41 (44%) midfacial and n = 21 (22.6%) skull base fractures. Cervical spine injuries primarily affected the upper cervical spine column: n = 39 (58.2%) vs. n = 28 (41.8%). Only in 3 of 50 cases (6%), the cervical spine injury was diagnosed coincidentally, and the cervical spine column was under immobilised. The operative treatment rate for maxillofacial injuries was 36% (n = 18), and for cervical spine injuries 20% (n = 10). The overall mortality rate was 8% (n = 4). The literature search yielded only 12 papers (11 retrospective and monocentric cohort studies) and is discussed before our own results. In cases of apparently isolated maxillofacial trauma, maxillofacial surgeons should be aware of a low but serious risk of underestimating an unstable cervical spine injury. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Chiu, Geoff A; Bullock, M; Edwards, A
The treatment of maxillofacial injuries forms a substantial part of the work in oral and maxillofacial units, but injuries sustained in work-related incidents are uncommon, mainly because of the strict enforcement of Health and Safety policies. We used data from the Health and Safety Executive in the United Kingdom to review the incidence and aetiology of maxillofacial injuries that result from industrial accidents in the UK, and highlight the case of a worker who sustained an isolated fracture of the nasoethmoidal complex when he was trapped in a cheese press. In 2010-2011, roughly 115,379 accidents or incidents at work were reported in the UK, and of the 1623 (1%) that were maxillofacial, 81% occurred in the service sector. The most common mechanism of injury was assault (37%) and the most common injury was contusion (30%). Since the introduction of the Health and Safety Act, work-related accidents in the UK have decreased considerably. However, they will continue to occur because of human error. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Das, Devjanl; Salazar, Lea
Patients with maxillofacial trauma require a careful evaluation due to the anatomical proximity of the maxillofacial region to the head and neck. Facial injuries can range from soft-tissue lacerations and nondisplaced nasal fractures to severe, complex fractures, eye injuries, and possible brain injury. Though the Advanced Trauma Life Support (ATLS) guidelines provide a framework for the management of trauma patients, they do not provide a detailed reference for many subtle or complex facial injuries. This issue adds a more comprehensive and systematic approach to the secondary survey of the maxillofacial area and emergency department management of injuries to the face. In addition to an overall review of maxillofacial trauma pathophysiology, associated injuries, and physical examination, this review will also discuss relevant imaging, treatment, and disposition plans.
Das, Devjani; Salazar, Lea; Zaurova, Milana
Patients with maxillofacial trauma require a careful evaluation due to the anatomical proximity of the maxillofacial region to the head and neck. Facial injuries can range from soft-tissue lacerations and nondisplaced nasal fractures to severe, complex fractures, eye injuries, and possible brain injury. Though the Advanced Trauma Life Support (ATLS) guidelines provide a framework for the management of trauma patients, they do not provide a detailed reference for many subtle or complex facial injuries. This issue adds a more comprehensive and systematic approach to the secondary survey of the maxillofacial area and emergency department management of injuries to the face. In addition to an overall review of maxillofacial trauma pathophysiology, associated injuries, and physical examination, this review will also discuss relevant imaging, treatment, and disposition plans. [Points & Pearls is a digest of Emergency Medicine Practice].
Kellman, Robert M; Losquadro, William D
Airway management in patients with maxillofacial trauma is complicated by injuries to routes of intubation, and the surgeon is frequently asked to secure the airway. Airway obstruction from hemorrhage, tissue prolapse, or edema may require emergent intervention for which multiple intubation techniques exist. Competing needs for both airway and surgical access create intraoperative conflicts during repair of maxillofacial fractures. Postoperatively, edema and maxillomandibular fixation place the patient at risk for further airway compromise.
Nanda, Anil; Khan, Imad Saeed; Goldman, Rose; Testa, Marcia
Concussion, also referred to as mild traumatic brain injury (TBI), is defined as a "complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces." Various symptoms may be observed in patients with concussions. All of these might not be evident at the time of the injury and be intermittent in their nature. It is estimated that 300,000 of the yearly TBIs in the United States are sports-related, the second leading cause for TBIs after motor vehicle accidents among people aged 15 to 24 years old. Due to some recently reported high profile injuries and deaths of sports personalities, sports-related concussion has seen increasing media and public interest in the last decade. We review the role of football in youth concussions and analyze the Nationwide Inpatient Sample from 2007 to 2009 to elucidate the outcome and costs associated with sports-related concussions of the youth in the United States. We also review the latest state legislative efforts to decrease the incidence of dangerous sports-related concussions in youth--the Louisiana Youth Concussion Act.
Mar 16, 2002 ... are thus seen as useful adjuncts in the treatment of some sports- related injuries. On the basis of their ability to down regulate the immune response, corticosteroids have been used extensively in the management of sports injuries to promote rapid return to the field of play. But to what extent do they affect ...
Objectives: To determine the prevalence and pattern of occurrence of sports - related dentofacial injuries among athletes participating in Rugby and Football in Nairobi, Kenya. Design: A descriptive cross-sectional study. Setting: Seventeen Secondary schools participating in either or both Rugby tournaments and the ...
Nagahiro, Shinji; Mizobuchi, Yoshifumi
We review the current topic in sports-related head injuries including acute subdural hematoma (ASDH), concussion, and chronic traumatic encephalopathy (CTE). Sports-related ASDH is a leading cause of death and severe morbidity in popular contact sports like American football in the USA and judo in Japan. It is thought that rotational acceleration is most likely to produce not only cerebral concussion but also ASDH due to the rupture of a parasagittal bridging vein, depending on the severity of the rotational acceleration injury. Repeated sports head injuries increase the risk for future concussion, cerebral swelling, ASDH or CTE. To avoid fatal consequences or CTE resulting from repeated concussions, an understanding of the criteria for a safe post-concussion return to play (RTP) is essential. Once diagnosed with a concussion, the athlete must not be allowed to RTP the same day and should not resume play before the concussion symptoms have completely resolved. If brain damage has been confirmed or a subdural hematoma is present, the athlete should not be allowed to participate in any contact sports. As much remains unknown regarding the pathogenesis and pathophysiology of sports-related concussion, ASDH, and CTE, basic and clinical studies are necessary to elucidate the crucial issues in sports-related head injuries.
Fong, Daniel Tik-Pui; Man, Chi-Yin; Yung, Patrick Shu-Hang; Cheung, Shui-Yuk; Chan, Kai-Ming
This study investigated the sport-related ankle injuries attending an accident and emergency (A&E) department during a 1-year period. A total of 1715 sports injuries cases attending an A&E department from 1 January 2005 to 31 December 2005 were prospectively recorded. Details of each classified case were recorded in a computerised record system by the triage nurse. At the end of the study period, all sport-related ankle injury cases were analysed. A total of 240 sport-related ankle injury cases were reported. Most cases were sustained from basketball (32.9%), soccer (31.7%) and hiking (5.8%) sports. The majority of the cases was ligamentous sprains (81.3%) and fractures (10.4%). The mean age of all patients was 24.6 years (S.D. = 12.3). Four fifths (80.4%) were male patients. All cases were not life threatening. Most cases (99.2%) were referred to orthopedics specialty. Radiography was routinely employed in 99.2% of the cases. Ligamentous sprains were mostly sustained in basketball (37.4%) and soccer (28.7%), and were often treated with bandaging (60.0%) and analgesics (48.7%). Most cases were discharged with or without referral to physiotherapy and specialty clinic (95.4%). Fractures were mostly sustained in soccer (52.0%), basketball (20.0%) and hiking (16.0%), and were very often admitted to hospital wards (84.0%). The estimated A&E attendance rate for all sports injuries, ankle injuries, ligamentous sprains and fractures were 1.68, 0.24, 0.19 and 0.02/1000 person-year. The results of this study together with the previous study on ankle sprain epidemiology suggested the following sports ankle injury pattern in Hong Kong-major and serious ankle ligamentous sprains and fractures were sustained from basketball, soccer and hiking, leading to A&E attendance, while minor sprains were sustained in running and jogging and racquet sports. We suggested that the Sports medicine specialists in Hong Kong should emphasise the ankle injury prevention strategies in these sports.
Kaneko, Hideto; Murakami, Mototsune; Nishizawa, Kazuya
Stress injuries (stress fractures and stress reactions) of the lumbosacral region are one of the causes of sports-related lower back pain in young individuals. These injuries can be detected by bone marrow edema lesion on MRI. However, little is known about the prevalence and clinical features of early stage lumbosacral stress injuries. This study aimed to evaluate the epidemiology of lumbosacral stress injuries. A total of 312 patients (under 18 years of age) who complained of sports-related lower back pain that had lasted for ≥7 days underwent magnetic resonance imaging (MRI) scans. We reviewed patients' records retrospectively. MRI showed that 33.0% of the patients had lumbar stress injuries and 1.6% had sacral stress injuries. Lumbar stress injuries were more common in males than in females and were found in 30% of 13- to 18-year-old patients. About 50% of the patients that participated in soccer or track and field were diagnosed with lumbar stress injuries. No clinical patterns in the frequencies of sacral stress injuries were detected due to the low number of patients that suffered this type of injury. Plain radiography is rarely able to detect the early stage lesions associated with lumbosacral stress injuries, but such lesions can be detected in the caudal-ventral region of the pars interarticularis on sagittal computed tomography scans. Thirty-three percent of young patients that complained of sports-related lower back pain for ≥7 days had lumbar stress injuries, while 1.6% of them had sacral stress injuries. Clinicians should be aware of the existence of these injuries. MRI is useful for diagnosing lumbosacral stress injuries.
O'Connell, John Edward; Hartnett, Claire; Hickey-Dwyer, Marie; Kearns, Gerard J
This is a 10-year retrospective study of patients with an isolated unilateral orbital floor fracture reconstructed with an autogenous iliac crest bone graft. The following inclusion criteria applied: isolated orbital floor fracture without involvement of the orbital rim or other craniofacial injuries, pre-/post-operative ophthalmological/orthoptic follow-up, pre-operative CT. Variables recorded were patient age and gender, aetiology of injury, time to surgery, follow-up period, surgical morbidity, diplopia pre- and post-operatively (Hess test), eyelid position, visual acuity, and the presence of en-/or exophthalmos (Hertel exophthalmometer). Twenty patients met the inclusion criteria. The mean age was 29 years. The mean follow up period was 26 months. No patient experienced significant donor site morbidity. There were no episodes of post-operative infection or graft extrusion. Three patients had diplopia in extremes of vision post-operatively, but no interference with activities of daily living. One patient had post-operative enophthalmos. Isolated orbital blow-out fractures may be safely and predictably reconstructed using autogenous iliac crest bone. The rate of complications in the group of patients studied was low. The value of pre- and post-operative ophthalmology consultation cannot be underestimated, and should be considered the standard of care in all patients with orbitozygomatic fractures, in particular those with blow-out fractures. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
Zamboni, Rodrigo Andrighetti; Wagner, João Carlos Birnfeld; Volkweis, Maurício Roth; Gerhardt, Eduardo Luis; Buchmann, Elissa Muller; Bavaresco, Caren Serra
to investigate the incidence and etiology of face trauma with diagnosis of facial fracture treated at the Buccomaxillofacial Surgery and Traumatology Service of the Santa Casa de Misericórdia Hospital Complex in Porto Alegre. we conducted a cross-sectional, retrospective epidemiological study of 134 trauma victims with 153 facial fractures. the male gender was the most affected (86.6%) and the incidence was higher in the age group from 21 to 30 years. The main etiology was assault (38.8%), followed by motor vehicle accidents (14.2%), motorcycle accidents (13.4%), falls (9%), road accidents (6.7%), sports accidents (5.2%), work accidents (5.2%), firearm injuries (4.5%) and cycling accidents (3%). The most frequent fractures were those of the zygomatic complex (44.5%), followed by fractures of the mandible (42.5%), maxillary bone (5.2%), nasal bones (4.5%) and zygomatic arch (3.3%). the fractures of the zygomatic complex and the mandible were the ones with the highest incidence in the facial traumas, having physical assaults as their main cause.
Rodrigo Andrighetti Zamboni
Full Text Available ABSTRACT Objectives: to investigate the incidence and etiology of face trauma with diagnosis of facial fracture treated at the Buccomaxillofacial Surgery and Traumatology Service of the Santa Casa de Misericórdia Hospital Complex in Porto Alegre. Methods: we conducted a cross-sectional, retrospective epidemiological study of 134 trauma victims with 153 facial fractures. Results: the male gender was the most affected (86.6% and the incidence was higher in the age group from 21 to 30 years. The main etiology was assault (38.8%, followed by motor vehicle accidents (14.2%, motorcycle accidents (13.4%, falls (9%, road accidents (6.7%, sports accidents (5.2%, work accidents (5.2%, firearm injuries (4.5% and cycling accidents (3%. The most frequent fractures were those of the zygomatic complex (44.5%, followed by fractures of the mandible (42.5%, maxillary bone (5.2%, nasal bones (4.5% and zygomatic arch (3.3%. Conclusion: the fractures of the zygomatic complex and the mandible were the ones with the highest incidence in the facial traumas, having physical assaults as their main cause.
Reynolds, Erin; Collins, Michael W
The field of sport-related concussion has grown exponentially over the past decade, with more concussion-specific clinics being identified in major hospital systems as well as independent practitioner's offices. To date, there is no standardized in-office protocol for managing ongoing symptoms. The University of Pittsburgh Medical Center (UPMC) Sports Concussion Program, established in 2000, is one of the largest programs in the USA, pioneering the way in clinical management, research, and education of sport-related concussion. This report will outline the essential components of a successful concussion clinic, using the UPMC Sports Concussion Program as a case example of best practice. We will share several case studies illustrating the individualized and complex nature of this injury, as well as review important rehabilitation components. © 2014 S. Karger AG, Basel.
Park, Min S; Levy, Michael L
With the increased conditioning, size, and speed of professional athletes and the increase in individuals engaging in sports and recreational activities, there is potential for rising numbers of traumatic brain injuries in sports. Fortunately, parallel strides in basic research technology and improvements in computer and video technology have created a new era of discovery in the study of the biomechanical aspects of sports-related head injuries. Although prevention will always be the most important factor in reducing the incidence of sports-related traumatic brain injuries, ongoing studies will lead to the development of newer protective equipment, improved recognition and management of concussions on the field of play, and modification of rules and guidelines to make these activities safer and more enjoyable.
Mannix, Rebekah; Meehan, William P; Pascual-Leone, Alvaro
Although growing awareness about the potential long-term deleterious effects of sport-related concussion has led to increased attention to the risks of collision sports, calls to ban these sports, such as American football, might be premature. Collision sports have a relatively high incidence of concussions, but participation in these sports also confers a host of benefits. In addition, the associated risks of participation, including concussion, have not been definitively shown to outweigh the benefits they provide, and the risk-benefit ratio might vary among individuals. The risks of concussion and repetitive concussions associated with collision sports are unknown in the general population and not well characterized even in elite athlete populations. In this article, we discuss current knowledge on sports-related concussion, its neurological consequences, and implications for regulation of the practice of collision sports.
Lee, Chee Wei; Foo, Qi Chao; Wong, Ling Vuan; Leung, Yiu Yan
The aims of this study were to provide an overview of maxillofacial trauma and its relationship to patient's demographic data and alcohol consumption within the state of Sabah. It was a retrospective study of maxillofacial trauma cases treated by Oral and Maxillofacial Surgery Department, Queen Elizabeth Hospital, Kota Kinabalu, Sabah, from January 1, 2009, until December 31, 2013. A total of 630 maxillofacial trauma cases were included. Details of the trauma were collected from patients' record, including patients' cause of injuries, injuries suffered, treatment indications, and treatment received. Patients' demographic data (age, gender), alcohol consumption in relation to causes, and type of maxillofacial injury were analyzed. There were 538 male (85.4%) and 92 female (14.6%) patients (ratio: 5.8:1), with mean age of 31.0 years. Most common causes of maxillofacial injury were motor vehicle accident (MVA; 66.3%), followed by fall (12.4%) and assault (11.6%). Motorcyclists made up more than half of the total cases (53.1%). Cases referred were primarily due to soft-tissue injury (458 cases). Other cases were dentoalveolar and maxillofacial bone fractures. Treatment provided for the fractures included open reduction and internal fixation (22.9%), closed reduction (28.7%), and conservative management (48.4%). Toilet and suturing were done for all patients with soft-tissue injury. Maxillofacial trauma is a major problem in Sabah. It affects mostly males in the age group of 21 to 30 years. Most of the MVA patients were motorcyclists. Mandibular fracture with parasymphysis involvement recorded the highest number. Most of the patients preferred conservative management, probably due to financial and logistic issue.
Johnson, Samuel T; Norcross, Marc F; Bovbjerg, Viktor E; Hoffman, Mark A; Chang, Eunwook; Koester, Michael C
Best practice recommendations for sports-related emergency preparation include implementation of venue-specific emergency action plans (EAPs), access to early defibrillation, and first responders-specifically coaches-trained in cardiopulmonary resuscitation and automated external defibrillator (AED) use. The objective was to determine whether high schools had implemented these 3 recommendations and whether schools with a certified athletic trainer (AT) were more likely to have done so. Schools with an AT were more likely to have implemented the recommendations. Cross-sectional study. Level 4. All Oregon School Activities Association member school athletic directors were invited to complete a survey on sports-related emergency preparedness and AT availability at their school. Chi-square and Fisher exact tests were used to analyze the associations between emergency preparedness and AT availability. In total, 108 respondents (37% response rate) completed the survey. Exactly half reported having an AT available. Only 11% (95% CI, 6%-19%) of the schools had implemented all 3 recommendations, 29% (95% CI, 21%-39%) had implemented 2, 32% (95% CI, 24%-42%) had implemented 1, and 27% (95% CI, 19%-36%) had not implemented any of the recommendations. AT availability was associated with implementation of the recommendations (χ 2 = 10.3, P = 0.02), and the proportion of schools with ATs increased with the number of recommendations implemented (χ 2 = 9.3, P Schools with an AT were more likely to implement venue-specific EAPs (52% vs 24%, P schools were inadequately prepared for sports-related emergencies. Schools with an AT were more likely to implement some, but not all, of the recommendations. Policy changes may be needed to improve implementation. Most Oregon high schools need to do more to prepare for sports-related emergencies. The results provide evidence for sports medicine professionals and administrators to inform policy changes that ensure the safety of athletes.
Elitsa G. Deliverska
Full Text Available Purpose: The goal of this material was to be an example of the complications that can occur in cases of zygoma fractures and to draw the attention of the clinicians to the need of accurate diagnose and early treatment of the associated with zygoma fractures traumas. Materials and methods: Medical records of 276 patients with different traumas in face and neck area treated in our department ware reviewed. Of those 64 suffered from zygoma fractures and they ware classified according to age, sex, cause of trauma, presence or absence of associated trauma, etc.Results: As other studies also show, we determined that the most common cause of injury was assault and road accidents, fallowed by sport, industrial, etc. Males between 20 and 40 years old ware the biggest group of patients, often after alcohol consumption.Associated traumas occurred more frequently in cases of motor vehicle accident than in other cases and ware presented by closed head trauma, ophthalmologic problems, extremities fractures, etc.Conclusion: Delayed treatment of zygoma injuries is feasible and yields in good results when the severity of trauma needs it, but early repair of such injuries prevent late complications and should be preferred when possible.
Dumic, Igor; Tankosic, Nikola; Stojkovic Lalosevic, Milica; Alempijevic, Tamara
Portal vein thrombosis (PVT) is an uncommon condition usually associated with hypercoagulable states or liver cirrhosis. PVT due to sports-related injuries is rarely reported and, to the best of our knowledge, only two cases have been reported thus far. Brazilian jiu-jitsu (BJJ) is a form of martial arts and is considered very safe with minimal risk for injury. It has growing popularity worldwide. Here, we report the first case of PVT secondary to abdominal trauma related to the practice of (BJJ) in an otherwise healthy 32-year-old man with no other traditional risk factors for PVT.
Valovich McLeod, Tamara C; Wagner, Alyssa J; Bacon, Cailee E Welch
Previous studies have identified the effect of sport-related concussion on health-related quality of life through the use of patient-reported outcome measures. However, there has been little research exploring the underlying mechanisms that influence these perceptions of health-related quality of life among adolescent athletes who have sustained a sport-related concussion. To explore the psychosocial aspects of concussion among adolescent athletes. Case series; Level of evidence, 4. A total of 12 interscholastic athletes (4 girls, 8 boys; mean ± SD age, 15.7 ± 1.7 years; grade level, 10.2 ± 1.4) were interviewed via a semistructured interview protocol between 15 and 30 days postinjury. Data analysis was guided by the consensual qualitative research tradition. Themes and categories emerged through consensus by a 3-person research team, and bias was minimized through the use of multiple-analyst triangulation. Participants identified numerous postconcussion symptoms that resulted in increasing difficulty with emotions (eg, irritable, easily frustrated), roles at school (eg, concentration difficulties, fatigue), and roles in their social environment (eg, letting the team down, not being able to contribute to sport). As a result, participants expressed how they tried to minimize or mask symptoms to decrease the potential of being viewed differently by their peers. Adolescent athletes perceived a significant effect of sport-related concussion on numerous areas of psychosocial and emotional health and well-being. Anticipatory guidance-with education regarding the possible signs and symptoms, risk factors, and recovery expectations following a concussion-is important to include in postinjury management. A better understanding of sport-related concussion and expected recovery could help to improve perceptions of this injury among interscholastic athletes. Additionally, best practices should be identified to assist health care professionals and school personnel in the
Meehan, William P; Taylor, Alex M; Proctor, Mark
Although much of the lay media attention surrounding sport-related concussion (SRC) focuses on professional athletes, SRC is a common injury in pediatric sports. The anatomy, biomechanics, and response to injury of the developing pediatric brain differ from those of the adult. Similarly, the neurocognitive abilities of the child are developing more rapidly than in an adult. The effects of concussive brain injury on the life of a child are different from those of an adult. This article focuses on the aspects of SRC that are specific to the younger athletes. Copyright © 2011 Elsevier Inc. All rights reserved.
Full Text Available Portal vein thrombosis (PVT is an uncommon condition usually associated with hypercoagulable states or liver cirrhosis. PVT due to sports-related injuries is rarely reported and, to the best of our knowledge, only two cases have been reported thus far. Brazilian jiu-jitsu (BJJ is a form of martial arts and is considered very safe with minimal risk for injury. It has growing popularity worldwide. Here, we report the first case of PVT secondary to abdominal trauma related to the practice of (BJJ in an otherwise healthy 32-year-old man with no other traditional risk factors for PVT.
Valovich McLeod, Tamara C; Hale, Troy D
To review relevant literature regarding the effect of concussion on vestibular function, impairments, assessments and management strategies. REASONING: Dizziness and balance impairments are common following sport-related concussion. Recommendations regarding the management of sport-related concussion suggest including tests of balance within the multifactorial assessment paradigm for concussive injuries. The literature was searched for guidelines and original studies related to vestibular impairments following concussion, oculomotor and balance assessments and treatment or rehabilitation of vestibular impairments. The databases searched included Medline, CINAHL, Sport Discus and the Cochrane Database of Systematic Reviews through October 2013. Dizziness following concussion occurs in ∼67-77% of cases and has been implicated as a risk factor for a prolonged recovery. Balance impairments also occur after concussion and last 3-10 days post-injury. Assessments of balance can be done using both clinical and instrumented measures with success. Vestibular rehabilitation has been shown to improve outcomes in patients with vestibular impairments, with one study demonstrating success in decreasing symptoms and increasing function following concussion. Best practices suggest that the assessment of vestibular function through cranial nerve, oculomotor and balance assessments are an important aspect of concussion management. Future studies should evaluate the effectiveness of vestibular rehabilitation for improving patient outcomes.
Wakefield, Hannah M; Olympia, Robert P; King, Tonya S; Wakefield, Bryan H; Weber, Chris J
Sport participation is an important part of the development of children and adolescents in the United States. The objective of this study was to determine positive and negative themes found in a selected number of sport-related films. A total of 44 sport-related films were independently viewed and analyzed by four reviewers. The most common sports depicted were baseball (27%) and football (25%). The most common positive themes were positive interactions with the coach, positive interactions with family and friends, and positive interactions with teammates (2.04, 1.42, 1.2 mean events per hour). The most common negative themes were taunting/fighting/poor sportsmanship, negative interactions with the coach, and drinking/smoking/drug use (2.13, 1.10, 0.94 mean events per hour). In conclusion, the coviewing of sport films among pediatric athletes and their coaches, athletic trainers, and/or parents in order to focus on "teachable moments" may encourage the acquisition and development of positive themes and the avoidance and de-emphasis of negative themes.
Mizobuchi, Yoshifumi; Nagahiro, Shinji
We review current topics in sport-related head injuries including acute subdural hematoma (ASDH), traumatic cerebrovascular disease, cerebral concussion, and chronic traumatic encephalopathy (CTE). Sports-related ASDH is a leading cause of death and severe morbidity in popular contact sports like American football and Japanese judo. Rotational acceleration can cause either cerebral concussion or ASDH due to rupture of a parasagittal bridging vein. Although rare, approximately 80% of patients with cerebral infarction due to sport participation are diagnosed with ischemia or infarction due to arterial dissection. Computed tomography angiography, magnetic resonance angiography, and ultrasound are useful for diagnosing arterial dissection; ultrasound is particularly useful for detecting dissection of the common and internal carotid arteries. Repeated sports head injuries increase the risks of future concussion, cerebral swelling, ASDH, and CTE. To avoid fatal consequences of CTE, it is essential to understand the criteria for safe post-concussion sports participation. Once diagnosed with a concussion, an athlete should not be allowed to return to play on the same day and should not resume sports before the concussion symptoms have completely resolved. Information about the risks and management of head injuries in different sports should be widely disseminated in educational institutions and by sport organization public relations campaigns.
Lischuk, Andrew W; Dorantes, Thomas M; Wong, William; Haims, Andrew H
A normally functioning hip joint is imperative for athletes who use their lower extremities with running, jumping, or kicking activities. Sports-related injuries of the hip and groin are far less frequent than injuries to the more distal aspect of the extremity, accounting for less than 10% of lower extremity injuries. Despite the lower incidence, hip and groin injuries can lead to significant clinical and diagnostic challenges related to the complex anatomy and biomechanical considerations of this region. Loads up to 8 times normal body weight have been documented in the joint in common daily activities, such as jogging, with significantly greater force expected during competitive athletics. Additionally, treatment for hip and groin injuries can obviate the participation of medical and surgical specialties, with a multidisciplinary approach frequently required. Delay in diagnosis and triage of these injuries may cause loss of time from competition and, potentially, early onset of degenerative changes. Magnetic resonance imaging (MRI) of the hip has proven to be the gold standard for the diagnosis of sports-related hip and groin injuries in the setting of negative radiographs. With its exquisite soft tissue contrast, multiplanar capabilities, and lack of ionizing radiation, MRI is unmatched in the noninvasive diagnosis of intra-articular and extra-articular pathology, as well as intraosseous processes. This review focuses on MRI of common athletic injuries of the hip and groin, including acetabular labral tears, femoral acetabular impingement syndrome, muscle injuries around the hip and groin (including athletic pubalgia), and athletic osseous injuries.
Mannix, Rebekah; Monuteaux, Michael C.; Stein, Cynthia J.; Bachur, Richard G.
Objective: To identify independent predictors of and use recursive partitioning to develop a multivariate regression tree predicting symptom duration greater than 28 days after a sport-related concussion. Methods: We conducted a prospective cohort study of patients in a sports concussion clinic. Participants completed questionnaires that included the Post-Concussion Symptom Scale (PCSS). Participants were asked to record the date on which they last experienced symptoms. Potential predictor variables included age, sex, score on symptom inventories, history of prior concussions, performance on computerized neurocognitive assessments, loss of consciousness and amnesia at the time of injury, history of prior medical treatment for headaches, history of migraines, and family history of concussion. We used recursive partitioning analysis to develop a multivariate prediction model for identifying athletes at risk for a prolonged recovery from concussion. Results: A total of 531 patients ranged in age from 7 to 26 years (mean 14.6 ± 2.9 years). The mean PCSS score at the initial visit was 26 ± 26; mean time to presentation was 12 ± 5 days. Only total score on symptom inventory was independently associated with symptoms lasting longer than 28 days (adjusted odds ratio 1.044; 95% confidence interval [CI] 1.034, 1.054 for PCSS). No other potential predictor variables were independently associated with symptom duration or useful in developing the optimal regression decision tree. Most participants (86%; 95% CI 80%, 90%) with an initial PCSS score of sport-related concussion is overall symptom burden. PMID:25381296
Setting: Department of Oral and Maxillofacial Surgery, Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania. ... age, gender, length of interval between injury and presentation to the hospital, aetiology, pattern of soft tissue injury and fractures, therapy, co-morbidity, complications and number of hospitalisation days.
The objective of this study is to assess the clinical outcomes of patients with maxillofacial fractures treated with rigid and non-rigid osteosynthesis and to compare the outcomes of both treatment protocols. The study design is descriptive and retrospective. The method involved the retrieval and assessment of all cases of ...
1,2Department of Dentistry, University of Rwanda, College of Medicine and Health Sciences, Rwanda. Prevalence of Oral and Maxillofacial ... treatment of facial bone fractures, dentoalveolar trauma, soft tissue injuries, as well as concomitant .... Only 10 (5.4%) out of 182 subjects were found to have not sustained any hard ...
Afshin Yadegari Naeeni
Full Text Available Background and Aims: Despite advances in trauma management, treatment of the consequent infections has remained a major challenge. Antibiotic prophylaxis has been widely applied to reduce such infections. Although bacteria are present in most body parts, severe infections after treatment are less frequent in the head and neck of healthy individuals. The aim of the present study was to review the reasonable application of antibiotic prophylaxis in maxillofacial trauma. Materials and Methods: In this review article, PubMed and Google Scholar databases were searched for studies on antibiotic prophylaxis in maxillofacial trauma published during 2000-2014. Conclusion: Antibiotics were not prescribed for tears and small clean wounds in the face and mouth. However, prophylaxis was applied for extensive mouth injuries which involved the facial skin. In case of maxillofacial fractures, 24-hour administration of antibiotics sufficed for compound fractures of the mandible and other parts of the face. Antibiotics were not required in other types of fractures. Prophylaxis should be applied over short pre- or post-operative periods based on the severity and complexity of maxillofacial fractures and their relations with intra- and extraoral environments. Apparently, more detailed studies are warranted to further clarify the subject.
Ogunmuyiwa, Stella Aimiede; Gbolahan, Olalere Omoyosola; Ayantunde, Abiodun Abraham; Odewabi, Adenike Abidemi
Trauma remains a leading cause of maxillofacial injury globally. Changing etiological factors and patterns of maxillofacial injury continue to be reported and are largely modulated by socio-geographic and environmental factors. It is important to have an in-depth understanding of the pattern and etiology in a particular region before effective preventive measures can be developed. The aim was to evaluate the patterns, etiological factors, and management of maxillofacial injuries in Ogun state, Nigeria. A prospective descriptive cohort study of all consecutive patients that presented with maxillofacial injuries at our center between January and December 2013. Information about demographic data, types of maxillofacial and associated injury, etiology of injury, treatment received and complications were collected and analyzed. Seventy patients presented with maxillofacial injury during the study period with a male to female ratio of 4:1. The age range was 9 months to 60 years with a mean of 30.11 ± standard deviation 14.97 years. Majority of the facial fractures were due to motorcycle related crashes. There were 57.1% mandibular fractures and 55.7% middle third fractures. Closed reduction with maxillo-mandibular fixation was the major method of treatment of facial fractures. Postoperative complications were observed in 11.4% of patients. Road traffic crashes (RTCs) remain the leading etiological factor of maxillofacial injuries in our center. Enforcement of stricter traffic regulations and possibly replacement of motorcycles with tricycles for commercial transportation may help to reduce the incidence of RTCs.
Koumoura, F; Konsolaki, E; Zachariades, N
A retrospective study covering a period of 3.5 years was undertaken to determine the incidence of work-related injuries in the maxillofacial region. A group of 2,383 patients treated at our institution with maxillofacial trauma of various causes was evaluated. Work-related maxillofacial injuries in this population ranked fourth in frequency of occurrence after traffic accidents, falls, and acts of violence. Hand tools were found to be the culprit of most of the injuries in the maxillofacial region. The majority of the fractures of the facial skeleton were comminuted and/or compound and mostly involved the mandible. In many cases there was a delay in the treatment of the maxillofacial injuries due to associated severe trauma involving other bones and internal organs. Such a delay in treatment can result in aesthetic problems, such as facial deformity and asymmetry, functional problems due to damage inflicted upon vital structures, such as the eyes and the facial nerve, and psychological problems that can be caused by facial scarring and the traumatic loss of teeth at an early age. The best way of treating work-related maxillofacial injuries is through prevention. That should include adequate training of workers, recognition of possible occupational hazards, and the implementation of strict safety measures in the work place.
Boffano, P.; Roccia, F.; Zavattero, E.; Dediol, E.; Uglešić, V.; Kovačič, Ž.; Vesnaver, A.; Konstantinović, V.S.; Petrović, M.; Stephens, J.; Kanzaria, A.; Bhatti, N.; Holmes, S.; Pechalova, P.F.; Bakardjiev, A.G.; Malanchuk, V.A.; Kopchak, A.V.; Galteland, P.; Mjøen, E.; Skjelbred, P.; Bertin, H.; Marion, F.; Guiol, J.; Corre, P.; Løes, S.; Lekven, N.; Laverick, S.; Gordon, P.; Tamme, T.; Akermann, S.; Karagozoglu, K.H.; Kommers, S.C.; Forouzanfar, T.
Objective The aim of this study is to present and discuss the demographic characteristics and patterns of assault-related maxillofacial fractures as reported by a European multicenter prospective study. Study Design Demographic and injury data were recorded for each patient who was a victim of an
Alexander D. Wright
Full Text Available Sport-related concussion is known to affect a variety of brain functions. However, the impact of this brain injury on cerebral autoregulation (CA is poorly understood. Thus, the goal of the current study was to determine the acute and cumulative effects of sport-related concussion on indices of dynamic CA. Toward this end, 179 elite, junior-level (age 19.6 ± 1.5 years contact sport (ice hockey, American football athletes were recruited for preseason testing, 42 with zero prior concussions and 31 with three or more previous concussions. Eighteen athletes sustained a concussion during that competitive season and completed follow-up testing at 72 h, 2 weeks, and 1 month post injury. Beat-by-beat arterial blood pressure (BP and middle cerebral artery blood velocity (MCAv were recorded using finger photoplethysmography and transcranial Doppler ultrasound, respectively. Five minutes of repetitive squat–stand maneuvers induced BP oscillations at 0.05 and 0.10 Hz (20- and 10-s cycles, respectively. The BP–MCAv relationship was quantified using transfer function analysis to estimate Coherence (correlation, Gain (amplitude ratio, and Phase (timing offset. At a group level, repeated-measures ANOVA indicated that 0.10 Hz Phase was significantly reduced following an acute concussion, compared to preseason, by 23% (−0.136 ± 0.033 rads at 72 h and by 18% (−0.105 ± 0.029 rads at 2 weeks post injury, indicating impaired autoregulatory functioning; recovery to preseason values occurred by 1 month. Athletes were cleared to return to competition after a median of 14 days (range 7–35, implying that physiologic dysfunction persisted beyond clinical recovery in many cases. When comparing dynamic pressure buffering between athletes with zero prior concussions and those with three or more, no differences were observed. Sustaining an acute sport-related concussion induces transient impairments in the capabilities of the cerebrovascular
Monroe, Kathy W; Thrash, Chris; Sorrentino, Annalise; King, William D
Participation in sports is a popular activity for children across the country. Prevention of sports-related injuries can be improved if details of injuries are documented and studied. A retrospective medical record review of injuries that occurred as a direct result of sports participation (both organized and non-organized play) from November 2006 to November 2007. Because the vast majority of injuries were a result of participation in football or basketball, these injuries were focused upon. The injuries specifically examined were closed head injury (CHI), lacerations and fractures. There were 350 football and 196 basketball injuries (total 546). Comparing injuries between the two groups fractures were found to be more prevalent in football compared to basketball (z = 2.14; p = 0.03; 95%CI (0.01, 0.16)). Lacerations were found to be less prevalent among helmeted patients than those without helmets. (z = 2.39; p = 0.02; 95%CI (-0.17,-0.03)). CHI was more prevalent among organized play compared to non-organized (z = 3.9; psports participants.
Sudden death of sportspersons is frequently in the news but is relatively uncommon when the total number of sudden deaths is taken into account (1500 vs 40 000 per year in France for example). Sport-related sudden death is often due to an unrecognized or underestimated cardiovascular disorder. The immediate causes of this dramatic event are age-dependent. Before 35, the most frequent causes are hypertrophic cardiomyopathy and arythmogenic right ventricular cardiomyopathy, while complications of coronary atheroma predominate later. Prevention begins with screening, which remains imperfect. Patients with cardiovascular disorders at risk of sudden death must adapt their sports activities accordingly. Knowledge of life-saving first-aid procedures by those supervising sports activities can improve the prognosis.
Woertler, Klaus; Waldt, Simone
Sports-related shoulder pain and injuries represent a common problem. In this context, glenohumeral instability is currently believed to play a central role either as a recognized or as an unrecognized condition. Shoulder instabilities can roughly be divided into traumatic, atraumatic, and microtraumatic glenohumeral instabilities. In athletes, atraumatic and microtraumatic instabilities can lead to secondary impingement syndromes and chronic damage to intraarticular structures. Magnetic resonance (MR) arthrography is superior to conventional MR imaging in the diagnosis of labro-ligamentous injuries, intrinsic impingement, and SLAP (superior labral anteroposterior) lesions, and thus represents the most informative imaging modality in the overall assessment of glenohumeral instability. This article reviews the imaging criteria for the detection and classification of instability-related injuries in athletes with special emphasis on the influence of MR findings on therapeutic decisions. (orig.)
McCrory, Paul; Feddermann-Demont, Nina; Dvořák, Jiří
OBJECTIVES: Various definitions for concussion have been proposed, each having its strengths and weaknesses. We reviewed and compared current definitions and identified criteria necessary for an operational definition of sports-related concussion (SRC) in preparation of the 5th Concussion Consensus...... Conference (Berlin, Germany). We also assessed the role of biomechanical studies in informing an operational definition of SRC. DESIGN: This is a systematic literature review. DATA SOURCES: Data sources include MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central...... Register of Clinical Trials and SPORT Discus (accessed 14 September 2016). ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Eligibility criteria were studies reporting (clinical) criteria for diagnosing SRC and studies containing SRC impact data. RESULTS: Out of 1601 articles screened, 36 studies were included...
Boeddinghaus, Rudolf [Perth Radiological Clinic, 127 Hamersley Road, Subiaco, Western Australia 6008 (Australia)], E-mail: firstname.lastname@example.org; Whyte, Andy [Perth Radiological Clinic, 127 Hamersley Road, Subiaco, Western Australia 6008 (Australia)], E-mail: email@example.com
A review of state-of-the-art maxillofacial imaging is presented. Current imaging techniques include intra-oral radiographs, dental panoramic tomography, multidetector helical computed tomography, cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI). The commonest conditions encountered in clinical radiological practice are reviewed, including maxillofacial deformities, complicated dental impactions, maxillofacial trauma, jaw lesions (cysts, neoplasms, fibro-osseous lesions (FOLs) and infections), and temporomandibular joint pathology. Pre-operative assessment for dental implant placement is also briefly reviewed.
Boeddinghaus, Rudolf; Whyte, Andy
A review of state-of-the-art maxillofacial imaging is presented. Current imaging techniques include intra-oral radiographs, dental panoramic tomography, multidetector helical computed tomography, cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI). The commonest conditions encountered in clinical radiological practice are reviewed, including maxillofacial deformities, complicated dental impactions, maxillofacial trauma, jaw lesions (cysts, neoplasms, fibro-osseous lesions (FOLs) and infections), and temporomandibular joint pathology. Pre-operative assessment for dental implant placement is also briefly reviewed
Salentijn, Erik G; Peerdeman, Saskia M; Boffano, Paolo; van den Bergh, Bart; Forouzanfar, Tymour
In the literature it is questioned if the presence of maxillofacial trauma is associated with the presence of brain injury. The aim of this study is to present a 10-year retrospective study of the incidence and aetiology of maxillofacial trauma associated with brain injury that required both oral and maxillofacial and neurosurgical intervention during the same hospital stay. Forty-seven patients from a population of 579 trauma patients undergoing maxillofacial surgery were identified. The main cause of injury was road traffic collision, followed by falls. Interpersonal violence correlated less well with traumatic brain injury. Most of the patients were males, aged 20-39 years. Frontal sinus fractures were the most common maxillofacial fractures (21.9%) associated with neurosurgical input, followed by mandibular fractures and zygomatic complex fractures. In the general maxillofacial trauma population, frontal sinus fractures were only found in 2.2% of the cases. At presentation to the Emergency Department the majority of the patients were diagnosed with severe traumatic brain injury and a Marshall CT class 2. Intracranial pressure monitoring was the most common neurosurgical intervention, followed by reconstruction of a bone defect and haematoma evacuation. Although it is a small population, our data suggest that maxillofacial trauma does have an association with traumatic brain injury that requires neurosurgical intervention (8.1%). In comparison with the overall maxillofacial trauma population, our results demonstrate that frontal sinus fractures are more commonly diagnosed in association with brain injury, most likely owing to the location of the impact of the trauma. In these cases the frontal sinus seems not specifically to act as a barrier to protect the brain. This report provides useful data concerning the joint management of oral and maxillofacial surgeons and neurosurgeons for the treatment of cranio-maxillofacial trauma and brain injury patients in
Krishnan, Ullas Chandrika; Byanyima, Rosemary Kusaba; Faith, Ameda; Kamulegeya, Adriane
The aim of this study was to investigate epidemiological features of maxillofacial fractures within trauma patients who had head and neck computed tomography (CT) scan at the Mulago National referral hospital. CT scan records of trauma patients who had head scans at the Department of Radiology over 1-year period were accessed. Data collected included sociodemographic factors, type and etiology of injury, and concomitant maxillofacial injuries. A total of 1330 trauma patients underwent head and neck CT scan in the 1-year study period. Out of these, 130 were excluded due to incomplete or unclear records and no evidence of injury. Of the remaining 1200, 32% (387) had maxillofacial fractures. The median age of the patients with maxillofacial fractures was 28 (range = 18-80) years and 18-27 age group was most common at 47.5%. Road traffic accidents constituted 49.1% of fractures. The single most affected isolated bone was the frontal bone (23%). The number of maxillofacial bones fractured was predicted by age group (df = 3 F = 5.358, P = 0.001), association with other fractures (df = 1 F = 5.317, P = 0.03). Good matched case-control prospective studies are needed to enable us tease out the finer difference in the circumstances and pattern of injury if we are to design appropriate preventive measures.
Martinez, Alan Y; Como, John J; Vacca, Maidana; Nowak, Michael J; Thomas, Charles L; Claridge, Jeffrey A
The purpose of this study was to compare and characterize 2 cohorts of patients with maxillofacial fractures within the same institution over 2 6-year time frames 20 years apart. A retrospective review of patients with maxillofacial fractures at the authors' institution from 2004 to 2010 was performed, and a comparison was made with the authors' experience from 1984 to 1990. The 1990 study showed 458 maxillofacial fractures (152 midface and 306 mandibular fractures). In the 2010 study, there were 1,731 maxillofacial fractures (1,313 midface and 418 mandibular fractures). There were significant differences in the mechanism of injury between the 1990 and 2010 studies: assaults decreased from 48.8% to 29.7%, motor vehicle collisions decreased from 39.1% to 29.6%, and falls increased from 3.6% to 22.1%. Comparison by age categories showed major changes in the following groups: maxillofacial fractures in patients 21 to 40 years old decreased from 61.7% to 35.3%, those in patients 41 to 65 years old increased from 13.1% to 35.4%, and those in patients at least 66 years old (elderly) increased from 0.2% to 14.5%. All these changes were statistically significant (P Maxillofacial trauma has changed significantly over the past 2 decades in the authors' institution. A decrease in assault-related injuries in the younger populations and an increase in the incidence of falls in the elderly were the main differences. There was a significant increase in elderly patients with maxillofacial trauma. This change emphasizes the need for adequate prevention programs and appropriate maxillofacial surgery teams to manage these injuries in the older patient. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Fagher, K; Lexell, J
The number of athletes with disabilities participating in organized sports and the popularity of the Paralympic Games is steadily increasing around the world. Despite this growing interest and the fact that participation in sports places the athlete at risk for injury, there are few studies concerning injury patterns, risk factors, and prevention strategies of injuries in disabled athletes. In this systematic literature search and critical review, we summarize current knowledge of the epidemiology of sports-related injuries in disabled athletes and describe their characteristics, incidence, prevalence, and prevention strategies. The outcomes of interest were any injury, either an acute trauma or an overuse event. PubMed, EMBASE, CINAHL, and Google Scholar were systematically searched and 25 of 605 identified studies met the inclusion criteria. Lower extremity injuries were more common in walking athletes, whereas upper extremity injuries were more prevalent in wheelchair athletes. The methodologies and populations varied widely between the studies. Few studies were sports or disability specific, which makes it difficult to determine specific risk factors, and few studies reported injury severity and prevention of injuries. Further longitudinal, systematic sports and disability specific studies are needed in order to identify and prevent injuries in athletes with disabilities. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Patel, Dilip R; Omar, Hatim; Terry, Marisa
The prevalence of anxiety disorders in adolescents range from 6% to 20%, and it is much higher for anxiety symptoms not meeting criteria for a specific anxiety disorder. The prevalence is much higher in females. Athletes participating in sports experience different levels of stress from competitive sports. For most young athletes (generally 13 to 24 years old, i.e., high-school and college age group) sport participation is reported to be no more stressful than many other activities of daily student or work life in general where competition is involved and performance is measured. Some level of sport related performance anxiety is considered to be normal and healthy; however, extreme anxiety in athletes can be detrimental in these performance situations. A number of factors may contribute to the development, severity, and persistence of performance anxiety related to sport participation. This article reviews the definitions, theories, clinical presentation, evaluation, and management principles of performance anxiety symptoms in young athletes. Copyright © 2010 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
Yrondi, Antoine; Brauge, David; LeMen, Johanne; Arbus, Christophe; Pariente, Jérémie
Head injuries are risk factors for chronic depressive disorders, but this association remains poorly explored with regards to concussion. The objective of this review was to evaluate the incidence of depressive symptoms and depression after sports-related concussion. We also endeavored to identify the response elements regarding the pathophysiology of these symptoms. A systematic search of PubMed and Embase was conducted focusing on papers published until 1st December, 2016, according to PRISMA criteria The following MESH terms were used: (concussion or traumatic brain injury) and sport and (depression or depressive disorder). A depressive disorder can appear immediately after a concussion: depressive symptoms seem to be associated with the symptoms of the concussion itself. A depressive disorder can also appear later, and is often linked to the frequency and number of concussions. Furthermore, the existence of a mood disorder prior to a concussion can contribute to the onset of a depressive disorder after a concussion. There is an overall limit concerning the definition of a depressive disorder. In addition, when these studies had controls, they were often compared to high-level athletes; yet, practicing sport regularly is a protective factor against mood pathologies. Depressive symptoms after a concussion seem to be associated with postconcussion symptoms. Repeat concussions can contribute to later-onset major depressive disorders. However, playing sports can protect against major depressive disorders: thus, it is essential to evaluate concussions as accurately as possible. Copyright © 2017 Elsevier Masson SAS. All rights reserved.
Refakis, Christian A; Turner, Christian D; Cahill, Patrick J
Concussions are becoming increasingly important to manage properly as sports participation continues to rise. Repeated injuries occurring before the brain has had a chance to recover from an initial insult are particularly dangerous and must be prevented. Although much national media attention has been devoted to concussions in professional sports, it is important to appreciate that athletes in any age group, children and adolescents in particular, are at risk of sports-related concussion. It is crucial to remove an athlete from play any time concussion is suspected. Once removed from play, recovery then begins with a period of cognitive and physical rest, followed by a gradual return to cognitive and athletic activities as symptoms resolve. Children and adolescents pose a unique challenge to the clinician managing their recovery, as the physical and cognitive rest periods required often involve time away from school and sports, which can be academically detrimental and socially isolating. Recently developed sideline assessment tools have greatly aided the urgent sideline assessment of an athlete suspected of having a concussion. In this article, a brief review of current guidelines is presented in tandem with the authors' preferred treatment of concussion.
Full Text Available The on-field diagnosis of sports-related concussion (SRC is complicated by the lack of an accurate and objective marker of brain injury.To compare subject-specific changes in the astroglial protein, S100B, before and after SRC among collegiate and semi-professional contact sport athletes, and compare these changes to differences in S100B before and after non-contact exertion.Longitudinal cohort study.From 2009-2011, we performed a prospective study of athletes from Munich, Germany, and Rochester, New York, USA. Serum S100B was measured in all SRC athletes at pre-season baseline, within 3 hours of injury, and at days 2, 3 and 7 post-SRC. Among a subset of athletes, S100B was measured after non-contact exertion but before injury. All samples were collected identically and analyzed using an automated electrochemiluminescent assay to quantify serum S100B levels.Forty-six athletes (30 Munich, 16 Rochester underwent baseline testing. Thirty underwent additional post-exertion S100B testing. Twenty-two athletes (16 Rochester, 6 Munich sustained a SRC, and 17 had S100B testing within 3 hours post-injury. The mean 3-hour post-SRC S100B was significantly higher than pre-season baseline (0.099±0.008 µg/L vs. 0.058±0.006 µg/L, p = 0.0002. Mean post-exertion S100B was not significantly different than the preseason baseline. S100B levels at post-injury days 2, 3 and 7 were significantly lower than the 3-hour level, and not different than baseline. Both the absolute change and proportional increase in S100B 3-hour post-injury were accurate discriminators of SRC from non-contact exertion without SRC (AUC 0.772 and 0.904, respectively. A 3-hour post-concussion S100B >0.122 µg/L and a proportional S100B increase of >45.9% over baseline were both 96.7% specific for SRC.Relative and absolute increases in serum S100B can accurately distinguish SRC from sports-related exertion, and may be a useful adjunct to the diagnosis of SRC.
Batista, Anne Margareth; Marques, Leandro Silva; Batista, Aline Elizabeth; Falci, Saulo Gabriel Moreira; Ramos-Jorge, Maria Letícia
The aim of this research was to assess oral and maxillofacial trauma in urban and rural populations of the same region. The data collected included age, gender, year and month of trauma occurrence, origin (rural and urban), cause of injury, and the type of oral and maxillofacial trauma. Records from 1121 patients with 790 instances of oral and maxillofacial trauma were evaluated. Statistical analysis was performed with the Statistical Package for Social Sciences (SPSS) version 17.0 software and involved descriptive statistics and Pearson's chi-squared test. Male patients were more prone to maxillofacial trauma (n = 537; 68%), and the patients were mostly from urban areas (n = 534; 67.6%). The male-to-female ratio was found to be 2.12:1 (urban zone, 1.72:1; rural zone, 3.49:1). The average age was 25.7 years (SD = 14.1). A traffic accident was the most common cause of oral and maxillofacial trauma (27%). The jaw (18%) was the most commonly fractured bone in the facial skeleton, followed by the zygoma (12.9%). Avulsion (8.5%) was the most common dental trauma. A significant statistical relationship was found between place of origin and gender (p trauma in individuals from urban areas. According to these data, it seems reasonable to assume that specific preventive public policy for urban and rural areas must respect the differences of each region.
Pacifici, L; DE Angelis, F; Orefici, A; Cielo, A
The goal of maxillofacial surgery is to restore the shape and functionality of maxillofacial region. In the past years, there has been a tremendous progress in this field because of significant advances in biotechnology that provided innovative biomaterials to efficiently reconstruct the maxillofacial injured region. By using appropriate selection of the implant biomaterial, it is possible to reconstruct the native tissue, both in form and function. The ideal biomaterial should mimic native tissues regarding density, strength, and modulus of elasticity. Autografts are currently the gold standard for replacement of missing tissues, but synthetic biomaterials have been widely used because they eliminate the discomfort to take the replacement tissue from the donor site. Among synthetic biomaterials, different metals may be utilized to efficiently reconstruct the maxillofacial injured region. This article makes an effort to summarize the most important metals in use in maxillofacial surgery, and point out advantages and disadvantage of each type.
Housman, Jeff; Dorman, Steve; Pruitt, Buzz; Ranjita, Misra; Perko, Michael
Objectives: To determine factors that influence sport-related dietary supplement consumption among NCAA Division 1 female student athletes and to estimate the plausibility of the theory of planned behavior (TPB) for predicting the use of sport-related dietary supplements among NCAA Division 1 female student athletes. Method: Self-report data were…
Cakabay, Taliye; Gokdogan, Ozan; Bezgin, Selin Üstün; Kocyigit, Murat
It has been aimed at evaluating the relationship of maxillofacial fractures in farmers, which are caused due to traumas while working in farms, with trauma etiologies, maxillofacial fracture areas, age, sex, and seasonal variables. Among the farmers who have come to our emergency service unit as a result of maxillofacial trauma between 2010 and 2012, 146 patients have been analyzed retrospectively. The patients' demographic findings, trauma etiologies, seasonal variables of trauma, and maxillofacial fracture area distribution have been analyzed. Patients' age varies between 12 and 80 and 87 of them are female (59.59%), while 59 are male (40.41%). The subjects' etiological distribution is as follows: 47.5% is traumas caused by cattle among the farm animals; 15.75% is traumas caused by the blows of agricultural tools; 12.33% is traumas caused by tractor accidents; 9.59% is traumas caused by falling from haystacks; 7.53% is traumas caused by falling from agricultural vehicles, and 6.85% is traumas caused by horse kicks. When trauma etiology, age, sex, seasonal distribution, and the maxillofacial fractures were analyzed, statistically significant results have been determined. Although the number of maxillofacial traumas is considerably high in farmers due to farm animals, agricultural devices, and agricultural tools, while these traumas can cause functional and aesthetically minor fractures on the face, they can cause important and serious fractures as well. While knowing the mechanism of etiological fractures and accidents in different study groups can be guiding in the speedy diagnosis and treatment of possible fractures, it can also be helpful in taking precautions against traumas in these groups as well.
Ellis, Michael J; Ritchie, Lesley J; McDonald, Patrick J; Cordingley, Dean; Reimer, Karen; Nijjar, Satnam; Koltek, Mark; Hosain, Shahid; Johnston, Janine; Mansouri, Behzad; Sawyer, Scott; Silver, Norm; Girardin, Richard; Larkins, Shannon; Vis, Sara; Selci, Erin; Davidson, Michael; Gregoire, Scott; Sam, Angela; Black, Brian; Bunge, Martin; Essig, Marco; MacDonald, Peter; Leiter, Jeff; Russell, Kelly
To summarize the clinical characteristics and outcomes of pediatric sports-related concussion (SRC) patients who were evaluated and managed at a multidisciplinary pediatric concussion program and examine the healthcare resources and personnel required to meet the needs of this patient population. We conducted a retrospective review of all pediatric SRC patients referred to the Pan Am Concussion Program from September 1st, 2013 to May 25th, 2015. Initial assessments and diagnoses were carried out by a single neurosurgeon. Return-to-Play decision-making was carried out by the multidisciplinary team. 604 patients, including 423 pediatric SRC patients were evaluated at the Pan Am Concussion Program during the study period. The mean age of study patients was 14.30 years (SD: 2.32, range 7-19 years); 252 (59.57%) were males. Hockey (182; 43.03%) and soccer (60; 14.18%) were the most commonly played sports at the time of injury. Overall, 294 (69.50%) of SRC patients met the clinical criteria for concussion recovery, while 75 (17.73%) were lost to follow-up, and 53 (12.53%) remained in active treatment at the end of the study period. The median duration of symptoms among the 261 acute SRC patients with complete follow-up was 23 days (IQR: 15, 36). Overall, 25.30% of pediatric SRC patients underwent at least one diagnostic imaging test and 32.62% received referral to another member of our multidisciplinary clinical team. Comprehensive care of pediatric SRC patients requires access to appropriate diagnostic resources and the multidisciplinary collaboration of experts with national and provincially-recognized training in TBI.
Caine, Dennis; Caine, Caroline; Maffulli, Nicola
To provide a critical review of the available literature on the descriptive epidemiology of pediatric sport-related injuries. MEDLINE (1966 to 2006) and SPORTDiscus (1975 to 2006) were searched to identify potentially relevant articles. A combination of medical subject headings and text words was used (epidemiology, children, adolescents, athletic injuries, sports, injury, and injuries). Additional references from the bibliographies of retrieved articles were also reviewed. Published research reports on the incidence and distribution of injury in children's and youth sports. Specific emphasis was placed on reviewing original studies, which report incidence rates (rate of injuries per unit athlete time). Forty-nine studies were selected for this review. Data summarized include incidence of injury relative to who is affected by injury (sport, participation level, gender, and player position), where injury occurs (anatomical and environmental location), when injury occurs (injury onset and chronometry), and injury outcome (injury type, time loss, clinical outcome, and economic cost). There is little epidemiological data on injuries for some pediatric sports. Many of the studies retrieved were characterized by methodological short-comings and study differences that limit interpretation and comparison of findings across studies. Notwithstanding, the studies reviewed are encouraging and injury patterns that should be studied further with more rigorous study designs to confirm original findings and to probe causes of injury and the effectiveness of preventive measures. Incidence and severity of injury are high in some child and youth sports. This review will assist in targeting the relevant groups and in designing future research on the epidemiology of pediatric sports injuries. Well-designed descriptive and analytical studies are needed to identify the public health impact of pediatric sport injury.
Patel, Darshan P; Redshaw, Jeffrey D; Breyer, Benjamin N; Smith, Thomas G; Erickson, Bradley A; Majercik, Sarah D; Gaither, Thomas W; Craig, James R; Gardner, Scott; Presson, Angela P; Zhang, Chong; Hotaling, James M; Brant, William O; Myers, Jeremy B
Most high-grade renal injuries (American Association for Surgery of Trauma (AAST) grades III-V) result from motor vehicle collisions associated with numerous concomitant injuries. Sports-related blunt renal injury tends to have a different mechanism, a solitary blow to the flank. We hypothesized that high-grade renal injury is often isolated in sports-related renal trauma. We identified patients with AAST grades III-V blunt renal injuries from four level 1 trauma centres across the United States between 1/2005 and 1/2014. Patients were divided into "Sport" or "Non-sport" related groups. Outcomes included rates of hypotension (systolic blood pressure 110bpm), concomitant abdominal injury, and procedural/surgical intervention between sports and non-sports related injury. 320 patients met study criteria. 18% (59) were sports-related injuries with the most common mechanisms being skiing, snowboarding and contact sports (25%, 25%, and 24%, respectively). Median age was 24 years for sports and 30 years for non-sports related renal injuries (p=0.049). Males were more commonly involved in sports related injuries (85% vs. 72%, p=0.011). Median injury severity score was lower for sports related injuries (10 vs. 27, pinjury scale scores. Sports related trauma was more likely to be isolated without other significant injury (69% vs. 39% (psports and non-sports renal injuries (p=0.30). Sports injuries had lower transfusion (7% vs. 47%, psports vs. 18% non-sports, p=0.95). High-grade sports-related blunt renal trauma is more likely to occur in isolation without other abdominal or thoracic injuries and clinicians must have a high suspicion of renal injury with significant blows to the flank during sports activities. Copyright © 2015 Elsevier Ltd. All rights reserved.
Bernard, E K; Akama, M K; Odhiambo, W A; Chindia, M L; Mua, B
To determine the aetiological factors and pattern of occurrence of maxillofacial soft tissue injuries (MF-STIs) presenting at a Kenyan National Referral Hospital in Nairobi. A cross-sectional study. The accident and emergency department of the Kenyatta National Hospital (KNH) between September 2009 and December 2009. Four hundred and twenty two patients treated for MF-STIs. The male to female ratio was 3.3:1. Motor vehicle accidents (MVA) were the leading cause of MF-STIs (44.6%) followed by interpersonal violence (IPV) (39.1%). MVA (50.0%) was the leading cause of MF-STIs in the less than 12-year-olds while falls from heights (58.3%) was the leading cause in under five-year-olds. IPV (48.1%) was the leading cause of facial fractures. There were no skeletal fractures observed in the under five-year-olds. Head injury (36%) and fractures of the long bones (52%) were the most common associated injuries. The leading causes of MF-STIs apparently differ from those of skeletal fractures.
Goiato, Marcelo Coelho; Haddad, Marcela Filié; dos Santos, Daniela Micheline; Pesqueira, Aldiéres Alves; Filho, Humberto Gennari; Pellizzer, Eduardo Piza
Cancer is regarded as abnormal cellular multiplication; it is not controlled by the organism, and its cells present a differentiated DNA. Initially, the disease does not show clinical signs, but it can be diagnosed by laboratory examinations. When tumors are present in the maxillofacial area, the carrier can lose structures in this area, resulting to the carrier's social environment exclusion. This article aims to show incidences and causes of malignant neoplasias in the maxillofacial area.
Parkins, G; Boamah, M O; Avogo, D; Ndanu, T; Nuamah, I K
Patients with maxillofacial injuries may sustain concomitant injuries. The presentation of other injuries may be the initial focus of attention of the primary attending surgeon who may miss the maxillofacial injuries to the detriment of the patient. To determine the incidence of injuries associated with maxillofacial injuries at Korle Bu Teaching Hospital (KBTH) from January 2009 to December 2010. A prospective study was carried out on patients who were referred to the Maxillofacial Unit of the University of Ghana Dental School and KBTH over the two years with maxillofacial injuries. Their age, sex, type of injury in the maxillofacial region, its aetiology and concomitant injuries were charted. The data was analysed using SPSS 16.0 software. Two hundred and fifty eight (258) patients were seen of which 67 (26.0%) had concomitant injuries. The average age was 29.1 years. The peak incidence was in the age group 21-30 (N=73, 28.3%). 74% were male and 26.0% female. The commonest cause of injury was road traffic accident (RTA) (N=142;55.0%). 52.7% (N=136) of the patients had injuries of the maxillofacial region. 26.7% (N=69) had mandibular fractures, 19.4% (N=50) had middle third fractures and 8.1% (N=21) had fractures of both. Concomitant injuries were mainly orthopaedic (N=31;12%) and the head and spinal region (N=29;11.2%). A significant number of patients who suffer maxillofacial injuries also sustain injuries of other parts of the body at KBTH. Prompt multidisciplinary management may contribute to improved outcomes.
Teshome, Amare; Andualem, Getaneh; Tsegie, Rediet; Seifu, Samuel
Maxillofacial injury poses a challenge to oral and maxillofacial surgeons working in developing countries with limited resource and human power. The present study aimed to determine the etiology, pattern, and management of maxillofacial trauma in Gondar university of Gondar hospital. A retrospective descriptive study design was used. Medical registration retrieving of patients with maxillofacial trauma visited dental center of University of Gondar Hospital from September 2013 to August 2015 was done. During data collection, etiology of trauma, pattern of fracture, treatment modality and complications were recorded using predesigned data collection template and analyzed using SPSS computer software version 20. Statistical analysis was done to show the sex distribution of maxillofacial trauma and the effect of alcohol intake on the incidence of trauma. During 2-year period, September 2013-August 2015, 326 patients of maxillofacial trauma were treated in the dental center of university of Gondar hospital. The mean age was 29.12 (± 8.62) with age range of 11-75 years. Majority of the study participants (47.2%) were within the age group of 21-30 years. Eighty percent of the participants were male with a male to female ratio of 4.02:1. Interpersonal violence (75.8%) and Road traffic accident (21.5%) were the leading causes. Males are at high risk of maxillofacial trauma relative to females (P maxillofacial trauma, while mandible and soft tissue were the most affected maxillofacial areas. The federal ministry of health, Ethiopia should have well-organized maxillofacial center in tertiary hospitals for emergency management to avoid morbidity and mortality.
Ellis, Michael J; Ritchie, Lesley J; Koltek, Mark; Hosain, Shahid; Cordingley, Dean; Chu, Stephanie; Selci, Erin; Leiter, Jeff; Russell, Kelly
The objectives of this study were twofold: (1) to examine the prevalence of emotional symptoms among children and adolescents with a sports-related concussion (SRC) who were referred to a multidisciplinary pediatric concussion program and (2) to examine the prevalence, clinical features, risk factors, and management of postinjury psychiatric outcomes among those in this clinical population. The authors conducted a retrospective chart review of all patients with SRC referred to a multidisciplinary pediatric concussion program between September 2013 and October 2014. Clinical assessments carried out by a single neurosurgeon included clinical history, physical examination, and Post-Concussion Symptom Scale (PCSS) scoring. Postinjury psychiatric outcomes were defined as a subjective worsening of symptoms of a preinjury psychiatric disorder or new and isolated suicidal ideation or diagnosis of a novel psychiatric disorder (NPD). An NPD was defined as a newly diagnosed psychiatric disorder that occurred in a patient with or without a lifetime preinjury psychiatric disorder after a concussion. Clinical resources, therapeutic interventions, and clinical and return-to-play outcomes are summarized. One hundred seventy-four patients (mean age 14.2 years, 61.5% male) were included in the study. At least 1 emotional symptom was reported in 49.4% of the patients, and the median emotional PCSS subscore was 4 (interquartile range 1-8) among those who reported at least 1 emotional symptom. Overall, 20 (11.5%) of the patients met the study criteria for a postinjury psychiatric outcome, including 14 patients with an NPD, 2 patients with isolated suicidal ideation, and 4 patients with worsening symptoms of a preinjury psychiatric disorder. Female sex, a higher initial PCSS score, a higher emotional PCSS subscore, presence of a preinjury psychiatric history, and presence of a family history of psychiatric illness were significantly associated with postinjury psychiatric outcomes
Fields, Sarah K; Collins, Christy L; Comstock, R Dawn
Sports-related violence is a form of interpersonal violence. Violence that occurs in and around the sporting world can have potentially severe physical and psychological repercussions for those involved. Although scholars in a wide range of disciplines have addressed three of the subsets of sports-related violence, they have done so without regard to the interconnected nature of the subsets, choosing instead to look at hazing, brawling, and foul play as independent problems. By separating hazing, brawling, and foul play and failing to recognize that their connection to sport connects them, scholars fail to see how sports-related violence is a broad example of interpersonal violence. This review describes some of the academic literature, primarily from the United States, and identifies similar themes and prevention suggestions that appear across disciplines. It also argues that the three subsets are an interconnected whole of sports-related violence that deserves more detailed study.
Li, Rui; Zhang, Rui; Li, Wenlu; Pei, Fei; He, Wei
The aim of this study was to analyzed the characteristics and treatment of maxillofacial injuries in the elder patients with maxillofacial injuries in central China. We retrospectively analyzed the characteristics and treatment of maxillofacial injuries in the patients over the age of 60 to analyze the trends and clinical characteristics of maxillofacial trauma in elder patients from the First Affiliated Hospital of Zhengzhou University (from 2010 to 2013) in central China and to present recommendations on prevention and management. Of the 932 patients with maxillofacial injuries, 126 aged over 60 years old accounting for 13.52% of all the patients (male:female, 1.74:1; mean age, 67.08 years old). Approximately 52% of the patients were injured by falls. The most frequently observed type of injuries was soft tissue injuries (100%), followed by facial fractures (83.05%). Of the patients with soft tissue injuries, the abrasions accounted the most, followed by lacerations. The numbers of patients of midface fracture (60 patients) were almost similar to the number of lower face fractures (66 patients). Eighty two patients (65.08%%) demonstrated associated injuries, of which craniocerebral injuries were the most prevalent. One hundred and four patients (82.54%) had other systemic medical conditions, with cardiovascular diseases the most and followed by metabolic diseases and musculoskeletal conditions. Furthermore, the study indicated a relationship between maxillofacial fractures and musculoskeletal conditions. Only 13 patients (10.32%) sustained local infections, of whom had other medical conditions. Most of the facial injuries (85.71%) in older people were operated including debridement, fixing loose teeth, reduction, intermaxillary fixation and open reduction and internal fixation (ORIF). Our analysis of the characteristics of maxillofacial injuries in the elder patents may help to promote clinical research to develop more effective treatment and possibly prevent
Ito, Ryohei; Kubota, Kosei; Inui, Akinari; Nakagawa, Hiroshi; Kon, Takao; Narita, Norihiko; Tamura, Yoshihiro; Oyama, Toshiaki; Satake, Anna; Furudate, Ken; Kobayashi, Wataru
World population has been ageing, and oral-maxillofacial trauma of geriatric population is expected to increase. The aim of this study was to analyse the characteristic features of oral-maxillofacial trauma in the geriatric population. Data from 127 patients aged 65 years old or older, who were treated for oral-maxillofacial trauma at the Department of Oral and Maxillofacial Surgery, Hirosaki University, from 2000 to 2014, were retrospectively analysed. The data from 292 patients aged 20-64 years were used as a comparison. Oral-maxillofacial trauma in the geriatric population had been increasing over 15-year period. The male to female ratio was 1.05:1 in the older group and 2.3:1 in the younger group. In the older group, 117 patients (92.1%) had one or more underlying systemic diseases, and 16 (12.6%) had suffered injuries in association with acute medical disorders. The most common injuries in the older group were bone fractures (46.5%). The ratio of fractures in the older group was lower than in the younger group (69.2%). Trauma in the older group most frequently occurred because of falls from a standing height or lower (52.0%), and the mandible was the most common site of fracture (74.6%). A conservative form of treatment for maxillofacial fractures was most commonly (86.4%) chosen for the older group, whilst surgical treatment was most commonly in the younger group (55.0%). Oral-maxillofacial trauma in the geriatric population shows characteristic features in terms of aetiology, patterns and treatment modalities. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Patel, Darshan P.; Redshaw, Jeffrey D.; Breyer, Benjamin N.; Smith, Thomas G.; Erickson, Bradley A.; Majercik, Sarah D.; Gaither, Thomas W.; Craig, James R.; Gardner, Scott; Presson, Angela P.; Zhang, Chong; Hotaling, James M.; Brant, William O.; Myers, Jeremy B.
© 2015 Elsevier Ltd. All rights reserved. Introduction: Most high-grade renal injuries (American Association for Surgery of Trauma (AAST) grades III-V) result from motor vehicle collisions associated with numerous concomitant injuries. Sports-related blunt renal injury tends to have a different mechanism, a solitary blow to the flank. We hypothesized that high-grade renal injury is often isolated in sports-related renal trauma. Material and methods: We identified patients with AAST grades III...
Peng, Xin; Mao, Chi; Zhang, Yi; Zhang, Lei; An, Jin-gang; Yu, Guang-yan
To evaluate the application, indications and outcomes of free flaps for ora-maxillofacial traumatic defects reconstruction. Twenty consecutive cases of ora-maxillofacial the traumatic defects reconstruction with free flaps were reviewed. All clinical data including causes of injuries, the type of defects, selection of free flaps, perioperative complications and the follow-up were analyzed. All the cases underwent free flap reconstruction for ora-maxillofacial traumatic defects: 8 cases with soft tissue defects, 12 cases with soft and hard tissue defects. Fifteen patients received two-stage operation and 5 patients underwent primary reconstruction at the time of debridement or fracture reduction. Twenty free flaps were applied for the reconstruction, 11 cases with fibula flap, 1 case with iliac crest free flap, 7 cases with radial forearm flap and 1 case with scapula flap. No flap failure occurred. The successful rate of free flaps transfer was 100%. The free flaps transfer is reliable and can reconstruct the ora-maxillofacial traumatic soft and hard tissue defects. Fibula and radial forearm free flap are the most common used flaps. Early aggressive surgery with free flaps transfer for traumatic defects can prevent the scar contracture and tissue displace, which can shorten the treatment period and improve the final outcome.
Giebel, Stephen; Kothari, Rashmi; Koestner, Amy; Mohney, Gretchen; Baker, Robert
Numerous guidelines to grade and manage sports-related concussions have been published. However, little is known about how frequently they are implemented in the emergency department. This study evaluates the current practices of emergency physicians (EPs) in managing sports-related concussions. To evaluate the current practice of EP evaluation and management of sports-related concussions. All EPs and emergency medicine residents in Kalamazoo County were surveyed regarding their management of sports-related concussions. The surveys obtained demographic data, participants' use of guidelines, and the importance of clinical and non-clinical factors in deciding when to allow a player to return to play. Of the 73 EP respondents, only 23% used a nationally recognized guideline, with no significant difference between attending and resident EPs. The symptomatic complaints of loss of consciousness, amnesia of the event, and difficulty concentrating were ranked most important by EPs in assessing patients with sports-related concussions. Among non-clinical factors, residents were significantly more likely than attendings to report that medical-legal, parental, and players' concerns were more likely to influence their decision in allowing a patient to return to play. EPs take into consideration important clinical factors in assessing patients with sports-related concussion. However, almost 75% do not use any nationally recognized guideline in their evaluation. Residents are more likely than attendings to be influenced by non-clinical factors. Copyright © 2011 Elsevier Inc. All rights reserved.
Giridhar, V Usha
Diet, nutrition, and dental health are closely related and have multidirectional impacts. Any oral diseases, may it be congenital, infective, traumatic, inflammatory, or neoplastic, affect routine functions of the oral cavity and even after corrective surgeries done to improve may adversely affect the food and fluid intake and further compromises nutritional status. Unlike other general surgeries, the surgeries done in oral and maxillofacial region impairs normal food intake, especially by mouth which is the preferred commonly used route. This oral cavity being harbored by multiple organisms makes it prone to further infection which again hampers the healing. Oral surgeries include the dentoalveolar region for the treatment of fracture or prosthetic reasons, for maxillofacial trauma, orthognathic surgeries, tumors, cleft lip and palate correction, etc., Nutrition plays a major role in the postoperative recovery and healing. Malnutrition in the Oral and Maxillofacial Surgery (OMFS) patients increases the postoperative morbidity and mortality rate. Nutrition in jaw fractures treated with intermaxillary fixation is more compromised. Healing is impaired in malnourished, critically ill, elderly, and patients with prolonged stay in hospital and hence nutrition in the form of enteral, parenteral, and oral sip feeding plays a major role in providing nutritional care. Preoperative nutrition and perioperative nutrition influence the postoperative outcome and hence metabolic and nutritional care is important for the uneventful healing. This article provides a basic review of the role of nutrition in the postoperative outcome of OMFS patients based on the search through articles in journal and internet.
Jeon, Eun-Gyu; Jung, Dong-Young; Lee, Jong-Sung; Seol, Guk-Jin; Choi, So-Young; Paeng, Jung-Young; Kim, Jin-Wook
Purpose: Maxillofacial fractures are rapidly increasing from car accidents, industrial accidents, teenaged criminal activity, and sports injuries. Accurate assessment, appropriate diagnosis, and preparing individual treatment plans are necessary to reduce surgical complications. We investigated recent trends of facial bone fracture by period, cause, and type, with the objective of reducing surgical complications. Methods: To investigate time trends of maxillofacial fractures, we reviewed medical records from 2,196 patients with maxillofacial fractures in 1981∼1987 (Group A), 1995∼1999 (Group B), and 2008∼2012 (Group C). We analyzed each group, comparing the number of patients, sex ratio, age, fracture site, and etiology. Results: The number of patients in each period was 418, 516, and 1,262 in Groups A to C. Of note is the increase in the number of patients from Group A to C. The sex ratios were 5.6:1, 3.5:1, and 3.8:1 in Groups A, B, and C. The most affected age group for fracture is 20∼29 in all three groups. Traffic accidents are the most common cause in Groups A and B, while there were somewhat different causes of fracture in Group C. Sports-induced facial trauma was twice as high in Group C compared with Group A and B. Mandible fracture accounts for a large portion of facial bone fractures overall. Conclusion: We observed an increase in facial bone fracture patients at Kyungpook National University Dental Hospital over the years. Although facial injury caused by traffic accidents was still a major cause of facial bone fracture in all periods, the percentage decreased. In recent years, isolated mandible fracture increased but mandible and mid-facial complex fracture decreased, possibly because of a reduction in traffic accidents. PMID:27489843
Background Although injuries related to sports and recreation represent a significant burden to children and youth, few studies have examined the descriptive epidemiology of sports-related injury since 2005, and some sports such as ringette have not been evaluated to date. The primary purpose of this study was to provide the descriptive epidemiology of sports-related injuries treated in emergency departments for children and youth aged 5 – 19. Methods A retrospective data analysis was performed using data from the Canadian Hospitals Injury Reporting and Prevention Program [CHIRPP] from fiscal years (April – March) 2007/08 to 2009/10. CHIRPP is a computerized information system designed by the Public Health Agency of Canada that collects information about injuries to people evaluated in emergency departments across 11 pediatric hospitals and 5 general hospitals in Canada. Thirteen sports or activities were analyzed (baseball, basketball, cycling, football, ice hockey, lacrosse, ringette, rugby, skiing, sledding, snowboarding, soccer, and volleyball). Descriptive statistics, including frequency by sport, age and sex, as well as the percent of concussions within each sport were calculated. Results Out of a total of 56, 691 reported sports and recreational injuries, soccer accounted for the largest proportion of injuries with 11,941 reported cases over the 3 year time period. Of these, approximately 30% were fractures. The 10 – 14 year age group reported the greatest proportion of injuries in 10 out of the 13 sports analyzed. In addition, males reported a greater number of overall injuries than females in 11 out of the 13 sports analyzed. The largest percentage of concussions was reported in ringette; these injuries accounted for 17.1% of overall injuries within this sport. Conclusions Injury prevention programs in Canada should focus on improving evidence-based programs to reduce the burden of injuries in all sports. PMID:24364875
Gould, Trenton E.; Piland, Scott G.; Caswell, Shane V.; Ranalli, Dennis; Mills, Stephen; Ferrara, Michael S.; Courson, Ron
Objective: To provide athletic trainers, health care professionals, and all those responsible for the care of athletes with clinical recommendations for preventing and managing sport-related dental and oral injuries. Background: Participation in competitive sports continues to grow at both the interscholastic and intercollegiate levels. Therefore, exposure to, and the incidence of athletic-related injury, including orofacial injury, will also likely increase. At the time of this writing, the leading governing agencies for interscholastic (National Federation of State High School Associations) and intercollegiate (National Collegiate Athletic Association) sports require only protective orofacial equipment (eg, mouthguards) for 5 and 4, respectively, of their sanctioned sports. Although orofacial injuries represent a small percentage of all sport-related injuries, the financial burden associated with these injuries (eg, tooth avulsion) can exceed $15 000 over an adult life. Therefore, effective management of sport-related dental injuries is critical to the long-term financial, physical, and emotional health of people who have experienced dental trauma. Recommendations: Based upon the current evidence regarding sport-related orofacial injury, we provide recommendations related to planning considerations, education, and mouthguard efficacy, material, fabrication, and care considerations. Additionally, suggested best practices for managing sport-related dental injury are also given for athletic trainers and other health care professionals. PMID:27875057
Zhou, Guangwei; Brodsky, Jacob R
To conduct objective assessment of children with balance and vestibular complaints following sports-related concussions and identify the underlying deficits by analyzing laboratory test outcomes. Case series with chart review. Pediatric tertiary care facility. Medical records were reviewed of 42 pediatric patients with balance and/or vestibular complaints following sports-related concussions who underwent comprehensive laboratory testing on their balance and vestibular function. Patients' characteristics were summarized and results analyzed. More than 90% of the children with protracted dizziness or imbalance following sports-related concussion had at least 1 abnormal finding from the comprehensive balance and vestibular evaluation. The most frequent deficit was found in dynamic visual acuity test, followed by Sensory Organization Test and rotational test. Patient's balance problem associated with concussion seemed to be primarily instigated by vestibular dysfunction. Furthermore, semicircular canal dysfunction was involved more often than dysfunction of otolith organs. Yet, sports-related concussion. Vestibular impairment is common among children with protracted dizziness or imbalance following sports-related concussion. Our study demonstrated that proper and thorough evaluation is imperative to identify these underlying deficits and laboratory tests were helpful in the diagnosis and recommendation of following rehabilitations. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.
Fagher, Kristina; Forsberg, Anna; Jacobsson, Jenny; Timpka, Toomas; Dahlström, Örjan; Lexell, Jan
Our knowledge of sports-related injuries in para-sport is limited and there are no data on how Paralympic athletes themselves perceive an injury. The aim of this qualitative study was to explore Paralympic athletes' perceptions of their experiences of sports-related injuries, risk factors and preventive possibilities. Eighteen Swedish Paralympic athletes with vision impairment, intellectual impairment, spinal cord injury, cerebral palsy, myelomeningocele, dysplasia and neuromuscular disorder, representing 10 different para-sports, were interviewed. The qualitative phenomenographic method was used to interpret the data. The analysis revealed nine categories of perceptions of experiences. The athletes perceived that their impairments were involved in the cause and consequential chains associated with a sports-related injury. Other categories that denoted and described these injuries were: sport overuse, risk behaviour, functional limitations, psychological stressors, the normalised pain, health hazards, individual possibilities to prevent sports-related injuries and unequal prerequisites. This qualitative study revealed that Paralympic athletes' perceptions of their experiences of sports-related injuries are complex and multifactorial, and in several ways differ from able-bodied athletes. This needs to be considered in the sports health and safety work within the Paralympic Movement as well as in the design of future injury surveillance systems and preventive programmes.
Reynolds, Erin; Collins, Michael W; Mucha, Anne; Troutman-Ensecki, Cara
The clinical management of sports-related concussions is a specialized area of interest with a lack of empirical findings regarding best practice approaches. The University of Pittsburgh Medical Center Sports Concussion Program was the first of its kind; 13 years after its inception, it remains a leader in the clinical management and research of sports-related concussions. This article outlines the essential components of a successful clinical service for the management of sports-related concussions, using the University of Pittsburgh Medical Center Sports Concussion Program as a case example. Drawing on both empirical evidence and anecdotal conclusions from this high-volume clinical practice, this article provides a detailed account of the inner workings of a multidisciplinary concussion clinic with a comprehensive approach to the management of sports-related concussions. A detailed description of the evaluation process and an in-depth analysis of targeted clinical pathways and subtypes of sports-related concussions effectively set the stage for a comprehensive understanding of the assessment, treatment, and rehabilitation model used in Pittsburgh today.
Lone, Parveen; Singh, Amrit Pal; Kour, Indumeet; Kumar, Misha
Introduction: The incidence of maxillofacial injuries is on the rise due to motor vehicle accidents and increased incidence of violence in recent times. The aim of this retrospective study was to determine the incidence, etiology, and the pattern of fractures in the maxillofacial region. Materials and Methods: After obtaining permission from the concerned authorities, a predesigned questionnaire was used to collect the necessary data from the department. A retrospective analysis of 787 patients, who suffered trauma and were managed in the Department of Oral and Maxillofacial Surgery, Indira Gandhi Government Dental College (IGGDC), Jammu over a period of 2 years was carried out. Results: Road traffic accident (RTA) was the common cause of maxillofacial injuries. Men sustained more injuries as compared to women. Injuries were most commonly sustained in the age group of 11-40 years, constituting about 76% of all injuries, mandibular fractures were the most common. Conclusion: RTAs were the commonest cause for the maxillofacial injuries. PMID:25937724
maxillofacial surgical clinics at a county referral hospital between January 2012 and December. 2013 with painless orbito-facial brawny swelling and development of a black eschar were reviewed. Occupational history, falls and/or contact with animal meat was enquired into. Microbiology, culture and sensitivity testing of the ...
Peng, Qian; Tang, Zhangui; Liu, Ousheng; Peng, Zhiwei
Rapid prototyping (RP) technologies have found many uses in dentistry, and especially oral and maxillofacial surgery, due to its ability to promote product development while at the same time reducing cost and depositing a part of any degree of complexity theoretically. This paper provides an overview of RP technologies for maxillofacial reconstruction covering both fundamentals and applications of the technologies. Key fundamentals of RP technologies involving the history, characteristics, and principles are reviewed. A number of RP applications to the main fields of oral and maxillofacial surgery, including restoration of maxillofacial deformities and defects, reduction of functional bone tissues, correction of dento-maxillofacial deformities, and fabrication of maxillofacial prostheses, are discussed. The most remarkable challenges for development of RP-assisted maxillofacial surgery and promising solutions are also elaborated.
Kucera, Kristen L; Fortington, Lauren V; Wolff, Catherine S; Marshall, Stephen W; Finch, Caroline F
Despite detailed recommendations for sports injury data capture provided since the mid-1990s, international data collection efforts for sport-related death remains limited in scope. The purpose of this paper was to review the data sources available for studying sport-related death and describe their key features, coverage, accessibility and strengths and limitations. The outcomes of interest for this review was death occurring as a result of participation in organised sport-related activity. Data sources used to enumerate death in sport were identified, drawing from the authors' knowledge/experience and review of key references from international organisations. The general purpose, case identification, structure, strengths and limitations of each source in relation to collection of data for sport-related death were summarised, drawing on examples from the international published literature to illustrate this application. Seven types of resources were identified for capturing deaths in sport. Data sources varied considerably in their ability to identify: participant status, sport relatedness of the death, types of sport-related deaths they capture, level of detail provided about the circumstances and medical care received. The most detailed sources were those that were dedicated to sports surveillance. Sport relatedness and type of sport may not be reliably captured by systems not dedicated to sports injury surveillance. Only one source permitted international comparisons and was limited to one sport (soccer). Data on sport-related death are currently collected across a wide variety of data sources. This review highlights the need for robust, comprehensive approaches with standardised methodologies enabling linkage between sources and international comparisons. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Boffano, P.; Roccia, F.; Zavattero, E.; Dediol, E.; Uglešić, V.; Kovačič, Ž.; Vesnaver, A.; Konstantinović, V.S.; Petrović, M.; Stephens, J.; Kanzaria, A.; Bhatti, N.; Holmes, S.; Pechalova, P.F.; Bakardjiev, A.G.; Malanchuk, V.A.; Kopchak, A.V.; Galteland, P.; Mjøen, E.; Skjelbred, P.; Grimaud, F.; Fauvel, F.; Longis, J.; Corre, P.; Løes, S.; Lekven, N.; Laverick, S.; Gordon, P.; Tamme, T.; Akermann, S.; Karagozoglu, K.H.; Kommers, S.C.; Meijer, B.; Forouzanfar, T.
Objective The aim of this study is to present and discuss the results of a European multicentre prospective study about pediatric maxillofacial trauma epidemiology during a year. Study Design The following data were recorded: gender, age, etiology, site of fracture, date of injury. Of the 3396
Boffano, P.; Roccia, F.; Zavattero, E.; Dediol, E.; Uglesic, V.; Kovacic, Z.; Vesnaver, A.; Konstantinovic, V.S.; Petrovic, M.; Stephens, J.; Kanzaria, A.; Bhatti, N.; Holmes, S.; Pechalova, P.F.; Bakardjiev, A.G.; Malanchuk, V.A.; Kopchak, A.V.; Galteland, P.; Mjoen, E.; Skjelbred, P.; Grimaud, F.; Fauvel, F.; Longis, J.; Corre, P.; Loes, S.; Lekven, N.; Laverick, S.; Gordon, P.; Tamme, T.; Akermann, S.; Karagozoglu, K.H.; Kommers, S.C.; Meijer, B.; Forouzanfar, T.
Objective The aim of this study is to present and discuss the results of a European multicentre prospective study about pediatric maxillofacial trauma epidemiology during a year. Study Design The following data were recorded: gender, age, etiology, site of fracture, date of injury. Of the 3396
Obimakinde, Obitade Sunday; Okoje, Victoria Njedika; Fasola, Abiodun Olubayo
Background: Assault, though a major cause of maxillofacial injuries in the developed nations, has not been adequately investigated among Nigerian population. This study aimed to analyze the pattern of maxillofacial injuries caused by assault in our institution. Methods: A descriptive clinical survey of patients with assault-induced oral and maxillofacial injuries presenting to our maxillofacial surgery clinic/emergency ward was carried out. Demographic data and pattern of injuries obtained from patients’ record and department trauma database were analyzed. Results: 156 patients presented with oral and maxillofacial injuries between October 2009 and December 2010. Thirty-four cases were due to assault and male to female ratio was 1.8:1. The mean age of the patients was 21.4±6.26 years (age range 2–48 years). 23.6% (n=8) of the injuries were due to domestic violence between spouses while 35.3% (n=12) resulted from fight. Students unrest and armed robbery attack accounted for six cases each (17.7%, n=6), while there were two cases due to child battering. 64.3% (n=22) of the injuries sustained involved soft tissues while 35.7% involved hard tissues. Contusion was the most common isolated soft tissue injury accounting for 56% (n=10) while dentoalveolar fracture was the most encountered hard tissue injury (62.5%, n=16). Conclusion: There is need for preventive strategies to reduce the incidence of assault-induced maxillofacial injuries. PMID:24027401
Shumate, Robert; Portnof, Jason; Amundson, Melissa; Dierks, Eric; Batdorf, Robert; Hardigan, Patrick
The purpose of this study was to analyze maxillofacial trauma sustained by patients at least 75 years old. With the injury patterns identified, treatment recommendations for the contemporary oral and maxillofacial surgeon are made. This study was a retrospective case series using data from 2 level 1 trauma centers. The variables of interest included age at traumatic event, gender, mechanism of trauma, concomitant injuries, radiographic studies performed, management of maxillofacial injuries, and disposition. Numerical analysis was completed with statistical software. One hundred seventy-six patients at least 75 years old who sustained facial trauma were identified. Ground-level falls caused most cases of maxillofacial trauma in the geriatric population. The median age at the time of trauma was 83 and 85 years for men and women, respectively. The most common injuries were midface fractures. Intracranial hemorrhage was the most common concomitant injury, and all but 1 patient underwent computed tomography of at least the head after their traumatic event. Most maxillofacial injuries were treated without operative repair. The information gained from this study suggests that oral and maxillofacial surgeons should counsel geriatric patients on the risk of falls and encourage the prevention of potential hazards for falls in their homes. Copyright © 2017. Published by Elsevier Inc.
Jul 26, 2014 ... industrial workers with nickel exposure. All patients involved in any form of maxillofacial trauma resulting in maxillofacial fractures were selected by careful clinical examination. The patients were treated at the same department for facial bone fractures using transosseous wires. Injuries sustained involving ...
Malara, Piotr; Malara, Beata; Drugacz, Jan
Background In spite of employing numerous devices improving the safety in motor vehicles, traffic accidents are still among the main reasons of maxillofacial injuries. The maxillofacial injuries remain the serious clinical problem because of the specificity of this anatomical region. The knowledge of etiologic factors and mechanisms of injuries can be helpful in a satisfactory trauma prevention. The aim of this study was to find out the incidence and the pattern of maxillofacial injuries resulting from traffic accidents in the patients treated in the Department of Maxillofacial Surgery (Silesian Medical Academy in Katowice, Poland) from January 2001 to December 2005. Methods The material consisted of 1024 case records of patients with maxillofacial injuries treated in the Maxillofacial Surgery Department of Silesian Medical Academy. The detailed analysis was carried out on the case records of 198 patients in the age of 3 to 68 with maxillofacial injuries resulting from traffic accidents. On the basis of data from a history, examination on admission, consultations and radiological examinations, patients' age and gender, we obtained the information on a pattern of injury and detailed description of an accident (the date and the time of an accident, the role of the patient in an accident). Results The traffic accidents were the cause of 19,93% maxillofacial injuries in the analyzed period of time. Most of the patients had injuries to the soft tissues of the face (22,21%), followed by tooth and alveolar process injuries (20,71%) and mandibular fractures (18,69%). All the types of injuries were more common in men than in women. The majority of the patients were car drivers followed by car passengers, pedestrians, cyclists and motor cyclists. The peak age of the patients was between 18 to 25 years. The prevalent number of accidents resulting in injuries to this region took place in spring, especially between noon and 4 PM. Conclusion Our results exhibit that road traffic
Full Text Available Abstract Background In spite of employing numerous devices improving the safety in motor vehicles, traffic accidents are still among the main reasons of maxillofacial injuries. The maxillofacial injuries remain the serious clinical problem because of the specificity of this anatomical region. The knowledge of etiologic factors and mechanisms of injuries can be helpful in a satisfactory trauma prevention. The aim of this study was to find out the incidence and the pattern of maxillofacial injuries resulting from traffic accidents in the patients treated in the Department of Maxillofacial Surgery (Silesian Medical Academy in Katowice, Poland from January 2001 to December 2005. Methods The material consisted of 1024 case records of patients with maxillofacial injuries treated in the Maxillofacial Surgery Department of Silesian Medical Academy. The detailed analysis was carried out on the case records of 198 patients in the age of 3 to 68 with maxillofacial injuries resulting from traffic accidents. On the basis of data from a history, examination on admission, consultations and radiological examinations, patients' age and gender, we obtained the information on a pattern of injury and detailed description of an accident (the date and the time of an accident, the role of the patient in an accident. Results The traffic accidents were the cause of 19,93% maxillofacial injuries in the analyzed period of time. Most of the patients had injuries to the soft tissues of the face (22,21%, followed by tooth and alveolar process injuries (20,71% and mandibular fractures (18,69%. All the types of injuries were more common in men than in women. The majority of the patients were car drivers followed by car passengers, pedestrians, cyclists and motor cyclists. The peak age of the patients was between 18 to 25 years. The prevalent number of accidents resulting in injuries to this region took place in spring, especially between noon and 4 PM. Conclusion Our results
Malara, Piotr; Malara, Beata; Drugacz, Jan
In spite of employing numerous devices improving the safety in motor vehicles, traffic accidents are still among the main reasons of maxillofacial injuries. The maxillofacial injuries remain the serious clinical problem because of the specificity of this anatomical region. The knowledge of etiologic factors and mechanisms of injuries can be helpful in a satisfactory trauma prevention. The aim of this study was to find out the incidence and the pattern of maxillofacial injuries resulting from traffic accidents in the patients treated in the Department of Maxillofacial Surgery (Silesian Medical Academy in Katowice, Poland) from January 2001 to December 2005. The material consisted of 1024 case records of patients with maxillofacial injuries treated in the Maxillofacial Surgery Department of Silesian Medical Academy. The detailed analysis was carried out on the case records of 198 patients in the age of 3 to 68 with maxillofacial injuries resulting from traffic accidents. On the basis of data from a history, examination on admission, consultations and radiological examinations, patients' age and gender, we obtained the information on a pattern of injury and detailed description of an accident (the date and the time of an accident, the role of the patient in an accident). The traffic accidents were the cause of 19.93% maxillofacial injuries in the analyzed period of time. Most of the patients had injuries to the soft tissues of the face (22.21%), followed by tooth and alveolar process injuries (20.71%) and mandibular fractures (18.69%). All the types of injuries were more common in men than in women. The majority of the patients were car drivers followed by car passengers, pedestrians, cyclists and motor cyclists. The peak age of the patients was between 18 to 25 years. The prevalent number of accidents resulting in injuries to this region took place in spring, especially between noon and 4 PM. Our results exhibit that road traffic accidents remain among the main
Guerriero, Réjean M; Proctor, Mark R; Mannix, Rebekah; Meehan, William P
Sport-related concussion affects athletes at every level of participation. The short and long-term effects of concussions that occur during childhood and adolescence are not fully understood. The purpose of this review is to describe the current burden of disease, current practice patterns and current recommendations for the assessment and management of sport-related concussions sustained by United States high school athletes. Millions of high school students participate in organized sports in the United States. Current estimates suggest that, across all sports, approximately 2.5 concussions occur for every 10 000 athletic exposures, in which an athletic exposure is defined as one athlete participating in one game or practice. At schools that employ at least one athletic trainer, most high school athletes who sustain sport-related concussions will be cared for by athletic trainers and primary care physicians. Approximately 40% will undergo computerized neurocognitive assessment. The number of high school athletes being diagnosed with sport-related concussions is rising. American football has the highest number of concussions in high school with girls' soccer having the second highest total number. Fortunately, coaches are becoming increasingly aware of these injuries and return-to-play guidelines are being implemented.
Full Text Available The purpose of this study was to evaluate the incidence of trauma victims of age 60 years and older who required maxillofacial intervention. The study analyses the pattern of injuries and the various factors that predict the treatment plan of these patients. A retrospective study was carried out in 1820 trauma patients who reported to the Sri. Ramachandra Dental College and Hospital and required maxillofacial intervention, over a period of 5 years (October 2000 and September 2005. Of the total trauma victims, 185 patients were found to be aged 60 years more. In the majority of the patients, the injury was due to road traffic accidents (79.4%. Males (72.4% sustained more injuries than females (27.6%. Soft tissue injuries were seen in 49.1% of the patients, while 14% had mandibular fractures. People in their early 60s were injured more often than their older counterparts. The findings of this study highlight the present situation with regard to maxillofacial trauma in patients aged 60 years and older and its management in this part of the country.
Winkler, Ethan A; Yue, John K; Burke, John F; Chan, Andrew K; Dhall, Sanjay S; Berger, Mitchel S; Manley, Geoffrey T; Tarapore, Phiroz E
OBJECTIVE Sports-related traumatic brain injury (TBI) is an important public health concern estimated to affect 300,000 to 3.8 million people annually in the United States. Although injuries to professional athletes dominate the media, this group represents only a small proportion of the overall population. Here, the authors characterize the demographics of sports-related TBI in adults from a community-based trauma population and identify predictors of prolonged hospitalization and increased morbidity and mortality rates. METHODS Utilizing the National Sample Program of the National Trauma Data Bank (NTDB), the authors retrospectively analyzed sports-related TBI data from adults (age ≥ 18 years) across 5 sporting categories-fall or interpersonal contact (FIC), roller sports, skiing/snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was used to identify predictors of prolonged hospital length of stay (LOS), medical complications, inpatient mortality rates, and hospital discharge disposition. Statistical significance was assessed at α sports-related TBIs were documented in the NTDB, which represented 18,310 incidents nationally. Equestrian sports were the greatest contributors to sports-related TBI (45.2%). Mild TBI represented nearly 86% of injuries overall. Mean (± SEM) LOSs in the hospital or intensive care unit (ICU) were 4.25 ± 0.09 days and 1.60 ± 0.06 days, respectively. The mortality rate was 3.0% across all patients, but was statistically higher in TBI from roller sports (4.1%) and aquatic sports (7.7%). Age, hypotension on admission to the emergency department (ED), and the severity of head and extracranial injuries were statistically significant predictors of prolonged hospital and ICU LOSs, medical complications, failure to discharge to home, and death. Traumatic brain injury during aquatic sports was similarly associated with prolonged ICU and hospital LOSs, medical complications, and failure to be discharged to
Akama, M K; Chindia, M L; Macigo, F G; Guthua, S W
Road Traffic Accidents (RTAs) are a major cause of morbidity and mortality in Kenya. Victims may suffer multiple injuries including maxillofacial injuries. In most developing countries RTAs are the leading cause of maxillofacial injuries. In an attempt to reduce RTAs, the government of Kenya has enacted a legislation requiring mandatory fitting of speed governors and safety belts by passenger service vehicles. To describe the characteristics and pattern of maxillofacial and associated injuries sustained in road traffic accidents. A cross-sectional study. Kenyatta National Hospital (KNH). All patients involved in RTAs brought to casualty and the dental department of KNH as well as accident victims admitted to the KNH mortuary over a four- month period from September 2004 to December 2004. Four hundred and thirteen (85.7%) had non-fatal injuries whereas 69 (14.3%) had sustained fatal injuries. Males in the 21-30-year age group were the most affected. Most accidents occurred during weekends with pedestrians being the leading casualties in 59.5% and 71.4% of non-fatal and fatal cases respectively. Most accidents were caused by passenger service vehicles (matatus) which were responsible for 62% and 40.6% of non-fatal and fatal injuries respectively. Non-use of safety belts was reported in 56.6% of the cases who suffered non-fatal injuries. In the non-fatal category 89.6% of the casualties had soft tissue injuries (STIs) involving the craniofacial region with facial cuts being the majority (69.2%). Two hundred and seventy three (66.1%) incidents of other STIs than those of the head region were noted, the lower limbs accounting for 45.4% of these. Only 5.1% of the casualties with non-fatal injuries had fractures involving the maxillofacial skeleton. Skeletal injuries other than those involving the maxillofacial region were found in 142 (34.1%) incidents. In the fatal category head injury alone was the leading cause of death accounting for 37.7% of the cases followed by
Meehan, William P; d'Hemecourt, Pierre; Collins, Christy L; Comstock, R Dawn
Little existing data describe which medical professionals and which medical studies are used to assess sport-related concussions in high school athletes. To describe the medical providers and medical studies used when assessing sport-related concussions. To determine the effects of medical provider type on timing of return to play, frequency of imaging, and frequency of neuropsychological testing. Descriptive epidemiology study. All concussions recorded by the High School Reporting Information Online (HS RIO) injury surveillance system during the 2009 to 2010 academic year were included. χ(2) analyses were conducted for categorical variables. Fisher exact test was used for nonparametric data. Logistic regression analyses were used when adjusting for potential confounders. Statistical significance was considered for P sport-related concussions, representing 14.6% of all injuries. Most (94.4%) concussions were assessed by athletic trainers (ATs), 58.8% by a primary care physician. Few concussions were managed by specialists. The assessment of 21.2% included computed tomography. Computerized neuropsychological testing was used for 41.2%. For 50.1%, a physician decided when to return the athlete to play; for 46.2%, the decision was made by an AT. After adjusting for potential confounders, no associations between timing of return to play and the type of provider (physician vs AT) deciding to return the athlete to play were found. Concussions account for nearly 15% of all sport-related injuries in high school athletes. The timing of return to play after a sport-related concussion is similar regardless of whether the decision to return the athlete to play is made by a physician or an AT. When a medical doctor is involved, most concussions are assessed by primary care physicians as opposed to subspecialists. Computed tomography is obtained during the assessment of 1 of every 5 concussions occurring in high school athletes.
Ozturk Ozden Tepekoylu
Full Text Available In Recent studies underline the fact that adolescents are, at many times, likely to experience serious communication problems with their families and close environments. So, the aim of this study is to determine positive impact of sport-related games, which are performed as extracurricular activities, on high school students’ communication skills. In the study, pre, & post-tests was utilized with the control group’s experimental patterns. Two participant groups were made up of totally 30 high school students, 15 of whom would be in the experimental group and the rest of whom were in the control group. The former group was given sport- related 20 applications for 10 weeks during which the latter group would not deal with any extracurricular activities. Meanwhile, before and after the applications, data was collected by means of “The Communication Skills Scale” which was developed by Korkut (1996 and then analysed through “two-way ANCOVA” test techniques. Results clarify that the considerable gap in scores of the students’ pre, & post-tests perception concerning their communication skills are clearly attributed to sport-related games and it was also established that scores of the students in the experimental group were meaningfully higher than ones in the control group. However, perception of communication skills in the both groups was not significantly different by sex of the students. Moreover, the common effect of sex and participation on sport- related games was not found statistically meaningful in terms of communication skills. Consequently, it could be said that sport-related games impact positively communication skills.
Meehan, William P.; d’Hemecourt, Pierre; Collins, Christy L.; Comstock, R. Dawn
Background Little existing data describe which medical professionals and which medical studies are used to assess sport-related concussions in high school athletes. Purpose To describe the medical providers and medical studies used when assessing sport-related concussions. To determine the effects of medical provider type on timing of return to play, frequency of imaging, and frequency of neuropsychological testing. Study Design Descriptive epidemiology study. Methods All concussions recorded by the High School Reporting Information Online (HS RIO) injury surveillance system during the 2009 to 2010 academic year were included. χ2 analyses were conducted for categorical variables. Fisher exact test was used for nonparametric data. Logistic regression analyses were used when adjusting for potential confounders. Statistical significance was considered for P sport-related concussions, representing 14.6% of all injuries. Most (94.4%) concussions were assessed by athletic trainers (ATs), 58.8% by a primary care physician. Few concussions were managed by specialists. The assessment of 21.2% included computed tomography. Computerized neuropsychological testing was used for 41.2%. For 50.1%, a physician decided when to return the athlete to play; for 46.2%, the decision was made by an AT. After adjusting for potential confounders, no associations between timing of return to play and the type of provider (physician vs AT) deciding to return the athlete to play were found. Conclusion Concussions account for nearly 15% of all sport-related injuries in high school athletes. The timing of return to play after a sport-related concussion is similar regardless of whether the decision to return the athlete to play is made by a physician or an AT. When a medical doctor is involved, most concussions are assessed by primary care physicians as opposed to subspecialists. Computed tomography is obtained during the assessment of 1 of every 5 concussions occurring in high school athletes
Breeze, J; Tong, D; Gibbons, A
Ballistic maxillofacial trauma in the UK is fortunately relatively rare, and generally involves low velocity handguns and shotguns. Civilian terrorist events have, however, shown that all maxillofacial surgeons need to understand how to treat injuries from improvised explosive devices. Maxillofacial surgeons in the UK have also been responsible for the management of soldiers evacuated from Iraq and Afghanistan, and in this review we describe the newer types of treatment that have evolved from these conflicts, particularly that of damage-control maxillofacial surgery. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.
Andrew J. Healey
Full Text Available Introduction: Blunt abdominal trauma is a rare but well-recognized cause of pancreatic transection. A delayed presentation of pancreatic fracture following sport-related blunt trauma with the coexisting diagnostic pitfalls is presented. Case Report: A 17-year-old rugby player was referred to our specialist unit after having been diagnosed with traumatic pancreatic transection, having presented 24 h after a sporting injury. Despite haemodynamic stability, at laparotomy he was found to have a diffuse mesenteric hematoma involving the large and small bowel mesentery, extending down to the sigmoid colon from the splenic flexure, and a large retroperitoneal hematoma arising from the pancreas. The pancreas was completely severed with the superior border of the distal segment remaining attached to the splenic vein that was intact. A distal pancreatectomy with spleen preservation and evacuation of the retroperitoneal hematoma was performed. Discussion/Conclusion: Blunt pancreatic trauma is a serious condition. Diagnosis and treatment may often be delayed, which in turn may drastically increase morbidity and mortality. Diagnostic difficulties apply to both paraclinical and radiological diagnostic methods. A high index of suspicion should be maintained in such cases, with a multi-modality diagnostic approach and prompt surgical intervention as required.
Full Text Available Facial fractures with occlusal derangement describe any fracture which directly or indirectly affects the occlusal relationship. Such fractures include dento-alveolar fractures in the maxilla and mandible, midface fractures - Le fort I, II, III and mandible fractures of the symphysis, parasymphysis, body, angle, and condyle. In some of these fractures, the fracture line runs through the dento-alveolar component whereas in others the fracture line is remote from the occlusal plane nevertheless altering the occlusion. The complications that could ensue from the management of maxillofacial fractures are predominantly iatrogenic, and therefore can be avoided if adequate care is exercised by the operating surgeon. This paper does not emphasize on complications arising from any particular technique in the management of maxillofacial fractures but rather discusses complications in general, irrespective of the technique used.
Singaram, Mohanavalli; G, Sree Vijayabala; Udhayakumar, Rajesh Kumar
This retrospective study aims to evaluate the prevalence of maxillofacial trauma in a developing country, along with its pattern, etiology and management. Data for the present study were collected from the Department of Dentistry, ESIC Medical College and Post Graduate Institute of Medical Sciences and Research, Chennai in India. The medical records of patients treated for maxillofacial injuries between May 2014 and November 2015 were retrospectively retrieved and analyzed for prevalence, pattern, etiology, and management of maxillofacial trauma. SPSS software version 16.0 was used for the data analysis. Maxillofacial fractures accounts for 93.3% of total injuries. The mean and standard deviation for the age of the patients were 35.0±11.8 years and with a minimum age of 5 years and maximum age of 75 years. Adults from 20 to 40 years age groups were more commonly involved, with a male to female ratio of 3:1. There was a statistically significantly higher proportion of males more commonly involved in accident and injuries (P maxillofacial injury was road traffic accidents (RTA) followed by falls and assaults, the sports injuries seem to be very less. In RTA, motorized two-wheelers (MTW) were the most common cause of incidents. The majority of victims of RTA were young adult males between the ages of 20 to 40 years. The malar bone and maxilla were the most common sites of fracture, followed by the mandible. The right side of the zygomatic complex was the predominant side of MTW injury. The majority of the zygomatic complex fractures were treated by conservative management. Open reduction and internal fixation were performed for indicated fracture patients.
Grandim Balarama Gupta Vinit
Full Text Available Myiasis is a rare disease primarily caused by the invasion of tissue by larvae of certain dipteran flies. Oral myiasis is still more "rare" and "unique" owing to the fact that oral cavity rarely provides the necessary habitat conducive for a larval lifecycle. Common predisposing factors are poor oral hygiene, halitosis, trauma, senility, learning disabilities, physically and mentally challenged conditions. Oral myiasis can lead to rapid tissue destruction and disfigurement and requires immediate treatment. Treatment consists of manual removal of maggots from the oral cavity after application of chemical agents. Good sanitation, personal and environmental hygiene and cleanliness and special care for debilitated persons are the best methods to prevent oral myiasis. This case report describes the presentation of oral myiasis caused by musca nebulo (common house fly in a 40-year-old male patient, with recent maxillofacial trauma. The patient was treated by manual removal larvae by topical application of turpentine oil, followed by surgical debridement of the wound and open reduction and internal fixation of the fracture.
Yue, John K; Winkler, Ethan A; Burke, John F; Chan, Andrew K; Dhall, Sanjay S; Berger, Mitchel S; Manley, Geoffrey T; Tarapore, Phiroz E
OBJECTIVE Traumatic brain injury (TBI) in children is a significant public health concern estimated to result in over 500,000 emergency department (ED) visits and more than 60,000 hospitalizations in the United States annually. Sports activities are one important mechanism leading to pediatric TBI. In this study, the authors characterize the demographics of sports-related TBI in the pediatric population and identify predictors of prolonged hospitalization and of increased morbidity and mortality rates. METHODS Utilizing the National Sample Program of the National Trauma Data Bank (NTDB), the authors retrospectively analyzed sports-related TBI data from children (age 0-17 years) across 5 sports categories: fall or interpersonal contact (FIC), roller sports, skiing/snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was used to identify predictors of prolonged length of stay (LOS) in the hospital or intensive care unit (ICU), medical complications, inpatient mortality rates, and hospital discharge disposition. Statistical significance was assessed at α sports-related TBIs were recorded in the NTDB, and these injuries represented 11,614 incidents nationally after sample weighting. Fall or interpersonal contact events were the greatest contributors to sports-related TBI (47.4%). Mild TBI represented 87.1% of the injuries overall. Mean (± SEM) LOSs in the hospital and ICU were 2.68 ± 0.07 days and 2.73 ± 0.12 days, respectively. The overall mortality rate was 0.8%, and the prevalence of medical complications was 2.1% across all patients. Severities of head and extracranial injuries were significant predictors of prolonged hospital and ICU LOSs, medical complications, failure to discharge to home, and death. Hypotension on admission to the ED was a significant predictor of failure to discharge to home (OR 0.05, 95% CI 0.03-0.07, p sports was independently associated with prolonged hospital LOS compared with FIC events (mean increase
Khan, Imran; Sybil, Deborah; Singh, Anurag; Aggarwal, Tarun; Khan, Rizwan
Successful management of airway in complex maxillofacial injuries is quite challenging. The complications and the post-operative care associated with tracheotomy makes it an unpopular choice for airway management meant solely for surgery in these patients. A retrospective analysis of 12 patients from June 2008 to December 2011, seeking treatment for pan facial fractures who underwent transmylohyoid oroendotracheal (submental) intubation is discussed here. The stepwise procedure is explained along with problems of intubation in pan facial fractures. The advantages, disadvantages and complications of transmylohyoid intubation are discussed and compared with alternative methods of air way management in such cases. This reliable, safe and easy method of airway management gives sterile surgical field without a change of tube.
Keskin, Elif Seda; Keskin, Ekrem; Atik, Bekir; Koçer, Abdülkadir
Nervus abducens is a pure motor nerve located in the pons. It retracts the eyeball laterally by stimulating rectus lateralis muscle. In case of their paralysis, diplopia and restriction in the eye movements while looking sideways, are seen. Since the same signs are seen due to the muscle entrapment in blowout fractures, its differential diagnosis has importance in terms of the treatment protocol and avoiding unnecessary operations. In this article, we present a 22-year-old male patient who was referred to our department due to the prediagnosis of blowout fracture following maxillofacial trauma. However, he was diagnosed with abducens nerve paralysis after the consultations and analysis and his restriction of movement was resolved via systemic steroid treatment instead of unnecessary operation. PMID:26981484
Patel, Dilip R; Yamasaki, Ai; Brown, Kelly
Over the past several decades there has been increased participation in sports by children and adolescents at earlier ages in the United States, as well as more intense participation and specialization in sports at very early ages. This trend has also partly contributed to the patterns of injuries seen in young athletes, and especially in recent years, injuries previously seen in mature athletes are being seen in young athletes. Overall, the vast majority of sport-related musculoskeletal injuries in children and adolescents are due to repetitive overuse and acute macrotrauma is less frequently seen in young athletes. Epidemiological data on sports injuries are provided by several national surveys. Investigators have used different methods to define sports injuries and the most widely used definition is based on athlete-exposure time. Certain aspects related to adolescent growth and development modulate the pattern of injuries. This article provides an overview of the epidemiology of sports-related musculoskeletal injuries seen in children and adolescents.
Bonnechère, B; Beauthier, J-P; Rooze, M; Jan, S Van Sint
Contact sports and sports with high risk of head traumatism are increasingly becoming more popular. This trend leads to a 60% increase of sport-related concussions in the decade. It is therefore important to summarize the current knowledge in this field (diagnosis, risk factors...) in order to help clinicians to improve this pathology management. Short and long term consequences are too often minimized by clinicians, while related clinical disorders should not be neglected (e.g. headaches, cognitive troubles, vestibular troubles, depression...). Complications risks are directly linked to the number of concussions or if patients return to play before complete recovery. Correct knowledge of symptoms and of the various assessment tests are consequently therefore important to know in order identity and tackle long term complications of sport-related concussions.
Manley, Geoff; Gardner, Andrew J; Schneider, Kathryn J; Guskiewicz, Kevin M; Bailes, Julian; Cantu, Robert C; Castellani, Rudolph J; Turner, Michael; Jordan, Barry D; Randolph, Christopher; Dvořák, Jiří; Hayden, K. Alix; Tator, Charles H; McCrory, Paul; Iverson, Grant L
Objective: Systematic review of possible long-term effects of sports-related concussion in retired athletes. Data sources Ten electronic databases. Study selection Original research; incidence, risk factors or causation related to long-term mental health or neurological problems; individuals who have suffered a concussion; retired athletes as the subjects and possible long-term sequelae defined as >10 years after the injury. Data extraction Study population, exposure/outcome measures, clinica...
Patel, Dilip R.; Yamasaki, Ai; Brown, Kelly
Over the past several decades there has been increased participation in sports by children and adolescents at earlier ages in the United States, as well as more intense participation and specialization in sports at very early ages. This trend has also partly contributed to the patterns of injuries seen in young athletes, and especially in recent years, injuries previously seen in mature athletes are being seen in young athletes. Overall, the vast majority of sport-related musculoskeletal inju...
Peters, D.M.; Jones, Gareth; Peters, John
This article investigates the 'preferred learning styles' and their relationship with grades for students undertaking sports-related undergraduate programmes at a higher education institution in the UK. Preferred 'learning styles' in students in this discipline have been identified as auditory, kinaesthetic and group, although the vast majority of students are multimodal in their learning preferences. Only individual learning style preference was found to be positively related to higher grade...
Lin, Ann C.; Salzman, Garrett A.; Bachman, Shelby L.; Burke, Rita V.; Zaslow, Tracy; Piasek, Carolina Z.; Edison, Bianca R.; Hamilton, Anita; Upperman, Jeffrey S.
Background: Parents of young athletes play a major role in the identification and management of sports-related concussions. However, they are often unaware of the consequences of concussions and recommended management techniques. Hypothesis: This study quantitatively assessed parental understanding of concussions to identify specific populations in need of additional education. We predicted that parents with increased education and prior sports- and concussion-related experience would have mo...
Full Text Available Sport-related mild traumatic brain injury (mTBI or concussion is a significant health concern to athletes with potential long-term consequences. The diagnosis of sport concussion and return to sport decision making is one of the greatest challenges facing health care clinicians working in sports. Blood biomarkers have recently demonstrated their potential in assisting the detection of brain injury particularly, in those cases with no obvious physical injury. We have recently discovered plasma soluble cellular prion protein (PrP(C as a potential reliable biomarker for blast induced TBI (bTBI in a rodent animal model. In order to explore the application of this novel TBI biomarker to sport-related concussion, we conducted a pilot study at the University of Saskatchewan (U of S by recruiting athlete and non-athlete 18 to 30 year-old students. Using a modified quantitative ELISA method, we first established normal values for the plasma soluble PrP(C in male and female students. The measured plasma soluble PrP(C in confirmed concussion cases demonstrated a significant elevation of this analyte in post-concussion samples. Data collected from our pilot study indicates that the plasma soluble PrP(C is a potential biomarker for sport-related concussion, which may be further developed into a clinical diagnostic tool to assist clinicians in the assessment of sport concussion and return-to-play decision making.
Stoller, Jacqueline; Carson, James D; Garel, Alisha; Libfeld, Paula; Snow, Catherine L; Law, Marcus; Frémont, Pierre
To identify differences and gaps in recommendations to patients for the management of sport-related concussion among FPs, emergency department physicians (EDPs), and pediatricians. A self-administered, multiple-choice survey was e-mailed to FPs, EDPs, and pediatricians. The survey had been assessed for content validity. Two community teaching hospitals in the greater Toronto area in Ontario. Two hundred seventy physicians, including FPs, EDPs, and pediatricians, were invited to participate. Identification of sources of concussion management information, usefulness of concussion diagnosis strategies, and whether physicians use common terminology when explaining cognitive rest strategies to patients after sport-related concussions. The response rate was 43.7%. Surveys were completed by 70 FPs, 23 EDPs, and 11 pediatricians. In total, 49% of FP, 52% of EDP, and 27% of pediatrician respondents reported no knowledge of any consensus statements on concussion in sport, and 54% of FPs, 86% of EDPs, and 78% of pediatricians never used the Sport Concussion Assessment Tool, version 2. Only 49% of FPs, 57% of EDPs, and 36% of pediatricians always advised cognitive rest. This study identified large gaps in the knowledge of concussion guidelines and implementation of recommendations for treating patients with sport-related concussions. Although some physicians recommended physical and cognitive rest, a large proportion failed to consistently advise this strategy. Better knowledge transfer efforts should target all 3 groups of physicians. Copyright© the College of Family Physicians of Canada.
Dessy, Alexa M; Yuk, Frank J; Maniya, Akbar Y; Gometz, Alex; Rasouli, Jonathan J; Lovell, Mark R; Choudhri, Tanvir F
Sports-related concussion has emerged as a public health crisis due to increased diagnosis of the condition and increased participation in organized and recreational athletics worldwide. Under-recognition of concussions can lead to premature clearance for athletic participation, leaving athletes vulnerable to repeat injury and subsequent short- and long-term complications. There is overwhelming evidence that assessment and management of sports-related concussions should involve a multifaceted approach. A number of assessment criteria have been developed for this purpose. It is important to understand the available and emerging diagnostic testing modalities for sports-related concussions. The most commonly used tools for evaluating individuals with concussion are the Post-Concussion Symptom Scale (PCSS), Standard Assessment of Concussion (SAC), Standard Concussion Assessment Tool (SCAT3), and the most recognized computerized neurocognitive test, the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). The strengths and limitations of each of these tools, and the Concussion Resolution Index (CRI), CogSport, and King-Devick tests were evaluated. Based on the data, it appears that the most sensitive and specific of these is the ImPACT test. Additionally, the King-Devick test is an effective adjunct due to its ability to test eye movements and brainstem function.
Ali, Fareedi Mukram; Al-Iryani, Ghassan M; Namis, Sultan Mohammed; Hezam, Asma Ali; Swaid, Salma Abdu; Alomar, Anas Esam
In many health services communities the scope of oral and maxillofacial surgery (OMFS) as a discipline is frequently not probably understood. Good awareness towards OMFS among different branches of health services providers is essential for better referral strategies and will be for the benefit of the patient. The cross-sectional study was done using a specially prepared questionnaire distributed randomly to 125 general medical practitioners working in Jazan province. In this questionnaire, there were also some close-ended questions to evaluate awareness regarding a variety of conditions treated by the oral and maxillofacial surgeons. Out of 125 participants, 105 (84%) were aware of the oral and maxillofacial surgery as a speciality branch of dentistry. Only 52 (41.6%) participants were aware of the different treatment modalities coming under the scope of oral and maxillofacial surgery. Also in the referral of cases to the oral and maxillofacial surgeon, 50 (40%) participants referred their oral and maxillofacial region cases to OMS. Tooth removal was the only procedure where most of the medical practitioners knew it is a speciality procedure of the oral and maxillofacial surgeon. For facial fractures, 76 medical practitioners believe it comes under the scope of the orthopaedic surgeon. Similarly, for facial abscesses, 81 and 36 practitioners responded that it is a job of a general surgeon and OMS respectively. There is low awareness toward the scope of oral and maxillofacial surgery in the medical community. Knowledge and awareness of the scope of oral and maxillofacial surgery can improve the success and promptness of delivery of health services.
Olojede, Aco; Gbotolorun, O M; Ogundana, O M; Emeka, I C; Emmanuel, M M; Oluseye, Sab; Runsewe, O
The human face often constitutes the first point of contact in various human interactions and it is frequently the preferred target for blows in assault cases. To analyze the pattern of assault-related maxillofacial injuries treated at the General Hospital, Lagos over a period of one year. This is one year prospective study of assault-related maxillofacial injuries treated at the Department of Oral-Maxillofacial Surgery, Dental Centre, General Hospital, Lagos, Nigeria. A face-to-face interviewer-administered structured proforma was used to obtain information from study subjects. Thirty-three patients with maxillofacial injuries met the inclusion criteria for this study. Their age ranged between 16 and 48 years with a mean age of 28.2 ± 7.4 years. There were 25(75.8%) males and 8(24.2%) females with a male/female ratio of 3:1. Majority of the patients, 24(72.7%) did not have any skilled employment while the remaining 9(27.3%) were road transport workers, specifically commercial bus drivers and motorcycle riders. The most frequently seen soft tissue injury was contusion which accounted for 17(51.5%) cases while 13 (39%) of the patients sustained mandibular fracture which was the most common hard tissue injury. Assault-related maxillofacial injuries are most common amongst young adult males who are not skillfully employed; this can be attributed to the increased disposition to violence in males in our environment.
Kulakov, A A; Butova, V G; Snurnitzina, Z A; Kulikova, A N
The aim of the study was to analyze the key trends of medical staff provision for maxillofacial surgery facilities. It is established that the provision of the population with maxillofacial surgeons staff has slightly decreased from 0.08 (year 2011) to 0.06 (year 2015). The amount of staff positions at this period has increased by 17.22%, the intensity of growth of employed positions has grown by 15.74%, which makes the understaffing rate equal to approximately 8-10%. The coefficient of part-time workers has also varied slightly from 1.4 in 2011 to 1.26 in 2015. Over 93% of maxillofacial surgeons work in hospitals. The qualification category was awarded to over 46.0% of specialists in this field, 97.6% of maxillofacial surgeons have a specialist certificate. The results indicate the need for a new project of personnel policy strategy for further training and professional growth of maxillofacial surgeons.
Dincă Luciana Laura
Full Text Available In this paper the benefits of using additive manufacturing technologies in maxillofacial reconstruction are highlighted. Based on a real clinical case, the paper describes the manufacture of an implant prototype replacing the right zygomatic bone and a part of maxilla using additive manufacturing technologies. The face is the most expressive part of the human body that makes us unique. It was shown that the maxillofacial prostheses help to improve the psychological state of patients affected by, because low self esteem feeling appears commonly to this patients with the facial defects. The aim of this paper is to show how using additive manufacturing technologies methods within this research, the producing a surgical model will help surgeon to improve the pre-operative planning. For this we used additive manufacturing technologies such as Stereolitography to achieve the biomodel and FDM-fused deposition modelling to obtain a prototype model because these technologies make it possible to obtain prosthesis according to the physical and mechanical requirements of the region of implantation.
Lee, Ji Hyun; Jung, Yun Hoa; Cho Bong Hae; Hwang, Dae Seok [School of Dentistry, Pusan National University, Pusan (Korea, Republic of)
The purpose of this study was to evaluate the diagnostic efficacy of panoramic radiographs for detection of mandibular fractures. The sample was comprised of 65 patients (55 fractured, 10 non-fractured) with 92 fracture sites confirmed by multi-detector computed tomography (CT). Panoramic radiographs were evaluated for mandibular fractures by six examiners; two oral and maxillofacial radiologists (observer A and B), two oral and maxillofacial surgeons (observer C and D), and two general dentists (observer E and F). Sensitivity of panoramic radiography for mandibular fractures was 95.7% in observer A and B, 93.5% in observer C and D and 80.4% in observer E and F. The lowest sensitivity was shown in symphyseal/parasymphyseal areas, followed by subcondylar/condylar regions. Panoramic radiography is adequate for detection of mandibular fractures. However, additional multidetector CT is recommended to ascertain some indecisive fractures of symphysis and condyle, and in complicated fractures.
Lee, Ji Hyun; Jung, Yun Hoa; Cho Bong Hae; Hwang, Dae Seok
The purpose of this study was to evaluate the diagnostic efficacy of panoramic radiographs for detection of mandibular fractures. The sample was comprised of 65 patients (55 fractured, 10 non-fractured) with 92 fracture sites confirmed by multi-detector computed tomography (CT). Panoramic radiographs were evaluated for mandibular fractures by six examiners; two oral and maxillofacial radiologists (observer A and B), two oral and maxillofacial surgeons (observer C and D), and two general dentists (observer E and F). Sensitivity of panoramic radiography for mandibular fractures was 95.7% in observer A and B, 93.5% in observer C and D and 80.4% in observer E and F. The lowest sensitivity was shown in symphyseal/parasymphyseal areas, followed by subcondylar/condylar regions. Panoramic radiography is adequate for detection of mandibular fractures. However, additional multidetector CT is recommended to ascertain some indecisive fractures of symphysis and condyle, and in complicated fractures.
Guruprasad, Yadavalli; Hemavathy, Or; Giraddi, Girish; Shetty, Jayaprasad N
Maxillofacial injuries pose a therapeutic challenge to trauma, maxillofacial and plastic surgeons practicing in developing countries. This was a retrospective study carried out to determine the incidence, etiology, injury characteristics of maxillofacial injuries reported at our centre. The data for this study were obtained from the medical records of 689 cases reported to our centre during the period from 2006-2009. Records of patients who were either treated in the emergency room as outpatients or the Department of Oral and Maxillofacial Surgery as inpatients were analyzed and were subjected to statistical analysis using statistical package for social sciences (SPSS) for Windows version 17.0. Data was summarized in form of proportions and frequency tables for categorical variables and was subjected to Chi-Square test. Out of 689 patients, 75.9% were male and 24.1% were female. 42.5% of the patients were in the age group of 21 to 30 years. Road traffic accidents accounted for the majority (74.3%) of cases of maxillofacial trauma. Mandible was seen as the most commonly fractured bone (50.3%) and 53.8% head and neck injuries were most common among the associated injuries. Road traffic accidents were clearly the most prevalent etiological factor for maxillofacial trauma. Measures on prevention of road traffic crashes should be strongly emphasized in order to reduce the occurrence of these injuries.
Thomas, Donald J; Coxe, Kathryn; Li, Hongmei; Pommering, Thomas L; Young, Julie A; Smith, Gary A; Yang, Jingzhen
We quantified the length of recovery time by week in a cohort of pediatric sports-related concussion patients treated at concussion clinics, and examined patient and injury characteristics associated with prolonged recovery. A retrospective, cohort design. Seven concussion clinics at a Midwest children's hospital. Patients aged 10 to 17 years with a diagnosed sports-related concussion presenting to the clinic within 30 days of injury. Length of recovery by week. Unadjusted and adjusted multinomial logistic regression analyses were used to model the effect of patient and injury characteristics on length of recovery by week. Median length of recovery was 17 days. Only 16.3% (299/1840) of patients recovered within one week, whereas 26.4% took longer than four weeks to recover. By 2 months postinjury, 6.7% of patients were still experiencing symptoms. Higher symptom scores at injury and initial visit were significantly associated with prolonged symptoms by week. Patients who presented to the clinic more than 2 weeks postinjury or who had 2 or more previous concussions showed increased risk for prolonged recovery. Females were at greater risk for prolonged recovery than males (odds ratio = 2.08, 95% confidence interval = 1.49-2.89). Age was not significantly associated with recovery length. High symptom scores at injury and initial visit, time to initial clinical presentation, presence of 2 or more previous concussions, and female sex are associated with prolonged concussion recovery. Further research should aim to establish objective measures of recovery, accounting for treatment received during the recovery. The median length of recovery is 17 days among pediatric sports-related concussion patients treated at concussion clinics. Only 16.3% of patients recovered within one week, whereas 26.4% took longer than 4 weeks to recover.
Hoskin, Annette K; Yardley, Anne-Marie E; Hanman, Kate; Lam, Geoffrey; Mackey, David A
To identify the causes of sports-related eye and adnexal injuries in children in Perth, Western Australia, to determine which sporting activities pose the highest risk of eye and adnexal injury to children. We performed a 12-year retrospective review of children admitted to hospital from 2002 to 2013 with sports-related ocular and adnexal eye injuries. The main outcome measures were the cause and type of ocular and adnexal injuries, age and gender risk factors. A total of 93 cases of sports-related ocular and adnexal injury were identified in the 12-year time period. A peak in injuries occurred for 12- to 14-year-olds with a second peak in 6- to 8-year-olds; the median age was 8.82 years (range = 1.59-16.47). Cycling, football (including soccer and Australian Rules Football), tennis, trampolining, fishing and swimming were the sports responsible for the greatest number of injuries, a total of 63%. More than one-third (35%) of injuries resulted from being struck by a blunt object, and more than a quarter (26%) were as a result of contact with a blunt projectile. Serious ocular and adnexal injuries have occurred in children as a result of participating in sports, with cycling and football being the largest contributors in the 12-year period we assessed. As we continue to encourage children to spend more time participating in sports and recreational activities, identifying associated risk factors will help us develop injury prevention strategies to promote eye safety for children. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Yengo-Kahn, Aaron M; Gardner, Ryan M; Kuhn, Andrew W; Solomon, Gary S; Bonfield, Christopher M; Zuckerman, Scott L
The risk of sport-related concussion (SRC) has emerged as a major public health concern. In rare instances, sport-related head injuries can be even more severe, such as subdural hemorrhage, epidural hemorrhage, or malignant cerebral edema. Unlike SRCs, sport-related structural brain injury (SRSBI) is rare, may require neurosurgical intervention, and can lead to permanent neurologic deficit or death. Data characterizing SRSBI are limited, and many have recognized the need to better understand these catastrophic brain injuries. The goal of the current series is to describe, in detail, the presentation, management, and outcomes of examples of these rare injuries. During the fall of 2015, three high school football players presented with acute subdural hemorrhages following in-game collisions and were treated at our institution within a span of 2 months. For the 2 athletes who required surgical intervention, a previous SRC was sustained within 4 weeks before the catastrophic event. One year after injury, 2 players have returned to school, though with persistent deficits. One patient remains nonverbal and wheelchair bound. None of the athletes has returned to sports. Acute subdural hemorrhage resultant from an in-game football collision is rare. The temporal proximity of the reported SRSBIs to recent SRCs emphasizes the importance of return-to-play protocols and raises questions regarding the possibility of second impact syndrome. Although epidemiologic conclusions cannot be drawn from this small sample, these cases provide a unique opportunity to demonstrate the presentation, management, and long-term outcomes of SRSBI in American high school football. Copyright © 2017 Elsevier Inc. All rights reserved.
Reshetnikov, A. P.; Kopylov, M. V.; Nasyrov, M. R., E-mail: firstname.lastname@example.org; Fisher, E. L.; Chernova, L. V. [Izhevsk State Medical Academy, Izhevsk, Russia (426034, Izhevsk, Kommunarov street, 281) (Russian Federation); Soicher, E. M. [Moscow State University of Medicine and Dentistry named after A.I. Evdokimov of the Ministry of Health of the Russian Federation, Moscow, Russia, (127473, Moscow, Delegatskaya str., 20/1) (Russian Federation)
At the dental clinic the infrared range radiation spectrum of tissues was used to study the dynamics of local temperature and structure of the skin, subcutaneous fat, and other tissues of the maxillofacial area in adult healthy volunteers and patients. In particular, we studied the dynamics of local temperature of mucous membranes of the mouth, teeth, and places in the mouth and dental structures in the norm and in various pathological conditions of the lips, gums, teeth, tongue, palate, and cheeks before, during and after chewing food, drinking water, medication, and inhalation of air. High safety and informational content of infrared thermography are prospective for the development of diagnostics in medicine. We have 3 new methods for infrared detection protected by patents in Russia.
Reshetnikov, A. P.; Kopylov, M. V.; Nasyrov, M. R.; Soicher, E. M.; Fisher, E. L.; Chernova, L. V.
At the dental clinic the infrared range radiation spectrum of tissues was used to study the dynamics of local temperature and structure of the skin, subcutaneous fat, and other tissues of the maxillofacial area in adult healthy volunteers and patients. In particular, we studied the dynamics of local temperature of mucous membranes of the mouth, teeth, and places in the mouth and dental structures in the norm and in various pathological conditions of the lips, gums, teeth, tongue, palate, and cheeks before, during and after chewing food, drinking water, medication, and inhalation of air. High safety and informational content of infrared thermography are prospective for the development of diagnostics in medicine. We have 3 new methods for infrared detection protected by patents in Russia.
Sanchez-Marquez, A.; Gil-Garcia, M.; Valls, C.; Narvaez-Garcia, J.; Andia-Navarro, E.; Pozuelo-Segura, O.; Portabella-Blavia, F.
Sports-related injuries of the lower extremity are frequent. Before magnetic resonance (MR) imaging was available, ultrasound, radionuclide scintigraphy and computed tomography were used to evaluate muscle trauma. Although relatively inexpensive, these imaging modalities are limited by their low specificity. The high degree of soft tissue contrast and multiplanar capability of MR imaging, allow direct visualization as well as characterization of traumatic muscle lesions. This pictorial review highlights the spectrum of traumatic muscle lesions on MRI, with emphasis on its typical appearances. (orig.)
Miller, Joseph H; Gill, Clarence; Kuhn, Elizabeth N; Rocque, Brandon G; Menendez, Joshua Y; O'Neill, Jilian A; Agee, Bonita S; Brown, Steven T; Crowther, Marshall; Davis, R Drew; Ferguson, Drew; Johnston, James M
OBJECT Pediatric sports-related concussions are a growing public health concern. The factors that determine injury severity and time to recovery following these concussions are poorly understood. Previous studies suggest that initial symptom severity and diagnosis of attention deficit hyperactivity disorder (ADHD) are predictors of prolonged recovery (> 28 days) after pediatric sports-related concussions. Further analysis of baseline patient characteristics may allow for a more accurate prediction of which patients are at risk for delayed recovery after a sports-related concussion. METHODS The authors performed a single-center retrospective case-control study involving patients cared for at the multidisciplinary Concussion Clinic at Children's of Alabama between August 2011 and January 2013. Patient demographic data, medical history, sport concussion assessment tool 2 (SCAT2) and symptom severity scores, injury characteristics, and patient balance assessments were analyzed for each outcome group. The control group consisted of patients whose symptoms resolved within 28 days. The case group included patients whose symptoms persisted for more than 28 days. The presence or absence of the SCAT2 assessment had a modifying effect on the risk for delayed recovery; therefore, stratum-specific analyses were conducted for patients with recorded SCAT2 scores and for patients without SCAT2 scores. Unadjusted ORs and adjusted ORs (aORs) for an association of delayed recovery outcome with specific risk factors were calculated with logistic regression analysis. RESULTS A total of 294 patients met the inclusion criteria of the study. The case and control groups did not statistically significantly differ in age (p = 0.7). For the patients who had received SCAT2 assessments, a previous history of concussion (aOR 3.67, 95% CI 1.51-8.95), presenting SCAT2 score Concussions resulting from playing a nonhelmet sport were also associated with a higher risk for prolonged symptoms in
Adam J. Mellott
Full Text Available Negative pressure wound therapy has greatly advanced the field of wound healing for nearly two decades, by providing a robust surgical adjunct technique for accelerating wound closure in acute and chronic wounds. However, the application of negative pressure wound therapy in maxillofacial applications has been relatively under utilized as a result of the physical articulations and contours of the head and neck that make it challenging to obtain an airtight seal for different negative pressure wound therapy systems. Adapting negative pressure wound therapies for maxillofacial applications could yield significant enhancement of wound closure in maxillofacial applications. The current review summarizes the basic science underlying negative pressure wound therapy, as well as specific maxillofacial procedures that could benefit from negative pressure wound therapy.
An increasing number of staff in oral and maxillofacial surgery (OMFS) departments take clinical photographs with their personal phones. We report the results of a survey on the use of smartphone photography in OMFS departments in the United Kingdom, and highlight the guidelines that govern their use and the associated ethical and medicolegal implications. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Kim, Jun Ho; Arita, Emiko Saito; Pinheiro, Lucas Rodrigues; Yoshimoto, Marcelo; Watanabe, Plauto Christopher Aranha; Cortes, Arthur Rodriguez Gonzalez
The present study aimed to present 4 cases and to undertake a systematic review on the current knowledge of the impact of cone beam computed tomographic (CBCT) artifacts on oral and maxillofacial surgical planning and follow-up. The MEDLINE (PubMed) database was searched for the period from February 2004 to February 2017, for studies on the impact of CBCT artifacts on surgical planning of oral and maxillofacial surgeries. The PRISMA statement was followed during data assessment and extraction. As a result, data extraction included information regarding: the use of CBCT to plan or follow-up oral and maxillofacial surgeries, presence and type identification of a CBCT artifact, and details on the impact of artifacts on image quality and/or surgical planning. Four cases were selected to illustrate the topic. The search strategy yielded 408 publications in MEDLINE (PubMed). An initial screening of the publications was performed using abstracts and key words. After application of exclusion criteria, a total of 11 studies were finally identified as eligible to be discussed. Studies revealed 3 main types of artifact: beam hardening, streak, and motion artifacts. Most of the studies suggest that artifacts significantly affect oral and maxillofacial surgical planning and follow-up, despite of allowing for identification of metal projectiles in cases of maxillofacial trauma. CBCT artifacts have a significant impact on oral and maxillofacial surgical planning and follow-up.
Waters, M G; Jagger, R G; Polyzois, G L
Maxillofacial prosthetic materials that contact skin or mucosa should have good wettability. A material that is easily wetted will form a superior lubricating layer between the supporting tissues and, thus, reduce friction and patient discomfort. The surface energy of a maxillofacial prosthetic material will give an indication of the amount of energy available for adhesion and of the susceptibility of the material to bacterial adhesion. This study evaluated the wettability and surface energies of a range of commercially available silicone rubber maxillofacial prosthetic materials. Contact angles and surface energies were measured by using a dynamic contact angle measuring technique. Four commonly used silicone maxillofacial materials were tested and their properties compared with those of an acrylic resin denture base material and a widely used denture soft lining material. There were no significant differences in the wettability of the silicone rubber materials. All materials were significantly less wetted than the denture acrylic resin material. There were no significant differences in the surface energies of the silicone rubber materials, but all were significantly lower than denture acrylic resin material. The Cahn dynamic contact angle analyzer was a quick and reproducible method for determining the contact angles and surface energies of maxillofacial materials. Further work is needed to improve the wettability of silicone rubber materials used for maxillofacial prostheses, thus, reducing their potential to produce friction with tissues.
Purcell, Laura; Harvey, Janice; Seabrook, Jamie A
Time to symptom resolution, return to school, and return to play after a sport-related concussion in children and adolescents (8-17 years of age) was examined using a retrospective cohort design. A total of 198 patients aged 8 to 17 years were included, with a mean age of 13.5 years (SD = 2.2). Patients aged 8 to 12 years were symptom-free in a median of 12.0 (range 1-60) days whereas 13- to 17-year olds were symptom-free in a median of 14.0 (range 1-300) days (P = .04). Patients aged 8 to 12 years returned to learn in a median of 4.0 (range 0-30) days compared with 2.5 (range 0-55.0) days in 13- to 17-year-olds (P = .86). Patients aged 8 to 12 years returned to play in a median of 14.0 (range 4-75) days compared with a median of 19.5 (range 5-75) days in 13- to 17-year-olds (P = .06). These results indicate that children and adolescents generally take 2 to 4 weeks to recover from a sport-related concussion. © The Author(s) 2015.
Kirschen, Matthew P; Tsou, Amy; Nelson, Sarah Bird; Russell, James A; Larriviere, Daniel
To examine the ethical and legal issues physicians face when evaluating and managing athletes with sports-related concussions, and to offer guidance to physicians as they navigate these situations. This position paper reviews and compares the components of sports-related concussion laws, including education, removal from play, and clearance for return to play. It highlights the challenges privacy laws present relevant to providing care to concussed athletes and suggests ways to help physicians overcome these obstacles. The report also explores the ethical considerations physicians should bear in mind as they evaluate and manage concussed athletes, addressing them through a framework that includes considerations of professionalism, informed decision-making, patient autonomy, beneficence, nonmaleficence, conflicts of interest, and distributive justice. Physicians caring for concussed athletes have an ethical obligation to ensure that their primary responsibility is to safeguard the current and future physical and mental health of their patients. Physicians have a duty to provide athletes and their parents with information about concussion risk factors, symptoms, and the risks for postconcussion neurologic impairments. Physicians should facilitate informed and shared decision-making among athletes, parents, and medical teams while protecting athletes from potential harm. Additionally, including concussion evaluation and management training in neurology residency programs, as well as developing a national concussion registry, will benefit patients by the development of policies and clinical guidelines that optimize prevention and treatment of concussive head injury. © 2014 American Academy of Neurology.
Reches, A; Kutcher, J; Elbin, R J; Or-Ly, H; Sadeh, B; Greer, J; McAllister, D J; Geva, A; Kontos, A P
The clinical diagnosis and management of patients with sport-related concussion is largely dependent on subjectively reported symptoms, clinical examinations, cognitive, balance, vestibular and oculomotor testing. Consequently, there is an unmet need for objective assessment tools that can identify the injury from a physiological perspective and add an important layer of information to the clinician's decision-making process. The goal of the study was to evaluate the clinical utility of the EEG-based tool named Brain Network Activation (BNA) as a longitudinal assessment method of brain function in the management of young athletes with concussion. Athletes with concussion (n = 86) and age-matched controls (n = 81) were evaluated at four time points with symptom questionnaires and BNA. BNA scores were calculated by comparing functional networks to a previously defined normative reference brain network model to the same cognitive task. Subjects above 16 years of age exhibited a significant decrease in BNA scores immediately following injury, as well as notable changes in functional network activity, relative to the controls. Three representative case studies of the tested population are discussed in detail, to demonstrate the clinical utility of BNA. The data support the utility of BNA to augment clinical examinations, symptoms and additional tests by providing an effective method for evaluating objective electrophysiological changes associated with sport-related concussions.
Hatamleh, M M; Haylock, Colin; Watson, J; Watts, D C
Maxillofacial prostheses are constructed by maxillofacial prosthetists and technologists (MPTs), as an alternative treatment when maxillofacial defects cannot be surgically fulfilled. A questionnaire was conducted surveying 220 MPTs working in all UK maxillofacial units about their opinions, attitudes, and experience regarding several aspects related to maxillofacial silicone prostheses. Numbers and percentages of maxillofacial prostheses, their retention method, serviceability, reduced serviceability causes, and digital technologies (DT) used in constructing prostheses were analysed. Thousand hundred and ninety-three prostheses were constructed (42% ocular, 31% auricular, 13% orbital, 12% nasal, 1% composite, more than one facial prosthesis). Adhesives commonly retained orbital (48%) and nasal (45%) prostheses. Implant-retained bars commonly retained auricular prostheses (70%). Ocular prostheses were entirely retained by undercuts. Implant-retained prostheses remained serviceable for twice as long (19-24 months) as adhesive-retained prostheses (7-12 months). Causes for prosthesis replacement included colour changes (71%), poor maintenance (41%), and silicone tear (37%). Thirty-one percent of MPTs used DT computer software and programs for designing and constructing maxillofacial prostheses. In conclusion, adhesives, implant-retained bars and magnets are commonly used retentive methods. Prosthesis failure is caused mainly by colour change, poor maintenance, silicone tear and delamination. Different DTs are used by one-third of MPTs. Copyright © 2010 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Full Text Available Kite flying is a popular sport among children. Most of the injuries sustained during kite flying are due to falls, cuts, head injuries, or fractures. Injury with innocent-looking kite string in the maxillofacial region is rare. A 4½-year-old male patient with a clean cut, deep incised wound exposing the fat and muscle was treated with primary closure. Kite flying is associated with injuries ranging from simple cuts to grave lacerations or head trauma. The severity of lacerations depends on the abrasive material that is often placed on the string of the kite to increase its ability to cut. Injuries related to kite flying are preventable. Preventive measures include choosing a safe location and the need for increasing awareness about the possible effects of such a sport.
Gardner, Andrew; Iverson, Grant L; Stanwell, Peter
Traditional structural neuroimaging techniques are normal in athletes who sustain sport-related concussions and are only considered to be clinically helpful in ruling out a more serious brain injury. There is a clinical need for more sophisticated, non-invasive imaging techniques capable of detecting changes in neurophysiology after injury. Concussion is associated with neurometabolic changes including neuronal depolarization, release of excitatory neurotransmitters, ionic shifts, changes in glucose metabolism, altered cerebral blood flow, and impaired axonal function. Proton magnetic resonance spectroscopy ((1)H-MRS, or simply MRS) is capable of measuring brain biochemistry and has the potential to identify and quantify physiologic changes after concussion. The focus of the current review is to provide an overview of research findings using MRS in sport-related concussion. A systematic review of articles published in the English language, up to February 2013, was conducted. Articles were retrieved via the databases: PsychINFO, Medline, Embase, SportDiscus, Scopus, Web of Science, and Informit using key terms: magnetic resonance spectroscopy, nuclear magnetic resonance spectroscopy, neurospectroscopy, spectroscopy, two-dimensional nuclear magnetic resonance spectroscopy, correlation spectroscopy, J-spectroscopy, exchange spectroscopy, nuclear overhauser effect spectroscopy, NMR, MRS, COSY, EXSY, NOESY, 2D NMR, craniocerebral trauma, mild traumatic brain injury, mTBI, traumatic brain injury, brain concussion, concussion, brain damage, sport, athletic, and athlete. Observational, cohort, correlational, cross-sectional, and longitudinal studies were all included in the current review. The review identified 11 publications that met criteria for inclusion, comprised of data on 200 athletes and 116 controls. Nine of 11 studies reported a MRS abnormality consistent with an alteration in neurochemistry. The results support the use of MRS as a research tool for identifying
AlRuhaimi, Khalid A.; Sailer, Hermann F.
In this study seventeen patients with neurofibromatosis in the maxillofacial region were presented. There was no great difference in the incidence of the disease between males and females. The patient age range was 1 to 75 years with a mean age of 21.5 years. Family history was positive in 5 cases. The spectrum of the clinical manifestations of this disease, known for its protean characteristics, were evident in all of our 17 patients. 14 (82.4%) patients had cafeau-lait spots; 3 (1 7.6%) had multiple cutaneous nodules; malignant transformation was documented in only one case (5.9%). Psychologic depression was recorded in 2 (11.8%) ceases, and one(5.9%) case had grand-mal epilepsy. A rare location of neurofibromatous nodules, i.e. in eye (iris nodules), was reported in only one (5.9%) case. The most frequently performed procedure in our cases was excision of the tumor mass which was, in most instances, incomplete. However, massive bleeding during surgical intervention was prominent in four cases and was overcome with extensive packing removed after approximately two weeks. An interesting finding in this study was the incidence of radiologic findings which was higher (76.4%) than previously reported. All cases of this study were unilateral and involvement of the mandible (65%) was more than that of the maxillae. (author)
You, Dong Soo
The author has studied maxillo-facial anatomical landmarks using Status X with two methods. The one has performed by application of contrast media on the human dry skull, the other has performed on living human skull as control group. Comparing the panagraphs taken by two methods, the author has drawn following results: 1. The panagraphs revealed the undistorted highly sharp panoramic shadows of each jaw on a film. 2. Diminishing the inserted anode tube to 4 cm (focal incisor distance 3 cm), overlapping-free representation of the in terdental spaces of the premolars and anterior teeth was taken. 3. Alternating the head position of the objects, direction of anode tube and film placing, the shadows of temporomandibular joint and zygomatic arch were taken without overlapping the other bone tissues. 4. In the panagraphs applied various shaped contrast media to each anatomical landmark, a radio-anatomical atlas which is necessary to interpret various bone tissues was taken. 5. In order to interpret panagraphic shadows easily, the author has tried this study by comparing the films of the living human skull with the films of the human dry skull applied contrast media.
Chetan B Raval
Full Text Available Background: Airway management in maxillofacial injuries presents with a unique set of problems. Compromised airway is still a challenge to the anesthesiologist in spite of all modalities available. Maxillofacial injuries are the result of high-velocity trauma arising from road traffic accidents, sport injuries, falls and gunshot wounds. Any flaw in airway management may lead to grave morbidity and mortality in prehospital or hospital settings and as well as for reconstruction of fractures subsequently. Methods: One hundred and seventy-seven patients of maxillofacial injuries, operated over a period of one and half years during July 2008 to December 2009 in Al-Nahdha hospital were reviewed. All patients were reviewed in depth with age related type of injury, etiology and techniques of difficult airway management. Results: The major etiology of injuries were road traffic accidents (67% followed by sport (15% and fall (15%. Majority of patients were young in the age group of 11-30 years (71 %. Fracture mandible (53% was the most common injury, followed by fracture maxilla (21%, fracture zygoma (19% and pan-facial fractures (6%. Maxillofacial injuries compromise mask ventilation and difficult airway due to facial fractures, tissue edema and deranged anatomy. Shared airway with the surgeon needs special attention due to restrictions imposed during surgery. Several methods available for securing the airway, both decision-making and performance, are important in such circumstances. Airway secured by nasal intubation with direct visualization of vocal cords was the most common (57%, followed by oral intubation (17%. Other methods like tracheostomy and blind nasal intubation was avoided by fiberoptic bronchoscopic nasal intubation in 26% of patients. Conclusion: The results of this study indicated that surgically securing the airway by tracheostomy should be revised compared to other available methods. In the era of rigid fixation of fractures and the
Jennifer K. Wagner
Full Text Available Sports-related genetic testing is a sector of the diverse direct-to-consumer (DTC industry that has not yet been examined thoroughly by academic scholars. A systematic search was used to identify companies in this sector and content analysis of online information was performed. More than a dozen companies were identified. Marketing practices observed generally did not target parents for child testing, and marketing images were mild compared to images used in popular media. Information was provided at a high reading level (industry-wide Flesh-Kincaid Grade Levels > 11. While ~75% of companies provide privacy policies and terms of service prior to purchase and ~40% provide scientific citations for their tests,
Wagner, Jennifer K.; Royal, Charmaine D.
Sports-related genetic testing is a sector of the diverse direct-to-consumer (DTC) industry that has not yet been examined thoroughly by academic scholars. A systematic search was used to identify companies in this sector and content analysis of online information was performed. More than a dozen companies were identified. Marketing practices observed generally did not target parents for child testing, and marketing images were mild compared to images used in popular media. Information was provided at a high reading level (industry-wide Flesh-Kincaid Grade Levels > 11). While ~75% of companies provide privacy policies and terms of service prior to purchase and ~40% provide scientific citations for their tests, e-commerce generally may adequately protect DTC genetics consumers without new federal legislation or regulation. PMID:25562204
Ellis, Michael J; McDonald, Patrick J; Cordingley, Dean; Mansouri, Behzad; Essig, Marco; Ritchie, Lesley
The decision to advise an athlete to retire from sports following sports-related concussion (SRC) remains a persistent challenge for physicians. In the absence of strong empirical evidence to support recommendations, clinical decision making must be individualized and should involve a multidisciplinary team of experts in concussion and traumatic brain injury. Although previous authors have advocated for a more conservative approach to these issues in child and adolescent athletes, there are few reports outlining considerations for this process among this unique population. Here, the authors use multiple case illustrations to discuss 3 subgroups of clinical considerations for sports retirement among pediatric SRC patients including the following: those with structural brain abnormalities identified on neuroimaging, those presenting with focal neurological deficits and abnormalities on physical examination, and those in whom the cumulative or prolonged effects of concussion are suspected or demonstrated. The authors' evolving multidisciplinary institutional approach to return-to-play and retirement decision making in pediatric SRC is also presented.
Ellis, Michael J; Cordingley, Dean M; Vis, Sara; Reimer, Karen M; Leiter, Jeff; Russell, Kelly
OBJECTIVE There were 2 objectives of this study. The first objective was to identify clinical variables associated with vestibulo-ocular dysfunction (VOD) detected at initial consultation among pediatric patients with acute sports-related concussion (SRC) and postconcussion syndrome (PCS). The second objective was to reexamine the prevalence of VOD in this clinical cohort and evaluate the effect of VOD on length of recovery and the development of PCS. METHODS A retrospective review was conducted for all patients with acute SRC and PCS who were evaluated at a pediatric multidisciplinary concussion program from September 2013 to May 2015. Acute SRS was defined as presenting concussion should include VOD. Additional research is needed to elucidate the natural history of VOD following SRC and establish evidence-based indications for targeted vestibular rehabilitation.
Asatryan, Babken; Vital, Cristina; Kellerhals, Christoph; Medeiros-Domingo, Argelia; Gräni, Christoph; Trachsel, Lukas D; Schmied, Christian M; Saguner, Ardan M; Eser, Prisca; Herzig, David; Bolliger, Stephan; Michaud, Katarzyna; Wilhelm, Matthias
In Switzerland, ECG screening was first recommended for national squad athletes in 1998. Since 2001 it has become mandatory in selected high-risk professional sports. Its impact on the rates of sports-related sudden cardiac death (SCD) is unknown. We aimed to study the incidence, causes and time trends of sports-related SCD in comparison to SCD unrelated to exercise in Switzerland. We reviewed all forensic reports of SCDs of the German-speaking region of Switzerland in the age group of 10 to 39 years, occurring between 1999 and 2010. Cases were classified into three categories based on whether or not deaths were associated with sports: no sports (NONE), recreational sports (REC), and competitive sports (COMP). Over the 12-year study period, 349 SCD cases were recorded (mean age 30±7 years, 76.5% male); 297 cases were categorized as NONE, 31 as REC, and 21 as COMP. Incidences of SCD per 100,000 person-years [mean (95% CI)] were the lowest in REC [0.43 (0.35-0.56)], followed by COMP [1.19 (0.89-1.60)] and NONE [2.46 (2.27-2.66)]. In all three categories, coronary artery disease (CAD) with or without acute myocardial infarction (MI) was the most common cause of SCD. Three professional athletes were identified in COMP category which all had SCD due to acute MI. There were no time trends, neither in overall, nor in cause-specific incidences of SCD. The incidence of SCD in young individuals in Switzerland is low, both related and unrelated to sports. In regions, like Switzerland, where CAD is the leading cause of SCD associated with competitions, screening for cardiovascular risk factors in addition to the current PPS recommendations might be indicated to improve detection of silent CAD and further decrease the incidence of SCD.
Feddermann-Demont, Nina; Echemendia, Ruben J; Schneider, Kathryn J; Solomon, Gary S; Hayden, K Alix; Turner, Michael; Dvořák, Jiří; Straumann, Dominik; Tarnutzer, Alexander A
Sport-related concussion (SRC) is a clinical diagnosis made after a sport-related head trauma. Inconsistency exists regarding appropriate methods for assessing SRC, which focus largely on symptom-scores, neurocognitive functioning and postural stability. Systematic literature review. MEDLINE, EMBASE, PsycINFO, Cochrane-DSR, Cochrane CRCT, CINAHL, SPORTDiscus (accessed July 9, 2016). Original (prospective) studies reporting on postinjury assessment in a clinical setting and evaluation of diagnostic tools within 2 weeks after an SRC. Forty-six studies covering 3284 athletes were included out of 2170 articles. Only the prospective studies were considered for final analysis (n=33; 2416 athletes). Concussion diagnosis was typically made on the sideline by an (certified) athletic trainer (55.0%), mainly on the basis of results from a symptom-based questionnaire. Clinical domains affected included cognitive, vestibular and headache/migraine. Headache, fatigue, difficulty concentrating and dizziness were the symptoms most frequently reported. Neurocognitive testing was used in 30/33 studies (90.9%), whereas balance was assessed in 9/33 studies (27.3%). The overall quality of the studies was considered low. The absence of an objective, gold standard criterion makes the accurate diagnosis of SRC challenging. Current approaches tend to emphasise cognition, symptom assessment and postural stability with less of a focus on other domains of functioning. We propose that the clinical assessment of SRC should be symptom based and interdisciplinary. Whenever possible, the SRC assessment should incorporate neurological, vestibular, ocular motor, visual, neurocognitive, psychological and cervical aspects. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Zhou, Jin; Heim, Derek; Levy, Andrew
Studies indicate that those participating in sports are a high-risk population for hazardous alcohol use. Previous research identifies psychosocial drivers underpinning this link between sports participation and risky drinking behavior; however, the evidence is restricted to cross-sectional prevalence studies. Theoretical evaluations suggest that psychologically constructed identities are a defining factor for behaviors in this context. Therefore, the present study sought to examine longitudinally the relationships among sports-related identities, well-being, and alcohol behaviors in those participating in sports. Respondents completed self-report questionnaires on their alcohol consumption, drinking motives, athlete identity (personal identity), sports group identification (social identity), and general well-being. A sample of 475 participants (male = 55.6%; mean age = 20.2 years) provided data at Time 1 for cross-sectional analysis. Longitudinal associations were conducted with 92 participants (male = 42.4%; mean age = 20.8 years) who provided follow-up data (Time 1 and 6 months later). Cross-sectional results revealed an association between social identity and alcohol consumption, which was fully mediated by positive reinforcement drinking motives. Correlation analysis found a significant positive relationship between Time 1 alcohol consumption and social identity 6 months later. Furthermore, social identity was positively associated with consumption, whereas athlete identity was negatively associated therewith. Finally, well-being was positively associated only with sports group identification over time. Our findings suggest that sport-related drinking may be an avenue for building group identification, and this identification is linked to well-being.
Luke, Anthony; Lazaro, Rondy M; Bergeron, Michael F; Keyser, Laura; Benjamin, Holly; Brenner, Joel; d'Hemecourt, Pierre; Grady, Matthew; Philpott, John; Smith, Angela
To examine the association between "overscheduling" and sports-related overuse and acute injuries in young athletes and to identify other potential contributing factors to create a working definition for "overscheduling injury." Survey. Six university-based sports medicine clinics in North America. Athletes aged 6 to 18 years (13.8 ± 2.6) and their parents and pediatric sports medicine-trained physicians. Questionnaires developed from literature review and expert consensus to investigate overscheduling and sports-related injuries were completed over a 3-month period. Physician's clinical diagnosis and injury categorization: acute not fatigue related (AI), overuse not fatigue related (OI), acute fatigue related (AFI), or overuse fatigue related (OFI). Overall, 360 questionnaires were completed (84% response rate). Overuse not fatigue-related injuries were encountered most often (44.7%), compared with AI (41.9%) and OFI (9.7%). Number of practices within 48 hours before injury was higher (1.7 ± 1.5) for athletes with OI versus those with AI (1.3 ± 1.4; P = 0.025). Athlete or parent perception of excessive play/training without adequate rest in the days before the injury was related to overuse (P = 0.016) and fatigue-related injuries (P = 0.010). Fatigue-related injuries were related to sleeping ≤6 hours the night before the injury (P = 0.028). When scheduling youth sporting events, potential activity volume and intensity over any 48-hour period, recovery time between all training and competition bouts, and potential between-day sleep time (≥ 7 hours) should be considered to optimize safety. An overscheduling injury can be defined as an injury related to excessive planned physical activity without adequate time for rest and recovery, including between training sessions/competitions and consecutive days.
Full Text Available In Switzerland, ECG screening was first recommended for national squad athletes in 1998. Since 2001 it has become mandatory in selected high-risk professional sports. Its impact on the rates of sports-related sudden cardiac death (SCD is unknown.We aimed to study the incidence, causes and time trends of sports-related SCD in comparison to SCD unrelated to exercise in Switzerland.We reviewed all forensic reports of SCDs of the German-speaking region of Switzerland in the age group of 10 to 39 years, occurring between 1999 and 2010. Cases were classified into three categories based on whether or not deaths were associated with sports: no sports (NONE, recreational sports (REC, and competitive sports (COMP.Over the 12-year study period, 349 SCD cases were recorded (mean age 30±7 years, 76.5% male; 297 cases were categorized as NONE, 31 as REC, and 21 as COMP. Incidences of SCD per 100,000 person-years [mean (95% CI] were the lowest in REC [0.43 (0.35-0.56], followed by COMP [1.19 (0.89-1.60] and NONE [2.46 (2.27-2.66]. In all three categories, coronary artery disease (CAD with or without acute myocardial infarction (MI was the most common cause of SCD. Three professional athletes were identified in COMP category which all had SCD due to acute MI. There were no time trends, neither in overall, nor in cause-specific incidences of SCD.The incidence of SCD in young individuals in Switzerland is low, both related and unrelated to sports. In regions, like Switzerland, where CAD is the leading cause of SCD associated with competitions, screening for cardiovascular risk factors in addition to the current PPS recommendations might be indicated to improve detection of silent CAD and further decrease the incidence of SCD.
Lin, Ann C; Salzman, Garrett A; Bachman, Shelby L; Burke, Rita V; Zaslow, Tracy; Piasek, Carolina Z; Edison, Bianca R; Hamilton, Anita; Upperman, Jeffrey S
Parents of young athletes play a major role in the identification and management of sports-related concussions. However, they are often unaware of the consequences of concussions and recommended management techniques. This study quantitatively assessed parental understanding of concussions to identify specific populations in need of additional education. We predicted that parents with increased education and prior sports- and concussion-related experience would have more knowledge and safer attitudes toward concussions. Cross-sectional survey. Level 5. Participants were parents of children brought to a pediatric hospital and 4 satellite clinics for evaluation of orthopaedic injuries. Participants completed a validated questionnaire that assessed knowledge of concussion symptoms, attitudes regarding diagnosis and return-to-play guidelines, and previous sports- and concussion-related experience. Over 8 months, 214 parents completed surveys. Participants scored an average of 18.4 (possible, 0-25) on the Concussion Knowledge Index and 63.1 (possible, 15-75) on the Concussion Attitude Index. Attitudes were safest among white women, and knowledge increased with income and education levels. Previous sports experience did not affect knowledge or attitudes, but parents who reported experiencing an undiagnosed concussion had significantly better concussion knowledge than those who did not. Parents with low income and education levels may benefit from additional concussion-related education. There exist many opportunities for improvement in parental knowledge and attitudes about pediatric sports-related concussions. Ongoing efforts to understand parental knowledge of concussions will inform the development of a strategic and tailored approach to the prevention and management of pediatric concussions.
Chorney, Stephen R; Suryadevara, Amar C; Nicholas, Brian D
We looked to determine the rates of audiovestibular symptoms following sports-related concussions among collegiate athletes. Further, we assessed the correlation between these symptoms and the time to return to participation in athletic activity. Retrospective analysis of the National Collegiate Athletic Association Injury Surveillance System (NCAA-ISS). The NCAA-ISS was queried from 2009 through 2014 for seven men's sports and eight women's sports across divisions 1, 2, and 3. Injuries resulting in concussions were analyzed for audiovestibular symptoms, duration of symptoms, and return to participation times. From 2009 to 2014, there were 1,647 recorded sports-related concussions, with athletes reporting dizziness (68.2%), imbalance (35.8%), disorientation (31.4%), noise sensitivity (29.9%), and tinnitus (8.5%). Concussion symptoms resolved within 1 day (17.1%), within 2 to 7 days (50.0%), within 8 to 30 days (25.9%), or persisted over 1 month (7.0%). Return to participation occurred within 1 week (38.3%), within 1 month (53.0%), or over 1 month (8.7%). Using Mann-Whitney U testing, overall symptom duration and return to competition time were significantly increased when any of these symptoms were present (P concussion symptom correlated with dizziness (P = 0.043) and noise sensitivity (P = 0.000), whereas return to participation times correlated with imbalance (P = 0.011) and noise sensitivity (P = 0.000). Dizziness and imbalance (odds ratio: 4.15, confidence interval: 3.20-5.38, P concussions. Dizziness and noise sensitivity correlated with the duration of concussive symptoms, whereas imbalance and noise sensitivity was correlated with prolonged return to competition time. 4. Laryngoscope, 127:2850-2853, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.
Tetteh, Sophia; Bibb, Richard J; Martin, Simon J
This study reviewed the current state of maxillofacial rehabilitation in resource-limited nations. A rigorous literature review was undertaken using several technical and clinical databases using a variety of key words pertinent to maxillofacial prosthetic rehabilitation and resource-limited areas. In addition, interviews were conducted with researchers, clinicians and prosthetists that had direct experience of volunteering or working in resource-limited countries. Results from the review and interviews suggest rehabilitating patients in resource-limited countries remains challenging and efforts to improve the situation requires a multifactorial approach. In conclusion, public health awareness programmes to reduce the causation of injuries and bespoke maxillofacial prosthetics training programmes to suit these countries, as opposed to attempting to replicate Western training programmes. It is also possible that usage of locally sourced and cheaper materials and the use of low-cost technologies could greatly improve maxillofacial rehabilitation efforts in these localities. Implications for Rehabilitation More information and support needs to be provided to maxillofacial defect/injuries patients and to their families or guardians in a culturally sensitive manner by governments. The health needs, economic and psychological needs of the patients need to be taken into account during the rehabilitation process by clinicians and healthcare organizations. The possibility of developing training programs to suit these resource limited countries and not necessarily follow conventional fabrication methods must be looked into further by educational entities.
Matsui, Yoshiro [Showa Univ., Tokyo (Japan). School of Dentistry
Osseointegrated implants have begun to be used not only in general practice in dentistry but also in various clinical situations in the maxillofacial region. The process has yielded three problems: the spread of application, new materials and diagnostic methods, and management for difficult situations. This paper presents basic data and clinical guidelines for new applications, it investigates the characteristics of the materials and the usefulness of a new diagnostic method, and it studies effective techniques for difficult cases. The results obtained are as follows: Investigations into the spreading application. The lateral and superior orbital rim have sufficient bone thickness and width for the implant body to be placed. Osseointegrated implants, especially by the fixed bridge technique, are not recommended in the craniofacial bone and jaws of young children. Implant placement into bone after/before irradiation must be performed in consideration of impaired osteogenesis, the decrease of trabecular bone, and the time interval between implantation and irradiation. Investigations into materials and diagnostic methods. Hydroxyapatite-coated and titanium implants should be selected according to the characteristics of the materials. A dental simulating soft may also be applicable in the craniofacial region. Investigations into the management of difficult cases. Hyperbaric oxygen therapy (HBO), bone morphogenetic protein (BMP), and tissue engineering should be useful for improving the quality and increasing the quantity of bone where implants are placed. Soft tissue around implants placed in the reconstructed area should be replaced with mucosal tissue. The data obtained here should be useful for increasing the efficiency of osseointegrated implants, but further basic research is required in the future. (author)
Osseointegrated implants have begun to be used not only in general practice in dentistry but also in various clinical situations in the maxillofacial region. The process has yielded three problems: the spread of application, new materials and diagnostic methods, and management for difficult situations. This paper presents basic data and clinical guidelines for new applications, it investigates the characteristics of the materials and the usefulness of a new diagnostic method, and it studies effective techniques for difficult cases. The results obtained are as follows: Investigations into the spreading application. The lateral and superior orbital rim have sufficient bone thickness and width for the implant body to be placed. Osseointegrated implants, especially by the fixed bridge technique, are not recommended in the craniofacial bone and jaws of young children. Implant placement into bone after/before irradiation must be performed in consideration of impaired osteogenesis, the decrease of trabecular bone, and the time interval between implantation and irradiation. Investigations into materials and diagnostic methods. Hydroxyapatite-coated and titanium implants should be selected according to the characteristics of the materials. A dental simulating soft may also be applicable in the craniofacial region. Investigations into the management of difficult cases. Hyperbaric oxygen therapy (HBO), bone morphogenetic protein (BMP), and tissue engineering should be useful for improving the quality and increasing the quantity of bone where implants are placed. Soft tissue around implants placed in the reconstructed area should be replaced with mucosal tissue. The data obtained here should be useful for increasing the efficiency of osseointegrated implants, but further basic research is required in the future. (author)
Chorney, Stephen R; Sobin, Lindsay; Goyal, Parul; Suryadevara, Amar C
Participation in National Collegiate Athletic Association (NCAA) sports increases annually, yet the risk of maxillofacial injuries among these athletes is unknown. We report the incidence and trends in maxillofacial injuries among NCAA athletes. Retrospective study of the NCAA Injury Surveillance System (ISS) representing athletes from seven men's and eight women's sports across Divisions 1, 2, and 3. Incidence of maxillofacial injuries by sport, gender, anatomic location, and injuries requiring surgery were measured. Athlete exposure data from 2004 to 2005 through 2013 to 2014 were analyzed, along with maxillofacial injuries recorded in the NCAA-ISS. There were 2,017 injuries recorded, which projects to 41,204 injuries from 202,087,229 athlete events, or 2.04 injuries per 10,000 athlete events (95% confidence interval [CI], 1.68 to 2.40). Women had higher injury rates, 2.06 versus 2.03 (P = 0.016 [95% CI 0.22 to 2.09]). Highest rates were noted in men's wrestling 7.02 (95% CI, 2.84 to 11.19) and men's basketball 4.80 (95% CI, 3.57 to 6.02), and were lowest in women's ice hockey 0.61 (95% CI, 0.17 to 1.06) and women's volleyball 0.43 (95% CI, 0.20 to 0.66). No gender differences in fractures or need for surgery, but men sustained more operative fractures, 27.85% versus 17.04% (P = 0.035 [95% CI, 0.79 to 20.82]). Men's football, women's ice hockey, women's volleyball, and women's gymnastics had consistently low fracture rates. Maxillofacial injuries represent approximately 3.4% of all injuries sustained by NCAA athletes. Women had a higher injury rate, whereas men had a higher rate of operative facial fractures. Awareness and improved facial protection, especially among noncontact sports, will be crucial in reducing the incidence of these injuries. 4. Laryngoscope, 127:1296-1301, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.
Despite advancements in medicine odontogenic maxillofacial infections are still prevalent in Lithuania. This pathology can be life threatening, and challenging in treatment. There have been no previous national Lithuanian studies about odontogenic maxillofacial infections. The present work evaluated different aspects related to management of Lithuanian patients with acute odontogenic maxillofacial infections (AOMI). This clinical study examined different AOMI-related determinants (social, cli...
Einy, Shmuel; Abdel Rahman, Nura; Siman-Tov, Maya; Aizenbud, Dror; Peleg, Kobi
Motor vehicle accidents (MVA) and falls are major causes of maxillofacial injuries posing real challenges for the medical staff. To describe the demographic and injury characteristics, as well as the treatment procedures of casualties diagnosed with maxillofacial injuries. The investigators implemented a multicenter retrospective study composed of hospitalized maxillofacial trauma patients recorded in the Israel Trauma Registry for 2000 to 2011. The predictor variable was mechanism of injury and the outcome variable was type of injury, severity, and hospital resources utilization. Descriptive and bivariate statistics with P values was set at 0.05. The study included 11,592 reported hospitalized maxillofacial trauma patients (39.4% of them were MVA, 33.5% were falls), with a male predominance of a 3:1 ratio. The high-risk age groups were the first 3 decades of life in both etiologies, while age groups above 75 years were also frequent in falls. Severity of maxillofacial injuries, multiple injuries, admission to intensive care units, hospitalization for more than 15 days, inpatient mortality, and rehabilitation after discharge was significantly higher in MVA compared with falls. Conversely, maxillofacial surgeries were performed slightly more among patients injured in falls (34.1% and 31.1% respectively), as tongue and mouth are more prone targets in falls, compared with zygoma, maxilla, mandible, and teeth in MVA. The results of this study suggest that the etiologies present an entire separate pattern of trauma. A better understanding and proper identification of their high-risk groups should lead to appropriate prevention programs and treatment protocols.
Shakib, Kaveh; Tan, Aaron; Soskic, Vukic; Seifalian, Alexander M
Regenerative nanotechnology is at the forefront of medical research, and translational medicine is a challenge to both scientists and clinicians. Although there has been an exponential rise in the volume of research generated about it for both medical and surgical uses, key questions remain about its actual benefits. Nevertheless, some people think that therapeutics based on its principles may form the core of applied research for the future. Here we give an account of its current use in oral and maxillofacial surgery, and implications and challenges for the future. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
M.R. Ramesh Babu
Full Text Available Deep vein thrombosis (DVT is caused by obstruction of blood flow of deep veins in upper and lower limb. One of the precipitating factors for DVT is surgery under general anesthesia exceeding 30 min. However, there are very few reports of DVT associated with surgery of oral and maxillofacial region. In this paper we report two cases of DVT involving left ilio-femoropopliteal deep vein in one patient treated for fractured left angle of mandible and left peroneal vein in the other patient treated for oral sub mucous fibrosis. Clinical and color Doppler examination were performed to diagnose the condition and were referred to vascular surgical unit of higher institute for further management. These cases illustrates any surgery of maxillofacial region is not free from risk of DVT, which can cause fatal pulmonary thromboembolism.
Babu, M R Ramesh; Ramesh, C; Thirumurugan, K; Prasad, G Arun
Deep vein thrombosis (DVT) is caused by obstruction of blood flow of deep veins in upper and lower limb. One of the precipitating factors for DVT is surgery under general anesthesia exceeding 30 min. However, there are very few reports of DVT associated with surgery of oral and maxillofacial region. In this paper we report two cases of DVT involving left ilio-femoropopliteal deep vein in one patient treated for fractured left angle of mandible and left peroneal vein in the other patient treated for oral sub mucous fibrosis. Clinical and color Doppler examination were performed to diagnose the condition and were referred to vascular surgical unit of higher institute for further management. These cases illustrates any surgery of maxillofacial region is not free from risk of DVT, which can cause fatal pulmonary thromboembolism.
Manodh, P; Prabhu Shankar, D; Pradeep, Devadoss; Santhosh, Rajan; Murugan, Aparna
Maxillofacial fractures occur in a significant proportion worldwide and can occur as an isolated injury or in combination with other severe injuries including cranial, spinal, and upper and lower body injuries requiring prompt diagnosis with possible emergency interventions. The epidemiology of facial fractures varies with regard to injury type, severity, and cause and depends on the population studied. Hence, understanding of these factors can aid in establishing clinical and research priorities for effective treatment and prevention of these injuries. In this present retrospective study, we provide a comprehensive overview regarding cranio-maxillofacial trauma on 3611 patients to assist the clinician in assessment and management of this unique highly specialized area of traumatology. A preformed pro forma was used to analyze the medical records of patients treated for facial trauma in The Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai. The distribution according to age, gender, etiology, type of injury, time interval between accident and treatment, loss of consciousness, facial bones involved, pattern of fracture lines, treatment offered, and postoperative complications were recorded and evaluated. We inferred male patients sustained more injuries mostly in the third decade of age. Road traffic accidents were the most common cause of injury. Mandible was the most commonly fractured bone in the facial skeleton. Soft tissue injuries occurred more in road traffic accidents and upper lip was the commonest site of injury. Our study provides insights into the epidemiology of facial injuries and associated factors and can be useful not only in developing prevention strategies but also for grading the existing legal regulations and also for framing a more effective treatment protocol.
Poorian, Behnaz; Bemanali, Mehdi; Chavoshinejad, Mohammad
Objective: To evaluate sensorimotor nerve damage in patients with maxillofacial trauma referring to Taleghani hospital, Tehran, Iran Methods: This cross-sectional study was conducted during a 2-year period from 2014 to 2012 in Taleghani hospital of Tehran. We included a total number of 495 patients with maxillofacial trauma referring to our center during the study period. The demographic information, type of fracture, location of fracture and nerve injuries were assessed and recorded in each patients. The frequency of sensorimotor injuries in these patients was recorded. Data are presented as frequencies and proportions as appropriate. Results: Overall we included 495 patients with maxillofacial trauma with mean age of 31.5±13.8 years. There were 430 (86.9% men and in 65 (13.1%) women among the patients. The frequency of nerve injuries was 67.7% (336 patients). The mean age of the patients with nerve injuries was 33.4 ± 3.7 years. Marginal mandibular branch of facial nerve was the most common involved nerve being involved in 5 patients (1%). Regarding trigeminal nerve, the inferior alveolar branch (194 patients 39.1%) was the most common involved branch followed by infraorbital branch (135 patients 27.2%). Mandibular fracture was the most common injured bone being reported in 376 patient (75.9%) patients followed by zygomatic bone in 100 patient (20%). Conclusion: The most frequent fracture occurred in mandible followed by zygoma and the most injured nerve was inferior alveolar nerve followed by infraorbital branch of trigeminal nerve. In facial nerve the marginal branch was the most involved nerve. The frequency of nerve injury and the male to female ratio was higher in the current study compared to the literature. PMID:27331065
Jin, Zuolin; Jiang, Xun; Shang, Lei
Maxillofacial-oral injuries is a serious health problem in China. The main aetiologic factors and types of maxillofacial-oral injuries differ according to different geographical areas and socio-economic statuses of populations in different countries or within the same country. The aim of this study was to analyze the types and external causes of maxillofacial-oral injuries among hospitalized patients in Xi'an, China, and thereafter to determine the status of maxillofacial-oral injuries in this region and to provide clinical clues for a future prevention of these injuries. Totally, 627 patients aged 3-64 years with maxillofacial-oral injuries, who were hospitalized in two public stomatological hospitals in Xi'an from 1 January 2008 to 31 December 2008, were included in this study. The types and external causes of injuries were analyzed in terms of age, gender and urban and rural location. The results showed that jaw fractures (n = 406, 64.8%) and contusion/laceration injuries (n = 161, 25.7%) were the most frequent injuries. Injuries were 4.6 times more common in males than in females. Most maxillofacial-oral injuries occurred in those aged 18-59 years (71.1%), with a peak incidence in the 15- to 39-year-old group (31.4%). The proportion of patients from urban areas (45.5%) was lower than that from rural areas (54.4%). Regardless of gender, age and location, vehicle traffic accidents was the most common cause (n = 263, 41.9%), followed by falls (n = 109, 17.2%) and fighting-induced injuries (n = 87, 13.9%). Preventive strategies for maxillofacial-oral injuries due to traffic accidents should be emphasized and promoted in the first hand, especially for males, rural residents and those aged between 18 and 59 years. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Jarosz, Krystian F; Ziccardi, Vincent B; Aziz, Shahid R; Sue-Jiang, Shuying
fracture repair. Almost all the dental classes believed that the specialty of OMS was both medical and dental in nature and that it is a very important dental specialty. Dental student perceptions of OMS change throughout their undergraduate training. The reasons for such a change are multivariate and might include factors such as the amount of didactic training and clinical exposure. It is vital to both recognize and address this change at an undergraduate level of training in an effort to increase educated referrals to a surgeon who might provide the best treatment options for the patient. A stronger understanding of the dental students' perception of OMS provides an opportunity for the oral and maxillofacial academic faculty to better educate students and, ultimately, strengthen our specialty. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Shellock, F G; Prentice, W E
Competitive and recreational athletes typically perform warm-up and stretching activities to prepare for more strenuous exercise. These preliminary activities are used to enhance physical performance and to prevent sports-related injuries. Warm-up techniques are primarily used to increase body temperature and are classified in 3 major categories: (a) passive warm-up - increases temperature by some external means; (b) general warm-up - increases temperature by nonspecific body movements; and (c) specific warm-up - increases temperature using similar body parts that will be used in the subsequent, more strenuous activity. The best of these appears to be specific warm-up because this method provides a rehearsal of the activity or event. The intensity and duration of warm-up must be individualised according to the athlete's physical capabilities and in consideration of environmental factors which may alter the temperature response. The majority of the benefits of warm-up are related to temperature-dependent physiological processes. An elevation in body temperature produces an increase in the dissociation of oxygen from haemoglobin and myoglobin, a lowering of the activation energy rates of metabolic chemical reactions, an increase in muscle blood flow, a reduction in muscle viscosity, an increase in the sensitivity of nerve receptors, and an increase in the speed of nervous impulses. Warm-up also appears to reduce the incidence and likelihood of sports-related musculoskeletal injuries. Improving flexibility through stretching is another important preparatory activity that has been advocated to improve physical performance. Maintaining good flexibility also aids in the prevention of injuries to the musculoskeletal system. Flexibility is defined as the range of motion possible around a specific joint or a series of articulations and is usually classified as either static or dynamic. Static flexibility refers to the degree to which a joint can be passively moved to the
Ravdin, Lisa D; Barr, William B; Jordan, Barry; Lathan, William E; Relkin, Norman R
To prospectively examine recovery of cognitive function within one month following subconcussive sports related head trauma. A prospective study of New York State licensed professional boxers who underwent testing of cognitive functioning before and after (within days, one week, and one month) a professional bout. Male professional athletes recruited from the New York State Athletic Commission and local boxing gyms. Twenty-six licensed professional boxers were enrolled in the protocol. Data is presented on the 18 participants who completed testing on at least three of the four time points. Serial neuropsychological assessment before and after the athletes engaged in competition. Neuropsychological measures of cognitive functioning, including new learning and memory, information processing speed, and mental flexibility. A series of repeated measures MANOVAS revealed significant within subject differences across testing on complex information processing and verbal fluency. Post hoc analyses indicated significant differences between time 1 (baseline) and time 4 (one month post), with scores one month following the bout indicating significantly improved performance. Memory scores did not change significantly across testing; however, prior boxing exposure measured by total number of professional bouts was associated with poorer memory performance. Cognitive testing one month following participation in a professional boxing bout yielded scores suggestive of recovery to a level above the baseline. We conclude that baseline assessment taken during periods of intense training are likely confounded by other pre-bout conditions (i.e., sparring, rapid weight loss, pre-bout anxiety) and do not represent true baseline abilities. Instability of performance associated with mild head injury may complicate the interpretation of post-injury assessments. Practice effects may also confound the interpretation of serial assessments, leading to underestimation of the effects of sports
Weber, Michelle L.; Welch, Cailee E.; Parsons, John T.; Valovich McLeod, Tamara C.
The purpose of this study was to evaluate school nurses' familiarity and perceptions regarding academic accommodations for student-athletes following sport-related concussion. School nurses (N = 1,246) accessed the survey School Nurses' Beliefs, Attitudes and Knowledge of Pediatric Athletes with Concussions (BAKPAC-SN). The BAKPAC-SN contained…
Fracture of the nose; Broken nose; Nasal fracture; Nasal bone fracture; Nasal septal fracture ... A fractured nose is the most common fracture of the face. It most ... occurs with other fractures of the face. Nose injuries and neck ...
Pavlíková, G.; Foltán, R.; Horká, M.; Hanzelka, T.; Borunská, H.; Šedý, Jiří
Roč. 40, č. 5 (2011), s. 451-457 ISSN 0901-5027 Institutional research plan: CEZ:AV0Z50390703 Keywords : piezosurgery * oral surgery * maxillofacial surgery Subject RIV: FJ - Surgery incl. Transplants; FH - Neurology (UEM-P) Impact factor: 1.506, year: 2011
Feb 2, 2011 ... were sarcomas among which 16% were found in the head and neck region (4). A clinico-pathologic study by Adebayo et al in Nigeria reported that 20% of maxillofacial malignancies were sarcomas with a slight female to male predilection of 1.3:1 (5,6). Bone sarcomas: Osteosarcoma is the most common.
Halstead, Mark E; Walter, Kevin D
Sport-related concussion is a "hot topic" in the media and in medicine. It is a common injury that is likely underreported by pediatric and adolescent athletes. Football has the highest incidence of concussion, but girls have higher concussion rates than boys do in similar sports. A clear understanding of the definition, signs, and symptoms of concussion is necessary to recognize it and rule out more severe intracranial injury. Concussion can cause symptoms that interfere with school, social and family relationships, and participation in sports. Recognition and education are paramount, because although proper equipment, sport technique, and adherence to rules of the sport may decrease the incidence or severity of concussions, nothing has been shown to prevent them. Appropriate management is essential for reducing the risk of long-term symptoms and complications. Cognitive and physical rest is the mainstay of management after diagnosis, and neuropsychological testing is a helpful tool in the management of concussion. Return to sport should be accomplished by using a progressive exercise program while evaluating for any return of signs or symptoms. This report serves as a basis for understanding the diagnosis and management of concussion in children and adolescent athletes.
King, Doug; Brughelli, Matt; Hume, Patria; Gissane, Conor
Sport-related concussions are a subset of mild traumatic brain injuries and are a concern for many sporting activities worldwide. To review and update the literature in regard to the history, pathophysiology, recognition, assessment, management and knowledge of concussion. Searches of electronic literature databases were performed to identify studies published up until April 2013. 292 publications focussing on concussion met the inclusion criteria, and so they were quality rated and reviewed. Concussion is hard to recognize and diagnose. Initial sideline assessment via the Sports Concussion Assessment Tool 3 (SCAT3), Child-SCAT3 or King-Devick test should be undertaken to identify athletes with concussion as part of a continuum of assessment modalities and athlete management. Sports medicine practitioners should be cognisant of the definition, extent and nature of concussion, and should work with coaches, athletes and trainers to identify and manage concussions. The most common reason for variations in management of concussion is lack of awareness of-and confusion about-the many available published guidelines for concussion. Future research should focus on better systems and tools for recognition, assessment and management of concussion. Sport participants' knowledge of concussion should be evaluated more rigorously, with interventions for sports where there is little knowledge of recognition, assessment and appropriate management of concussion.
Participation in high school sports helps promote a physically active lifestyle. High school sports participation has grown from an estimated 4 million participants during the 1971-72 school year to an estimated 7.2 million in 2005-06. However, despite the documented health benefits of increased physical activity (e.g., weight management, improved self-esteem, and increased strength, endurance, and flexibility), those who participate in athletics are at risk for sports-related injuries. High school athletes account for an estimated 2 million injuries, 500,000 doctor visits, and 30,000 hospitalizations annually. To date, the study of these injuries has been limited by inabilities to calculate injury rates, compare results among groups, and generalize findings from small, nonrepresentative samples. During the 2005-06 school year, researchers at a children's hospital in Ohio used an Internet-based data-collection tool to pilot an injury surveillance system among athletes from a representative national sample of U.S. high schools. This report summarizes the findings of that study, which indicated that participation in high school sports resulted in an estimated 1.4 million injuries at a rate of 2.4 injuries per 1,000 athlete exposures (i.e., practices or competitions). Surveillance of exposure-based injury rates in a nationally representative sample of high school athletes and analysis of injury patterns can help guide activities aimed at reducing these injuries.
Schneider, Kathryn J; Leddy, John J; Guskiewicz, Kevin M; Seifert, Tad; McCrea, Michael; Silverberg, Noah D; Feddermann-Demont, Nina; Iverson, Grant L; Hayden, Alix; Makdissi, Michael
The objective of this systematic review was to evaluate the evidence regarding rest and active treatment/rehabilitation following sport-related concussion (SRC). Systematic review. MEDLINE (OVID), CINAHL (EbscoHost), PsycInfo (OVID), Cochrane Central Register of Controlled Trials (OVID), SPORTDiscus (EbscoHost), EMBASE (OVID) and Proquest DissertationsandTheses Global (Proquest) were searched systematically. Studies were included if they met the following criteria: (1) original research; (2) reported SRC as the diagnosis; and (3) evaluated the effect of rest or active treatment/rehabilitation. Review articles were excluded. Twenty-eight studies met the inclusion criteria (9 regarding the effects of rest and 19 evaluating active treatment). The methodological quality of the literature was limited; only five randomised controlled trials (RCTs) met the eligibility criteria. Those RCTs included rest, cervical and vestibular rehabilitation, subsymptom threshold aerobic exercise and multifaceted collaborative care. A brief period (24-48 hours) of cognitive and physical rest is appropriate for most patients. Following this, patients should be encouraged to gradually increase activity. The exact amount and duration of rest are not yet well defined and require further investigation. The data support interventions including cervical and vestibular rehabilitation and multifaceted collaborative care. Closely monitored subsymptom threshold, submaximal exercise may be of benefit. PROSPERO 2016:CRD42016039570. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Resch, Jacob E; McCrea, Michael A; Cullum, C Munro
Since the late nineties, computerized neurocognitive testing has become a central component of sport-related concussion (SRC) management at all levels of sport. In 2005, a review of the available evidence on the psychometric properties of four computerized neuropsychological test batteries concluded that the tests did not possess the necessary criteria to warrant clinical application. Since the publication of that review, several more computerized neurocognitive tests have entered the market place. The purpose of this review is to summarize the body of published studies on psychometric properties and clinical utility of computerized neurocognitive tests available for use in the assessment of SRC. A review of the literature from 2005 to 2013 was conducted to gather evidence of test-retest reliability and clinical validity of these instruments. Reviewed articles included both prospective and retrospective studies of primarily sport-based adult and pediatric samples. Summaries are provided regarding the available evidence of reliability and validity for the most commonly used computerized neurocognitive tests in sports settings.
Odom, Mitchell J; Lee, Young M; Zuckerman, Scott L; Apple, Rachel P; Germanos, Theodore; Solomon, Gary S; Sills, Allen K
This study evaluated the test-retest reliability of a novel computer-based, portable balance assessment tool, the Equilibrate System (ES), used to diagnose sports-related concussion. Twenty-seven students participated in ES testing consisting of three sessions over 4 weeks. The modified Balance Error Scoring System was performed. For each participant, test-retest reliability was established using the intraclass correlation coefficient (ICC). The ES test-retest reliability from baseline to week 2 produced an ICC value of 0.495 (95% CI, 0.123-0.745). Week 2 testing produced ICC values of 0.602 (95% CI, 0.279-0.803) and 0.610 (95% CI, 0.299-0.804), respectively. All other single measures test-retest reliability values produced poor ICC values. Same-day ES testing showed fair to good test-retest reliability while interweek measures displayed poor to fair test-retest reliability. Testing conditions should be controlled when using computerized balance assessment methods. ES testing should only be used as a part of a comprehensive assessment.
McCrory, P R; Berkovic, S F
To describe the motor and convulsive manifestations in acute sports-related head injury. A total of 234 cases of concussive injuries during the 1995 through 1997 football seasons were obtained from the Australian Football League Medical Officers Association injury survey. Of these, 102 cases were recorded adequately on television videotape and were analyzed by two independent observers using a standardized recording form detailing injury mechanics and clinical features of the episodes. Motor and convulsive features were correlated with mechanical variables and with duration of loss of consciousness using linear modeling techniques. Tonic posturing occurred in 25 subjects, clonic movements in 6, righting movement in 40, and gait unsteadiness in 42. In one subject the tonic and clonic features were sufficiently prolonged to be deemed a concussive convulsion. The only risk factor for tonic posturing using logistic regression was the presence of loss of consciousness (p = 0.0001). There was a trend toward facial impact being an independent predictor of tonic posturing but this did not reach significance. No other independent variable predicted the development of clonic movements, righting movements, or gait unsteadiness. Subtle motor manifestations such as tonic posturing and clonic movements commonly occur in concussion; the main predictive factor for tonic posturing is the presence of loss of consciousness. The authors speculate that these clinical features are due to brainstem dysfunction secondary to biomechanical forces inducing a transient functional decerebration.
Full Text Available Objectives: Deterioration in postural control mechanisms is termed postural instability and results increased postural sway and many laboratory techniques and instruments are characterized by a wide range of neurological signs and symptoms to the medical management. Thus the current study designed to assess the reliability of commonly used clinical measures of balance and determined normal values. Also, the second purpose was scrutiny of effect age, length weight and body mass index (BMI on perform clinical balance tests. Methods: One hundred and thirty three participants (18-59 years, that have at least three time sports activity in one week, performed three timed tests: Time- up and Go (TUG, Tandem Gait (TG, and Walking on Balance Beam (WOBB on firm surface. Results: Reliability data were produced for each tests of motor performance. We found that the first performance of three trials was slower, and the relationship between some factors and these battery tests were examined. Means(±SD for each measure were averaged across three trials. Time to complete TG was 13.6±1.1s. TUG value was 6.9±1.03 and WOBB was 6.9±1.03s. Discussion: our results revealed that three clinical balance test batteries-TUG, TG and WOBB tests are the stability measures to assess of sports related concussion. Also, the results of current study appeared that the time to perform these tests was slower than the other studies.
Full Text Available Objectives: Deterioration in postural control mechanisms is termed postural instability and results increased postural sway and many laboratory techniques and instruments are characterized by a wide range of neurological signs and symptoms to the medical management. Thus the current study designed to assess the reliability of commonly used clinical measures of balance and determined normal values. Also, the second purpose was to evaluate the scrutiny of age, length weight and body mass index (BMI effects on performing clinical balance tests. Methods: One hundred and thirty three participants (18-59 years, that have at least three time sports activity in one week, performed three timed tests including Time-up and Go (TUG, Tandem Gait (TG, and Walking on Balance Beam (WOBB on firm surface. Results: Reliability data were produced for each tests of motor performance. We found that the first performance of three trials was slower, and the relationship between some factors and these battery tests were examined. Means(±SD for each measure were averaged across three trials. Time to complete TG was 13.6±1.1s. TUG value was 6.9±1.03 and WOBB was 6.9±1.03s. Discussion: our results revealed that three clinical balance test batteries-TUG, TG and WOBB tests are the stability measures to assess the sports related concussion. Also, the results of current study showed that the time to perform these tests was slower than the other studies.
Solomon, Gary S; Kuhn, Andrew W; Zuckerman, Scott L
Since its third iteration in 2008, the international Concussion in Sport Group (CISG) has delineated several 'modifying factors' that have the potential to influence the management of sport-related concussions (SRC). One of these factors is co- and pre-morbidities, which includes migraines, mental health disorders, attention-deficit hyperactive disorder (ADHD), learning disability, and sleep disorders. Mental health disorders, and in particular, depression, have received some attention in the management of SRC and in this review we summarize the empirical evidence for its inclusion as a modifying factor. This review is divided into three main bodies of findings: (1) the incidence and prevalence of depression and depressive symptoms in non-concussed and concussed athletes, with comparison made to the general population; (2) managing the post-concussion athlete and accounting for premorbid depressive symptoms; and (3) depression as a long-term effect of repetitive head trauma. Overall, it has been reported that certain subpopulations of athletes have similar or even higher rates of depressive symptoms when compared to the general population. The challenge of accounting for these baseline-depressive symptoms while managing the post-concussive athlete is stressed. And lastly, the prevalence of depression and its relationship to concussion in later-life is discussed.
Register-Mihalik, Johna; Baugh, Christine; Kroshus, Emily; Y Kerr, Zachary; Valovich McLeod, Tamara C
To offer an overview of sport-related concussion (SRC) prevention and education strategies in the context of the socioecological framework (SEF). Athletic trainers (ATs) will understand the many factors that interact to influence SRC prevention and the implications of these interactions for effective SRC education. Concussion is a complex injury that is challenging to identify and manage, particularly when athletes fail to disclose symptoms to their health care providers. Education is 1 strategy for increasing disclosure. However, limited information addresses how ATs can integrate the many factors that may influence the effectiveness of SRC education into their specific settings. Public health models provide an example through the SEF, which highlights the interplay among various levels of society and sport that can facilitate SRC prevention strategies, including education. For ATs to develop appropriate SRC prevention strategies, a framework for application is needed. A growing body of information concerning SRC prevention indicates that knowledge alone is insufficient to change concussion-related behaviors. The SEF allows this information to be considered at levels such as policy and societal, community, interpersonal (relationships), and intrapersonal (athlete). The use of such a framework will facilitate more comprehensive SRC prevention efforts that can be applied in all athletic training practice settings. Clinical Applications: Athletic trainers can use this information as they plan SRC prevention strategies in their specific settings. This approach will aid in addressing the layers of complexity that exist when developing a concussion-management policy and plan.
Iverson, Grant L; Lovell, Mark R; Collins, Michael W
The purpose of this study was to examine the validity of ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing), a computerized neuropsychological test battery, for measuring attention and processing speed in athletes with concussions. This was accomplished by comparing the computerized testing to a traditional neuropsychological measure, the Symbol Digit Modalities Test (SDMT). Participants were 72 amateur athletes who were seen within 21 days of sustaining a sports-related concussion (Mean = 9.4, SD = 5.4 days). As predicted, the SDMT correlated more highly with the Processing Speed and Reaction Time composites than the Verbal Memory and Visual Memory Composites from ImPACT. The composite scores from ImPACT and the SDMT were subjected to exploratory factor analysis, revealing a two-factor solution interpreted as Speed/Reaction Time and Memory. It appears as if the Processing Speed Composite, Reaction Time Composite, and SDMT are measuring a similar underlying construct in this sample of concussed amateur athletes.
Sandel, Natalie; Reynolds, Erin; Cohen, Paul E; Gillie, Brandon L; Kontos, Anthony P
Conceptual models for assessing and treating sport-related concussion (SRC) have evolved from a homogenous approach to include different clinical profiles that reflect the heterogeneous nature of this injury and its effects. There are six identified clinical profiles, or subtypes from SRC, and one such clinical profile is the anxiety/mood profile. Athletes with this profile experience predominant emotional disturbance and anxiety following SRC. The purpose of this targeted review was to present an overview of the empirical evidence to support factors contributing to the anxiety/mood profile, along with methods of evaluation and treatment of this clinical profile following SRC. We discuss the potential underlying mechanisms and risk factors for this clinical profile, describe comprehensive assessments to evaluate concussed athletes with an anxiety/mood clinical profile, and explore behavioral and other interventions for treating these athletes. Although there is limited, but growing empirical evidence for the anxiety/mood clinical profile following SRC, understanding this clinical profile is germane for clinicians who are treating athletes with emotional sequelae after SRC.
O'Dell, M Cody; Jaramillo, Diego; Bancroft, Laura; Varich, Laura; Logsdon, Gregory; Servaes, Sabah
With increasing participation and intensity of training in youth sports in the United States, the incidence of sports-related injuries is increasing, and the types of injuries are shifting. In this article, the authors review sports injuries of the lower extremity, including both acute and overuse injuries, that are common in or specific to the pediatric population. Common traumatic injuries that occur in individuals of all ages (eg, tears of the acetabular labrum and anterior cruciate ligament) are not addressed, although these occur routinely in pediatric sports. However, some injuries that occur almost exclusively in high-level athletes (eg, athletic pubalgia) are reviewed to increase awareness and understanding of these entities among pediatric radiologists who may not be familiar with them and thus may not look for them. Injuries are described according to their location (ie, hip, knee, or foot and ankle) and pathologic process (eg, apophysitis, osteochondritis dissecans). Examples of abnormalities and normal variants of the anatomy that are often misdiagnosed are provided. The injuries reviewed represent a common and growing subset of pathologic processes about which all pediatric and musculoskeletal radiologists should be knowledgeable. Understanding physeal injury is especially important because missed diagnoses can lead to premature physeal closure and osteoarthritis. © RSNA, 2016.
Myer, Gregory D.; Faigenbaum, Avery D.; Ford, Kevin R.; Best, Thomas M.; Bergeron, Michael F.; Hewett, Timothy E.
Regular participation in organized youth sports does not ensure adequate exposure to skill- and health-related fitness activities; and sport training without preparatory conditioning does not appear to reduce risk of injury in young athletes. Recent trends indicate that widespread participation in organized youth sports is occurring at a younger age, especially in girls. Current public health recommendations developed to promote muscle strengthening and bone building activities for youth aged 6 and older, along with increased involvement in competitive sport activities at younger ages, has increased interest and concern from parents, clinicians, coaches and teachers regarding the optimal age to encourage and integrate more specialized physical training into youth development programs. This review synthesizes the latest literature and expert opinion regarding when to initiate neuromuscular conditioning in youth and presents a how to integrative training conceptual model that could maximize the potential health-related benefits for children by reducing sports-related injury risk and encouraging lifelong regular physical activity. PMID:21623307
Trojian, Thomas H; Wang, David H; Leddy, John J
Concussions are common neurologic events that affect many athletes. Very little has been studied on the treatment of concussions with supplements and medications. The U.S. Food and Drug Administration (FDA) reminds us that no supplement has been proven to treat concussions. Many animal studies show that supplements have potential for improving the effects of a brain injury but none have been shown to be of consistent benefit in human studies. Animal studies on severe traumatic brain injury (TBI) may not therefore be applicable transfer to sports-related concussions (SRC).Of the many supplements reviewed in this article, omega-3 fatty acids (Ω-3 FA) have potential for SRC treatment but in the one human trial those taking higher dosages preinjury had more concussions. In animal studies, postinjury administration was as effective as pretreatment. N-acetyl-cysteine has demonstrated a positive short-term effect on blast injuries in soldiers if administered within 24 h, but there are no studies in SRC. Caffeine, conversely, may be detrimental if taken after SRC. Lower serum levels of vitamins D, C, or E preinjury have worse outcomes in animal studies. Preinjury correction of deficiencies may be of benefit. Current human trials for nicotinamide ribose, melatonin, and branched chain amino acids (BCAA) may soon provide more evidence for the use of these supplements to reduce the impact of SRC in athletes.
David B. Kamadjaja
Full Text Available The purpose of this report is to present two cases of jaw locking with two different etiologies. In case #1, jaw locking occured 5.5 months after a surgical reduction and internal fixation on the fractured maxilla and mandible. Some plain radiographic x-ray were made but failed to give adequate information in establishing the cause of trismus. The three dimensional computed tomography (3D-CT was finally made and able to help guide the pre-operative diagnosis and treatment. Two-steps gap arthroplasty were done comprising a gap arthroplasty leading to acceptable outcome. An adult patient in case #2 with a history of trauma at his childhood and bird-like face apprearance clinically, was unable to open the mouth since the time of accident. The patient was diagnosed with bilateral ankylosis of temporomandibular joints. One side (right gap arthroplasty was done and resulted in normal mouth opening.
Lepilin A.V. Bakhteeva G.R.
The ratio of male and female patients during the study period did not change (men 89%, women — 11 %. Single fractures that do not require surgical treatment were dominated. Operating activities during the study period of fracture increased. For 5 years, the number of complications of traumatic injuries remained the same. Conclusion. Statistical analysis of traumatic injuries of the maxillofacial region shows that the average age of the patients decreased by almost 5 years, reduced average hospital stay. Most of the patients were admitted to the profile department in the early period (up to 3 days after preparation, but 21.6% of the patients were received only with the development of complications. The article concludes that there is a need to find new methods of diagnosis, treatment and prevention of complications of traumatic injuries.
Manley, Geoff; Gardner, Andrew J; Schneider, Kathryn J; Guskiewicz, Kevin M; Bailes, Julian; Cantu, Robert C; Castellani, Rudolph J; Turner, Michael; Jordan, Barry D; Randolph, Christopher; Dvořák, Jiří; Hayden, K Alix; Tator, Charles H; McCrory, Paul; Iverson, Grant L
Systematic review of possible long-term effects of sports-related concussion in retired athletes. Ten electronic databases. Original research; incidence, risk factors or causation related to long-term mental health or neurological problems; individuals who have suffered a concussion; retired athletes as the subjects and possible long-term sequelae defined as > 10 years after the injury. Study population, exposure/outcome measures, clinical data, neurological examination findings, cognitive assessment, neuroimaging findings and neuropathology results. Risk of bias and level of evidence were evaluated by two authors. Following review of 3819 studies, 47 met inclusion criteria. Some former athletes have depression and cognitive deficits later in life, and there is an association between these deficits and multiple prior concussions. Former athletes are not at increased risk for death by suicide (two studies). Former high school American football players do not appear to be at increased risk for later life neurodegenerative diseases (two studies). Some retired professional American football players may be at increased risk for diminishment in cognitive functioning or mild cognitive impairment (several studies), and neurodegenerative diseases (one study). Neuroimaging studies show modest evidence of macrostructural, microstructural, functional and neurochemical changes in some athletes. Multiple concussions appear to be a risk factor for cognitive impairment and mental health problems in some individuals. More research is needed to better understand the prevalence of chronic traumatic encephalopathy and other neurological conditions and diseases, and the extent to which they are related to concussions and/or repetitive neurotrauma sustained in sports. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Carson, James D; Rendely, Alexandra; Garel, Alisha; Meaney, Christopher; Stoller, Jacqueline; Kaicker, Jatin; Hayden, Leigh; Moineddin, Rahim; Frémont, Pierre
To compare the knowledge and use of recommendations for the management of sport-related concussion (SRC) among sport and exercise medicine physicians (SEMPs) and emergency department physicians (EDPs) to assess the success of SRC knowledge transfer across Canada. A self-administered, multiple-choice survey accessed via e-mail by SEMPs and EDPs. The survey had been assessed for content validity. Canada. The survey was completed between May and July 2012 by SEMPs who had passed the diploma examination of the Canadian Academy of Sport and Exercise Medicine and by EDPs who did not hold this diploma. Knowledge and identification of sources of concussion management information, use of concussion diagnosis strategies, and whether physicians use common and consistent terminology when explaining cognitive rest strategies to patients after an SRC. There was a response rate of 28% (305 of 1085). The SEMP and EDP response rates were 41% (147 of 360) and 22% (158 of 725), respectively. Of the responses, 41% of EDPs and 3% of SEMPs were unaware of any consensus statements on concussion in sport; 74% of SEMPs used the Sport Concussion Assessment Tool, version 2 (SCAT2), "usually or always," whereas 88% of EDPs never used the SCAT2. When queried about how cognitive rest could best be achieved after an SRC, no consistent answer was documented. Differences and a lack of consistency in the implementation of recommendations for SRC patients were identified for SEMPs and EDPs. It appears that the SCAT2 is used more in the SEMP setting than in the emergency context. Further knowledge transfer efforts and research should address the barriers to achieving more consistent advice given by physicians who attend SRC patients. Copyright© the College of Family Physicians of Canada.
McClure, D Jake; Zuckerman, Scott L; Kutscher, Scott J; Gregory, Andrew J; Solomon, Gary S
The management of sports-related concussions (SRCs) utilizes serial neurocognitive assessments and self-reported symptom inventories to assess recovery and safety for return to play (RTP). Because postconcussive RTP goals include symptom resolution and a return to neurocognitive baseline levels, clinical decisions rest in part on understanding modifiers of this baseline. Several studies have reported age and sex to influence baseline neurocognitive performance, but few have assessed the potential effect of sleep. We chose to investigate the effect of reported sleep duration on baseline Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) performance and the number of patient-reported symptoms. We hypothesized that athletes receiving less sleep before baseline testing would perform worse on neurocognitive metrics and report more symptoms. Cross-sectional study; Level of evidence, 3. We retrospectively reviewed 3686 nonconcussed athletes (2371 male, 1315 female; 3305 high school, 381 college) with baseline symptom and ImPACT neurocognitive scores. Patients were stratified into 3 groups based on self-reported sleep duration the night before testing: (1) short, sleep duration on baseline ImPACT performance. A univariate ANCOVA was performed to investigate the influence of sleep on total self-reported symptoms. When controlling for age and sex as covariates, the MANCOVA revealed significant group differences on ImPACT reaction time, verbal memory, and visual memory scores but not visual-motor (processing) speed scores. An ANCOVA also revealed significant group differences in total reported symptoms. For baseline symptoms and ImPACT scores, subsequent pairwise comparisons revealed these associations to be most significant when comparing the short and intermediate sleep groups. Our results indicate that athletes sleeping fewer than 7 hours before baseline testing perform worse on 3 of 4 ImPACT scores and report more symptoms. Because SRC management and RTP
McCrory, Paul; Feddermann-Demont, Nina; Dvořák, Jiří; Cassidy, J David; McIntosh, Andrew; Vos, Pieter E; Echemendia, Ruben J; Meeuwisse, Willem; Tarnutzer, Alexander A
Various definitions for concussion have been proposed, each having its strengths and weaknesses. We reviewed and compared current definitions and identified criteria necessary for an operational definition of sports-related concussion (SRC) in preparation of the 5th Concussion Consensus Conference (Berlin, Germany). We also assessed the role of biomechanical studies in informing an operational definition of SRC. This is a systematic literature review. Data sources include MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Clinical Trials and SPORT Discus (accessed 14 September 2016). Eligibility criteria were studies reporting (clinical) criteria for diagnosing SRC and studies containing SRC impact data. Out of 1601 articles screened, 36 studies were included (2.2%), 14 reported on criteria for SRC definitions and 22 on biomechanical aspects of concussions. Six different operational definitions focusing on clinical findings and their dynamics were identified. Biomechanical studies were obtained almost exclusively on American football players. Angular and linear head accelerations linked to clinically confirmed concussions demonstrated considerable individual variation. SRC is a traumatic brain injury that is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces with several common features that help define its nature. Limitations identified include that the current criteria for diagnosing SRC are clinically oriented and that there is no gold/standard to assess their diagnostic properties. A future, more valid definition of SRC would better identify concussed players by demonstrating high predictive positive/negative values. Currently, the use of helmet-based systems to study the biomechanics of SRC is limited to few collision sports. New approaches need to be developed to provide objective markers for SRC. © Article author(s) (or their employer(s) unless otherwise
Collins, Michael W; Iverson, Grant L; Lovell, Mark R; McKeag, Douglas B; Norwig, John; Maroon, Joseph
Investigate the relationship between on-field markers of concussion severity and postinjury neuropsychological and symptom presentation in an athlete-specific population. Case control study. Multicenter analysis of high school and college athletes. A total of 78 athletes sustaining sports-related concussion were selected from a larger sample of 139 concussed athletes. ASSESSMENT OF PREDICTOR VARIABLES: On-field presence of disorientation, posttraumatic amnesia, retrograde amnesia, and loss of consciousness. ImPACT, a computerized neuropsychological test battery, was administered pre-season and, on average, 2 days postinjury. Good postinjury presentation (n = 44) was defined as no measurable change, relative to baseline, in terms of both ImPACT memory and symptom composite scores. Poor presentation (n = 34) was defined as a 10-point increase in symptom reporting and 10-point decrease in memory functioning (exceeding the 80% confidence interval for measurement error on ImPACT). Athletes failing to meet good or poor selection criteria (n = 61) were not included in the analysis. Odds ratios revealed that athletes demonstrating poor presentation at 2 days postinjury were over 10 times more likely (P presentation. Similarly, athletes with poor presentation were over 4 times more likely (P poor presentation groups in terms of on-field loss of consciousness. The presence of amnesia, not loss of consciousness, appears predictive of symptom and neurocognitive deficits following concussion in athletes. Athletes presenting with on-field amnesia should undergo comprehensive and individualized assessment prior to returning to sport participation. Continued refinement of sports concussion grading scales is warranted in lieu of consistent findings that brief loss of consciousness is not predictive of concussion injury severity.
Paddack, Michael; DeWolf, Ryan; Covassin, Tracey; Kontos, Anthony
College sport organizations and associations endorse concussion-management protocols and policies. To date, little information is available on concussion policies and practices at community college institutions. To assess and describe current practices and policies regarding the assessment, management, and return-to-play criteria for sport-related concussion (SRC) among member institutions of the California Community College Athletic Association (CCCAA). Cross-sectional study. Web-based survey. A total of 55 head athletic trainers (ATs) at CCCAA institutions. Data about policies, procedures, and practices regarding SRC were collected over a 3-week period in March 2012 and analyzed using descriptive statistics, the Fisher exact test, and the Spearman test. Almost half (47%) of ATs stated they had a policy for SRC assessment, management, and return to play at their institution. They reported being in compliance with baseline testing guidelines (25%), management guidelines (34.5%), and return-to-play guidelines (30%). Nearly 31% of ATs described having an SRC policy in place for academic accommodations. Conference attendance was positively correlated with institutional use of academic accommodations after SRC (r = 0.44, P = .01). The number of meetings ATs attended and their use of baseline testing were also positively correlated (r = 0.38, P = .01). At the time of this study, nearly half of CCCAA institutions had concussion policies and 31% had academic-accommodation policies. However, only 18% of ATs at CCCAA institutions were in compliance with all of their concussion policies. Our findings demonstrate improvements in the management of SRCs by ATs at California community colleges compared with previous research but a need for better compliance with SRC policies.
Gräni, Christoph; Chappex, Nina; Fracasso, Tony; Vital, Cristina; Kellerhals, Christoph; Schmied, Christian; Saguner, Ardan M; Trachsel, Lukas D; Eser, Prisca; Michaud, Katarzyna; Wilhelm, Matthias
Sports-related sudden cardiac deaths (SrSCDs) occur most frequently in highly dynamic and/or static sports. We aimed to assess the incidence and characteristics of SrSCDs in Switzerland and to compare SrSCD occurrence according to sports categories with the sports participation behaviour in the general population. Between 1999 and 2010, forensic reports of SrSCDs in young individuals (10-39 years of age) were retrospectively reviewed and categorised based on peak static (increasing from I to III) and dynamic sports components (increasing from A to C). Data were compared to the sports participation behaviour of the Swiss population. Sixty-nine SrSCDs were identified. Forty-eight (69.6%) occurred during recreational sports (REC) and 21 (30.4%) during competitive sports (COMP). Incidences (per 100,000 athlete person-years) for COMP and REC were 0.90 and 0.52, respectively (p = 0.001). Most SrSCDs occurred in IC (23 cases, 33.3%), followed by IIC (13, 18.9%), IIIA and IIIC (11 each, 15.9%), IIIB (6, 8.7%), IIA (4, 5.8%) and IB sports categories (1, 1.5%). No SrSCDs were found in IA and IIB sports categories. Incidences between sports categories (IIIA 0.25, IB 0.25, IC 0.18, IIC 0.33 and IIIC 0.25) were not significantly different except to IIA (0.94, p sports category. Coronary artery disease (CAD) was the most common underlying pathology of SrSCD. In this Swiss cohort, incidence of SrSCD was very low and similar in all sports categories classified by their static and dynamic components. However, the incidence was higher in COMP compared to REC, and CAD proved to be the most common underlying cause of SrSCD. © The European Society of Cardiology 2016.
Brook, Emily M.; Kroshus, Emily; Hu, Caroline H.; Gedman, Marissa; Collins, Jamie E.; Matzkin, Elizabeth G.
Background: There are limited data on the incidence of concussion and concussion symptom nondisclosure among collegiate women’s ice hockey athletes. Purpose: To determine the incidence of sports-related concussion (SRC) in National Collegiate Athletic Association (NCAA) women’s ice hockey athletes. Study Design: Descriptive epidemiology study. Methods: An anonymous online survey was completed by 459 NCAA women’s ice hockey athletes. Players reported diagnosed concussions as well as incidents where they experienced an impact or blow to the head followed by symptoms associated with a concussion; reports spanned the duration of the 2014-2015 season and throughout players’ organized hockey career. Results: About half (n = 219, 47.7%) of respondents reported at least 1 diagnosed concussion over the duration of their entire organized ice hockey career. A total of 13.3% (n = 61) of respondents reported a diagnosed concussion during the 2014-2015 season. The incidence rate was 1.18 (95% CI, 0.92-1.51) per 1000 athlete-exposures to a game or practice and 0.58 (95% CI, 0.45-0.74) per 1000 hours of ice time. One-third (34.2%, n = 157) of players reported at least 1 impact where they experienced concussion-like symptoms during the 2014-2015 season; 82.8% of these players reported that they continued to play after at least 1 of these impacts, and 66.8% of players reported at least 1 impact where they never disclosed any symptoms. Conclusion: There is a high incidence of SRC in collegiate women’s ice hockey and a concerning level of symptom nondisclosure. Additional research is needed to understand the causes of concussion and reasons for the lack of symptom disclosure, including factors specific to female athletes and contextual issues specific to women’s collegiate ice hockey. PMID:28812036
Makdissi, Michael; Schneider, Kathryn J; Feddermann-Demont, Nina; Guskiewicz, Kevin M; Hinds, Sidney; Leddy, John J; McCrea, Michael; Turner, Michael; Johnston, Karen M
To conduct a systematic review of the literature regarding assessment and treatment modalities in patients with persistent symptoms following sport-related concussion (SRC). We searched Medline, Embase, SPORTSDiscus, PsycINFO, CINAHL, Cochrane library and ProQuest Dissertation & Theses Global electronic databases. Studies were included if they were original research, reported on SRC as the primary source of injury, included patients with persistent postconcussive symptoms (>10 days) and investigated the role of assessment or treatment modalities. Of 3225 articles identified in the preliminary search, 25 articles met the inclusion criteria. 11 articles were concerned with assessment and 14 articles with treatment of persistent symptoms following SRC. There were three randomised control trials and one quasi-experimental study. The remainder consisting of cross-sectional studies, historical cohorts and case series. 'Persistent symptoms' following SRC can be defined as clinical recovery that falls outside expected time frames (ie, >10-14 days in adults and >4 weeks in children). It does not reflect a single pathophysiological entity, but describes a constellation of non-specific post-traumatic symptoms that may be linked to coexisting and/or confounding pathologies. A detailed multimodal clinical assessment is required to identify specific primary and secondary processes, and treatment should target specific pathologies identified. There is preliminary evidence supporting the use of symptom-limited aerobic exercise, targeted physical therapy and a collaborative approach that includes cognitive behavioural therapy. Management of patients with persistent symptoms is challenging and should occur in a multidisciplinary collaborative setting, with healthcare providers with experience in SRC. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly
Wong-On, Manuel; Til-Pérez, Lluís; Balius, Ramón
A combination of magnetic resonance imaging (MRI) with real-time high-resolution ultrasound (US) known as fusion imaging may improve visualization of musculoskeletal (MSK) sports medicine injuries. The aim of this study was to evaluate the applicability of MRI-US fusion technology in MSK sports medicine. This study was conducted by the medical services of the FC Barcelona. The participants included volunteers and referred athletes with symptomatic and asymptomatic MSK injuries. All cases underwent MRI which was loaded into the US system for manual registration on the live US image and fusion imaging examination. After every test, an evaluation form was completed in terms of advantages, disadvantages, and anatomic fusion landmarks. From November 2014 to March 2015, we evaluated 20 subjects who underwent fusion imaging, 5 non-injured volunteers and 15 injured athletes, 11 symptomatic and 4 asymptomatic, age range 16-50 years, mean 22. We describe some of the anatomic landmarks used to guide fusion in different regions. This technology allowed us to examine muscle and tendon injuries simultaneously in US and MRI, and the correlation of both techniques, especially low-grade muscular injuries. This has also helped compensate for the limited field of view with US. It improves spatial orientation of cartilage, labrum and meniscal injuries. However, a high-quality MRI image is essential in achieving an adequate fusion image, and 3D sequences need to be added in MRI protocols to improve navigation. The combination of real-time MRI and US image fusion and navigation is relatively easy to perform and is helping to improve understanding of MSK injuries. However, it requires specific skills in MSK imaging and still needs further research in sports-related injuries. Toshiba Medical Systems Corporation.
Flaherty, Michael R; Raybould, Toby; Jamal-Allial, Aziza; Kaafarani, Haytham M A; Lee, Jarone; Gervasini, Alice; Ginsburg, Richard; Mandell, Mark; Donelan, Karen; Masiakos, Peter T
To determine physician-reported adherence to and support of the 2010 Massachusetts youth concussion law, as well as barriers to care and clinical practice in the context of legislation. Primary care physicians (n = 272) in a large pediatric network were eligible for a cross-sectional survey in 2014. Survey questions addressed key policy and practice provisions: concussion knowledge, state regulations and training, practice patterns, referrals, patient characteristics, and barriers to care. Analyses explored relationships between practice and policy, adjusting for physician demographic and practice characteristics. The survey response rate was 64% among all responders (173 of 272). A total of 146 respondents who had evaluated, treated, or referred patients with a suspected sports-related concussion in the previous year were eligible for analysis. The vast majority (90%) of providers agreed that the current Massachusetts laws regarding sports concussions are necessary and support the major provisions. Three-quarters (74%) had taken a required clinician training course on concussions. Those who took training courses were significantly more likely to develop individualized treatment plans (OR, 3.6; 95% CI, 1.1-11.0). Physician training did not improve screening of youth with concussion for depression or substance use. Most physicians (77%) advised patients to refrain from computer, telephone, or television for various time periods. Physicians reported limited communication with schools. Primary care physicians report being comfortable with the diagnosis and management of concussions, and support statewide regulations; however, adherence to mandated training and specific legal requirements varied. Broader and more frequent training may be necessary to align current best evidence with clinical care and state-mandated practice. Copyright © 2016 Elsevier Inc. All rights reserved.
Meier, Timothy B; Bellgowan, Patrick S F; Mayer, Andrew R
Growing evidence suggests that sports-related concussions (SRC) may lead to acute changes in intrinsic functional connectivity, although most studies to date have been cross-sectional in nature with relatively modest sample sizes. We longitudinally assessed changes in local and global resting state functional connectivity using metrics that do not require a priori seed or network selection (regional homogeneity; ReHo and global brain connectivity; GBC, respectively). A large sample of collegiate athletes (N = 43) was assessed approximately one day (1.74 days post-injury, N = 34), one week (8.44 days, N = 34), and one month post-concussion (32.47 days, N = 30). Healthy contact sport-athletes served as controls (N = 51). Concussed athletes showed improvement in mood symptoms at each time point (p's concussion (p's concussion. ReHo in sensorimotor, visual, and temporal cortices increased over time post-concussion, and was greatest at one month post-injury. Conversely, ReHo in the frontal cortex decreased over time following SRC, with the greatest decrease evident at one month post-concussion. Differences in ReHo relative to healthy athletes were primarily observed at one month post-concussion rather than the more acute time points. Contrary to our hypothesis, no significant cross-sectional or longitudinal differences in GBC were observed. These results are suggestive of a delayed onset of local connectivity changes following SRC.
Virji-Babul, Naznin; Hilderman, Courtney G E; Makan, Nadia; Liu, Aiping; Smith-Forrester, Jenna; Franks, Chris; Wang, Z J
Sports-related concussion is a major public health issue; however, little is known about the underlying changes in functional brain networks in adolescents following injury. Our aim was to use the tools from graph theory to evaluate the changes in brain network properties following concussion in adolescent athletes. We recorded resting state electroencephalography (EEG) in 33 healthy adolescent athletes and 9 adolescent athletes with a clinical diagnosis of subacute concussion. Graph theory analysis was applied to these data to evaluate changes in brain networks. Global and local metrics of the structural properties of the graph were calculated for each group and correlated with Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) scores. Brain networks of both groups showed small-world topology with no statistically significant differences in the global metrics; however, significant differences were found in the local metrics. Specifically, in the concussed group, we noted: 1) increased values of betweenness and degree in frontal electrode sites corresponding to the (R) dorsolateral prefrontal cortex and the (R) inferior frontal gyrus and 2) decreased values of degree in the region corresponding to the (R) frontopolar prefrontal cortex. In addition, there was significant negative correlation between degree and hub value, with total symptom score at the electrode site corresponding to the (R) prefrontal cortex. This preliminary report in adolescent athletes shows for the first time that resting-state EEG combined with graph theoretical analysis may provide an objective method of evaluating changes in brain networks following concussion. This approach may be useful in identifying individuals at risk for future injury.
Kamath, Rajay A. D.; Bharani, Shiva; Hammannavar, Reshma; Ingle, Sumit P.; Shah, Ankit G.
Materials and Methods A 6-year retrospective analysis of 111 patients treated for maxillofacial fractures in Davangere, Karnataka from January 2004 to December 2009 was performed. Variables like age, gender, occupation, type of fracture and mechanism of injury, concomitant injury, mode of treatment, and complications were recorded and assessed. Results Men between 21 and 30 years were mostly affected (male-to-female ratio = 10:1; age range = 17.60 years; mean 31.7 ± 9.8 [standard deviation]). Most fractures were caused by road traffic accidents (RTAs; 74.7%), followed by interpersonal violence (IPV; 15.8%), falls (4.2%), industrial hazards and animal attacks (2.1% each), and self-inflicted injury (1.1%). Forty-two cases were isolated zygomaticomaxillary complex (ZMC) fractures. The total number of facial fractures documented was 316, of which 222 were purely related to the ZMC; however, 11 were confined only to the midface. Fifty-three cases had concomitant lower jaw fractures, totaling 83. Ophthalmic injuries occurred in 30.52% of cases. Ninety-two cases were treated with open reduction and internal fixation (ORIF), and three cases were managed conservatively. The complication rate observed was 25.26%. Conclusion RTA continues to be the chief etiological factor in maxillofacial injury with males being affected predominantly. IPV and falls next contribute significantly to the incidence of such injuries. Concomitant injuries, however, require prompt recognition and appropriate management. ORIF still remains the mainstay of treatment; however, fixation devices are constantly being improved upon in an attempt to reduce immobilization time thereby facilitating early return to function with minimal morbidity. Nevertheless, future advances in maxillofacial trauma diagnosis and management are likely to reduce associated morbidity. PMID:24294402
Chung, Yoo Tai; Lee, Sang Chull
This report based on 300 cases of serious diseases in maxillofacial region by radiograms seen at the department of dental radiodontics, infirmary school of dentistry, Kyung Hee University from October 1971 to August 1974. The maxillofacial diseases were analysed upon the following items, such as 1) the frequency of dominant diseases, 2) sex-ratio of male to female, 3) predominant region of diseases, 4) comparison with the age, 5) the incidence of diseases in relative to the individual teeth. The results were obtained as follows. 1) Among the total of 300 cases of the patients, the frequency of dominant diseases of patients were fractures of facial bone (44.3 ± 2.87%), inflammatory diseases (22.7 ± 2.39%), cysts (11.1 ± 1.62%), tumors(10.7 ± 1.77%), maxillary sinusitis (7.9 ± 1.56%), temporomandibular joint disorders(3.3 ± 1.05%) in the order. 2) The sex ratio of male to female in occurrence of jaw fractures were 7.3 : 1, temporomandibular joint disorders were 2.1 : 1, inflammatory diseases were 1.8:1, maxillary sinusitis were 1.7 : 1, but tumors were 1: 1, while cysts were 1:1 .2 in sex difference.3) The predominant region of mandibular fractures were symphysis (17.3 ± 3.27%), canine region (15.0 ± 3.09%), and angle region(14.3 ± 3.04%) in the order. Inflammatory diseases were occurred frequently in mandible and it's left side were a little dominant. Odontogenic cysts were observed frequently in maxilla, but regardless of right and left. Carcinomas were involved most frequently in maxilla, while sarcomas and ameloblastomas in mandible. Frequency of the maxillary sinusitis w ere dominant in right side and molar area, also temporomandibular joint disorders were dominant in right side. 4) To study comparing with the age, jaw fractures showed the highest ratio at the 2nd decade (32.3 ± 4.06%), and 3rd decade (27.8 ± 3.89%), 4th decade (19.6 ± 3.44%), 6th decade (9.0 ± 2.47%), 5th decade(6.0 ± 2.06%), lst decade(5.3 ± 1.95%) in the order. But 7th decade
Chindia, M L; Guthua, S W; Awange, D O; Wakoli, K A
Osteosarcoma (OS) is a highly malignant tumour and is the most common primary neoplasm of bone; although rare, especially in the maxillofacial skeleton. This article presents 14 Kenyan cases of OS of the maxillofacial bones seen between January 1991 and July 1997: 11 in the mandible, two in the maxilla and one in the right zygomatic arch. Patients ranged in age from one week to 50 years (Mean = 29.7), with an equal gender distribution. While pain and rapid swelling were the commonest clinical features, the radiographic and histopathological characteristics were as varied as has been described elsewhere. Generally, effective management of most of the cases was poor due to late presentation for treatment.
Jang, Dong Il; Jeong, Gyeong Seop; Han, Min Gu
This book introduces basic theory and analytical solution of fracture mechanics, linear fracture mechanics, non-linear fracture mechanics, dynamic fracture mechanics, environmental fracture and fatigue fracture, application on design fracture mechanics, application on analysis of structural safety, engineering approach method on fracture mechanics, stochastic fracture mechanics, numerical analysis code and fracture toughness test and fracture toughness data. It gives descriptions of fracture mechanics to theory and analysis from application of engineering.
Rossato, Claire; Brackenridge, Celia
This article reports on the results of an online survey of child protection training for students on sport-related degrees and Initial Teacher Training Physical Education courses, and on the views of recently-graduated teachers of the usefulness of such training in their everyday work. The results indicate that child protection training is provided on most courses but in varying amounts. Respondents to the survey reported positively, in the main, about the effects of new requirements for te...
Mitchell, Rebecca; Brighton, Barbara; Sherker, Shauna
To describe the epidemiology of competition and training-based surf sport-related injury in Australia in the years 2003-2011. A retrospective epidemiological review. Information on surf sport-related injuries was obtained from Surf Life Saving Australia's SurfGuard Incident Reporting Database during 1 January 2003 to 20 August 2011. There were 2645 surf sport-related competition or training-related incidents. Males and females experienced similar proportions of injury by activity type, with older individuals experiencing a higher proportion of injuries during training than younger individuals. Minor first aid was required for 54.5% of the competition and 43.7% of the training-related incidents, with major first aid required in just over 10% of both incident types. Overall, inflatable rescue boats, beach flags, and surf boats were the most common activities performed at the time of the incident, with returning to shore and negotiating the break the most common possible contributing factors to surf boat incidents. Bruises/contusions, strains, inflammation/swelling, and sprains were the most common types of injuries that occurred during both competition and training. RICE--Rest-Ice-Compression-Elevation--was the most common form of initial treatment for the injury during both competition and training. Participation in surf sports is not without risk of injury. Information from this study will inform injury prevention efforts for surf sport and act as a guide for future research in this area, and towards improved injury surveillance for surf sport-related injuries. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Kesting, Marco Rainer; Wolff, Klaus-Dietrich; Nobis, Christopher Philipp; Rohleder, Nils Hagen
Following its renaissance in ophthalmology during the 1990s, preserved human amniotic membrane (HAM) has become an attractive biomaterial for all surgical disciplines. This article reviews the current and potential use of HAM in oral and maxillofacial surgery, its postulated properties and common preservation techniques. Literature was identified by an electronic search of PubMed in July 2012; this was supplemented from the reference lists of the consulted papers. HAM has been used in the field of oral and maxillofacial surgery from 1969 onwards because of its immunological preference and its pain-reducing, antimicrobial, mechanical and side-dependent adhesive or anti-adhesive properties. The effects of HAM on dermal and mucosal re-epithelialisation have been highlighted. Typically, HAM is applied after being banked in a glycerol-preserved, DMSO-preserved or freeze-dried and irradiated state. Whereas the use of HAM in flap surgery and in intra-oral and extra-oral lining is reported frequently, novel HAM applications in post-traumatic orbital surgery and temporomandibular joint surgery have been added since 2010. Tissue engineering with HAM is a fast-expanding field with a high variety of future options. Preserved HAM is considered to be a safe and sufficient biomaterial in all fields of oral and maxillofacial wound healing. Recently published novel indications for HAM application lack a high level of evidence and need to be studied further.
Echemendia, Ruben J; Iverson, Grant L; McCrea, Michael; Broshek, Donna K; Gioia, Gerard A; Sautter, Scott W; Macciocchi, Stephen N; Barr, William B
Over the past 20 years, clinical neuropsychologists have been at the forefront of both scientific and clinical initiatives aimed at developing evidence-based approaches to the evaluation and management of sport-related concussion. These efforts have directly impacted current policy on strategies for injury assessment and return-to-play by athletes after concussion. Many states are considering legislation requiring (a) education of athletes, parents, coaches, and school/organization officials on the recognition, evaluation, and management of sport-related concussions; (b) removal from play of any youth athlete that is suspected of having sustained a concussion; and (c) not allowing the student to return to participation until the student is evaluated and cleared for return to participation in writing by an appropriate healthcare professional. It is the official position of the American Academy of Clinical Neuropsychology (AACN), American Board of Neuropsychology (ABN), Division 40 (Neuropsychology) of the American Psychological Association (APA), and the National Academy of Neuropsychology (NAN) that neuropsychologists should be included among the licensed health care professionals authorized to evaluate, clinically manage, and provide return to play clearance for athletes who sustain a sport-related concussion.
Sheets, James L; Yuan, Judy Chia-Chun; Sukotjo, Cortino; Davis, Betsy K; Wee, Alvin G
The motivation of maxillofacial prosthodontists to go into fellowship training and specific procedures in maxillofacial prosthetics practice once they have completed training has not been previously evaluated. The purpose of this study was to survey maxillofacial prosthodontists in the United States to investigate their reasons for pursuing maxillofacial prosthetic training and their practice profiles. In June 2015, a survey was sent to all US maxillofacial prosthodontists asking for descriptive demographics, their reasoning as to what prompted entrance into a maxillofacial prosthetic program, and their practice pattern. Frequencies, percentages, means, and standard deviations were calculated and reported. The survey response rate was 60.4%. The main reason for pursuing maxillofacial training was primarily personal satisfaction, prosthodontic residency exposure, and mentorship rather than media exposure and compensation. The time spent in prosthodontic practice varied among practitioners, with the majority of practice time spent accomplishing standard prosthodontic procedures (65.59%) versus maxillofacial (25.53%) or surgical procedures (9.67%). Of 12 clinical maxillofacial procedures inquired about, the most prevalent were obturators, dental oncology, and mandibular resections. This study reveals that personal satisfaction, mentorship, and prosthodontic residency exposure were the reasons most prosthodontists pursued an additional year of maxillofacial prosthetic fellowship. Most were very satisfied with their training and chosen career path and would recommend an additional year of training. The majority of maxillofacial prosthodontists provided maxillofacial prosthetic treatment for approximately one fourth of their practice time. The most common procedures performed were obturators, dental oncology, and mandibular resections. Copyright © 2017 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
USAARL Report No. 2013-05 Methodology to Assess Field of View of Maxillofacial Protective Devices By Jose E. Cap6-Aponte William McLean Josue...13-11-2012 Final Methodology to Assess Field of View of Maxillofacial Protective Devices Jose E. Capo-Aponte William McLean Josue Sosa Steve Martin...Scott Street Fort Detrick, MD 21702 USAMRMC Approved for public release; distribution unlimited. The frequency of maxillofacial battlefield injuries
Yang, Jingzhen; Peek-Asa, Corinne; Noble, James M; Torner, James; Schmidt, Paul; Cooper, Martha L
Universities are increasingly implementing programs to effectively respond to and manage sport-related concussions (SRCs). One such effort is to develop common data elements (CDEs) and standardize data collection methods. The objectives of this study were to describe CDEs currently collected by Big Ten and Ivy League universities for SRC studies, and to compare the data collected with the core CDEs recommended by the National Institute of Neurological Disorders and Stroke (NINDS). We conducted an anonymous cross-sectional online survey among medical staff at the 14 Big Ten and 8 Ivy League universities (one per university) between September and October 2015. The survey instrument, including 9 questions corresponding to the concussion data collected before, during, and after a concussion, was developed and pilot-tested before field use. We analyzed patterns of the concussion CDEs being collected, including when, what, and how the data were collected and stored, and compared them with the NINDS' recommended core CDEs. A total of 19 out of 22 universities were included, with 13 from Big Ten and 6 from Ivy-League universities. All 19 participating universities currently collected concussion data with athletes before, during, and after a concussion. Great similarities in data collection were observed at baseline and acutely post-concussion across participating universities. All 19 universities collected at least one of the ten recommended acute symptoms checklists, and 18 universities collected one of the four recommended core neuropsychological function cognitive measures. However, CDEs in the sub-acute and chronic timeframes were limited, with only 9 (47%) universities collecting post-concussion short to long term outcome data. While over 60% of universities collected and stored concussion data electronically, only 17% to 42% of data collected were readily available for research. Significant inter-institutional similarities in acute concussion CDEs were found. Further
Sufrinko, Alicia; Pearce, Kelly; Elbin, R J; Covassin, Tracey; Johnson, Eric; Collins, Michael; Kontos, Anthony P
Researchers have reported that sleep duration is positively related to baseline neurocognitive performance. However, researchers have yet to examine the effect of preinjury sleep difficulties on postconcussion impairments. To compare neurocognitive impairment and symptoms of athletes with preinjury sleep difficulties to those without after a sport-related concussion (SRC). Cohort study; Level of evidence, 3. The sample included 348 adolescent and adult athletes (age, mean ± SD, 17.43 ± 2.34 years) with a diagnosed SRC. The sample was divided into 2 groups: (1) 34 (10%) participants with preinjury sleep difficulties (sleeping less as well as having trouble falling asleep; SLEEP SX) and (2) 231 (66%) participants without preinjury sleep difficulties (CONTROL). The remaining 84 (24%) participants with minimal sleep difficulties (1 symptom) were excluded. Participants completed the Immediate Postconcussion Assessment and Cognitive Test (ImPACT) and Postconcussion Symptom Scale (PCSS) at baseline and 3 postinjury intervals (2, 5-7, and 10-14 days after injury). A series of repeated-measures analyses of covariance with Bonferroni correction, controlling for baseline non-sleep-related symptoms, were conducted to compare postinjury neurocognitive performance between groups. Follow-up exploratory t tests examined between-group differences at each time interval. A series of analyses of variance were used to examine total PCSS score, sleep-related, and non-sleep-related symptoms across time intervals between groups. Groups differed significantly in PCSS scores across postinjury intervals for reaction time (P SLEEP SX group performing worse than controls at 5-7 days (mean ± SD, 0.70 ± 0.32 [SLEEP SX], 0.60 ± 0.14 [CONTROL]) and 10-14 days (0.61 ± 0.17 [SLEEP SX]; 0.57 ± 0.10 [CONTROL]) after injury. Groups also differed significantly on verbal memory performance (P = .04), with the SLEEP SX (68.21 ± 18.64) group performing worse than the CONTROL group (76.76 ± 14
de Hoyo Moisés
Full Text Available This study aimed to analyze the effects of power training using traditional vertical resistance exercises versus direction specific horizontal inertial flywheel training on performance in common sport-related tasks. Twenty-three healthy and physically active males (age: 22.29 ± 2.45 years volunteered to participate in this study. Participants were allocated into either the traditional training (TT group where the half squat exercise on a smith machine was applied or the horizontal flywheel training (HFT group performing the front step exercise with an inertial flywheel. Training volume and intensity were matched between groups by repetitions (5-8 sets with 8 repetitions and relative intensity (the load that maximized power (Pmax over the period of six weeks. Speed (10 m and 20 m, countermovement jump height (CMJH, 20 m change of direction ability (COD and strength during a maximal voluntary isometric contraction (MVIC were assessed before and after the training program. The differences between groups and by time were assessed using a two-way analysis of variance with repeated measures, followed by paired t-tests. A significant group by time interaction (p=0.004 was found in the TT group demonstrating a significantly higher CMJH. Within-group analysis revealed statistically significant improvements in a 10 m sprint (TT: −0.17 0.27 s vs. HFT: −0.11 0.10 s, CMJH (TT: 4.92 2.58 cm vs. HFT: 1.55 2.44 cm and MVIC (TT: 62.87 79.71 N vs. HFT: 106.56 121.63 N in both groups (p < 0.05. However, significant differences only occurred in the 20 m sprint time in the TT group (−0.04 0.12 s; p = 0.04. In conclusion, the results suggest that TT at the maximal peak power load is more effective than HFT for counter movement jump height while both TT and HFT elicited significant improvements in 10 m sprint performance while only TT significantly improved 20 m sprint performance.
Kerr, Zachary Y; Marshall, Stephen W; Dompier, Thomas P; Corlette, Jill; Klossner, David A; Gilchrist, Julie
Sports-related injuries can have a substantial impact on the long-term health of student-athletes. The National Collegiate Athletic Association (NCAA) monitors injuries among college student-athletes at member schools. In academic year 2013-14, a total of 1,113 member schools fielded 19,334 teams with 478,869 participating student-athletes in NCAA championship sports (i.e., sports with NCAA championship competition) (1). External researchers and CDC used information reported to the NCAA Injury Surveillance Program (NCAA-ISP) by a sample of championship sports programs to summarize the estimated national cumulative and annual average numbers of injuries during the 5 academic years from 2009-10 through 2013-14. Analyses were restricted to injuries reported among student-athletes in 25 NCAA championship sports. During this period, 1,053,370 injuries were estimated to have occurred during an estimated 176.7 million athlete-exposures to potential injury (i.e., one athlete's participation in one competition or one practice). Injury incidence varied widely by sport. Among all sports, men's football accounted for the largest average annual estimated number of injuries (47,199) and the highest competition injury rate (39.9 per 1,000 athlete-exposures). Men's wrestling experienced the highest overall injury rate (13.1 per 1,000) and practice injury rate (10.2 per 1,000). Among women's sports, gymnastics had the highest overall injury rate (10.4 per 1,000) and practice injury rate (10.0 per 1,000), although soccer had the highest competition injury rate (17.2 per 1,000). More injuries were estimated to have occurred from practice than from competition for all sports, with the exception of men's ice hockey and baseball. However, injuries incurred during competition were somewhat more severe (e.g., requiring ≥7 days to return to full participation) than those acquired during practice. Multiple strategies are employed by NCAA and others to reduce the number of injuries in
Kostyun, Regina O; Milewski, Matthew D; Hafeez, Imran
Sleep disturbances are a hallmark sign after a sport-related concussion (SRC). Poor sleep has been shown to adversely affect baseline neurocognitive test scores, but it is not comprehensively understood how neurocognitive function is affected by disrupted sleep during recovery from a concussion. To identify the correlation between adolescent athletes' neurocognitive function and their self-reported sleep quantity and sleep disturbance symptoms during recovery from SRC. Cross-sectional study; Level of evidence, 3. Immediate Post-Concussion Assessment and Cognition Testing (ImPACT) data were retrospectively collected for 545 adolescent athletes treated for SRC at a sports medicine concussion clinic. Patients were stratified into groups based on 2 criteria: self-reported sleep duration and self-reported sleep disturbance symptoms during postinjury ImPACT testing. Sleep duration was classified as short (9 hours). Sleep disturbance symptoms were self-reported as part of the Post-Concussion Symptom Scale (PCSS) as either sleeping less than normal, sleeping more than normal, or having trouble falling asleep. One-way analyses of variance were conducted to examine the effects that sleep duration as well as self-reported sleep disturbance symptoms had on composite scores. A total of 1067 ImPACT tests were analyzed: test 1, 545; test 2, 380; and test 3, 142. Sleeping fewer than 7 hours the night before testing correlated with higher PCSS scores (P sleeping longer than 9 hours correlated with worse visual memory (P = .01), visual motor speed (P sleep disturbance symptoms, patients demonstrated worse composite scores during ImPACT testing when they self-reported sleeping more than normal (ImPACT test 1: verbal memory, P memory, P memory, P sleep had been disrupted. Adolescent patients who perceive that their sleep is somehow disrupted after SRC may report a greater number of concussion symptoms during their recovery. In addition, the study results suggest that sleeping more
Bandte, Angela; Fritzsche, Friederike-Sophie; Emami, Pedram; Kammler, Getrud; Püschel, Klaus; Krajewski, Kara
Soccer, bicycling, and horseback riding are sports most commonly associated with traumatic brain injury (TBI) in Germany. The latter 2 sports activities are commonly practiced with helmets, and data on helmet use and usefulness vary widely. On Ethics Committee approval, a retrospective analysis was performed for patients age 5-17 between January 2009 and August 2014 based on a diagnosis of TBI, using the electronic patient file for 2 university hospital locations. Descriptive data analysis and multivariate and univariate logistic regression were used to calculate odds ratios (ORs). A total of 380 children were identified, including 162 females (42.6%) and 218 males (57.4%), with a mean age of 11.9 ± 3.8 years. Activities included bicycling (n = 64), horseback riding (n = 19), and soccer (n = 16). Helmet use was documented in 26 patients (14 cyclists, 12 riders), and nonuse was documented in 20 (all cyclists). Compared with not wearing a helmet, wearing a helmet was associated with a trend toward lower odds of loss of consciousness (OR, 0.7; 95% confidence interval [CI], 0.18-2.52). A cohort of 251 patients with non-sports-related TBI (NSTBI) served as a control group for further analyses. Compared with the NSTBI group, the odds of amnesia were 2.9 times greater (95% CI, 1.1-21.6) in the patients with a riding-related TBI and 4.8 times greater (95% CI, 0.3-239) in those with a cycling-related TBI, and the odds of epidural hematoma were 2.2 times greater (95% CI, 0.4-12.3) in those with a cycling-related TBI and 4.9 times greater (95% CI, 0.5-50.4) greater in those with a soccer-related TBI. We gained important epidemiologic data on pediatric TBI in our region. Despite the descriptive nature of the data, a trend toward reduced odds of loss of consciousness was seen in the helmet wearers. Nevertheless, serious injury can occur despite helmet use. Copyright © 2018 Elsevier Inc. All rights reserved.
Tuckett, J W; Lynham, A; Lee, G A; Perry, M; Harrington, U
In 1978 the Advanced Trauma Life Support guidelines were first implemented and are viewed by many as the gold standard of care in the emergency setting. It may not be immediately obvious where assessment and management of maxillofacial injuries fits within these trauma guidelines. This article aims to provide a concise, contemporary guide for the treatment of maxillofacial trauma in the emergency setting. An electronic database search was conducted in PubMed and Science Direct on articles from 1970 to the present day. The key search terms were Maxillofacial, Trauma, ATLS, Advanced Trauma Life Support, EMST, Early Management of Severe Trauma, Airway, Eye, Ophthalmic and Management. The findings were compiled into a review article. The article was then reviewed by experts in the fields of Maxillofacial Surgery and Ophthalmology to ensure content and contextual accuracy. Physicians are becoming increasingly exposed to major maxillofacial injuries. Resuscitative measures can be complex and require prompt decisions especially in gaining a secure airway. A proposed treatment algorithm for maxillofacial trauma patients has been devised by the authors. It is imperative that sight preserving assessment and interventions are not forgotten in the emergency management of maxillofacial trauma. We propose an algorithm for the management of maxillofacial trauma, and recommend the use of CT as a powerful adjunct to clinical examination in patients with maxillofacial trauma. Copyright © 2013 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. All rights reserved.
King, Brett J; Levine, Adam
The future of office-based anesthesia for oral and maxillofacial surgery is at risk. Oral and maxillofacial surgeons have been on the forefront of providing safe and effective outpatient anesthesia for decades. Recent changes in Medicare policies have had, and will continue to have, a significant effect on the training of oral and maxillofacial surgery residents regarding anesthesia. The outcome of these changes can have a major effect on the specialty of oral and maxillofacial surgery and a cornerstone of the profession. Copyright © 2017 Elsevier Inc. All rights reserved.
Paprocki, Gregory J
The role of the maxillofacial prosthodontist in the treatment of head and neck cancer patients is not well understood in the medical community. Frequently, dental professionals are called upon by physicians to provide advice regarding the complex needs of head and neck cancer patients. Most general dentists have had limited training in this area. The general dentist has the opportunity to provide the bridge between the physician and the maxillofacial prosthodontist, who can provide treatment information to both the general dentist and the physician. A better understanding of maxillofacial prosthodontics can clarify which patients should be referred to a maxillofacial prosthodontist for treatment.
PEHLİVAN, Çisem; RUDARLI NALÇAKAN, Gülbin; AKTUĞ ERGAN, Semra
Aim: Nutritional deficiencies occur in elite athletes in aesthetic branches who suffer from intensive training programs and strict weight control. Increased disability, the weakening of the immune system, menstrual disorders and increased risk of bone fracture due to abnormal bone mineralization impair the quality of life and threaten the health of athletes. The purpose of this study was to determine body composition, nutrition and hydration status, bone mineral density levels and some physio...
Fagher, Kristina; Jacobsson, Jenny; Timpka, Toomas; Dahlström, Örjan; Lexell, Jan
Paralympic sport provides sporting opportunities for athletes with a disability, with the Paralympic Games as the main event. Participation in sport is, however, associated with a significant risk for sustaining injuries and illnesses. Our knowledge of sports-related injuries and illnesses in Paralympic sport is very limited and there are no large-scale epidemiological cohort studies. The purpose here is to present a protocol for a prospective longitudinal study: The Sports-Related Injuries and Illnesses in Paralympic Sport Study (SRIIPSS). An argument-based method for investigation of design problems was used to structure the study protocol. The primary requirement of the protocol is to allow prospective studies over time and include exposure to both training and competition. To reflect the complexity of Paralympic sport with athletes' pre-existing impairments, use of assistive equipment, pain and other and medical issues, it is required that the data collection system is specifically adapted to Paralympic sport. To allow the collection of data, at the same time as there is limited access to coaches and medical personnel, it is advantageous that data can be collected online directly from the athletes. Based on this a self-report athlete monitoring system will be developed, where the athletes can enter data weekly via their mobile phones or lap-tops. Data will be collected from around 100 Swedish Paralympic athletes for approximately 1 year, which will allow us to i) prospectively estimate the annual incidence of sports-related injuries and illnesses and ii) explore risk factors and mechanisms for sustaining sports-related injuries and illnesses based on athlete exposure and training loads. For effective implementation of injury and illness prevention measures, comprehensive epidemiological knowledge is required. This study will be the first prospective longitudinal self-report study of sports-related injuries and illnesses in Paralympic sport over a longer period
Rahman, Roslan Abdul; Ramli, Roszalina; Rahman, Normastura Abdul; Hussaini, Haizal Mohd; Idrus, Sharifah Munirah Ai; Hamid, Abdul Latif Abdul
Maxillofacial trauma in children is not common worldwide. Domestic injuries are frequently seen in younger children while older children are mostly involved in motor vehicle accidents (MVA). The objective of this study was to analyze the pattern of maxillofacial injuries in pediatric patients referred to three government main hospitals in different areas of West Malaysia. Patients' records of three selected hospitals in Malaysia (National University of Malaysia Hospital, Kajang Hospital and Seremban Hospital) from January 1999 to December 2001 were reviewed. Data associated with demographics, etiology of injury in relation to age group, type of injuries whether soft tissues of hard tissue in relation to age group and treatment modalities were collected. A total of 521 pediatric patients' records were reviewed. Malays made up the majority of patients with maxillofacial injuries in the three hospitals. Males outnumbered females in all the three hospitals. Injuries commonly occur in the 11-16 years old. MVA was the most common etiology followed by fall and assault. Soft tissue injuries were the most common type of injuries in all the hospitals. In relation to fractures, mandible was the most common bone to fracture with condyle being the most common site. Orbital fracture was the most common fracture in the midfacial area. Most of the fractures were managed conservatively especially in the younger age groups. Open reduction with or without internal fixation was more frequently carried out in the 11-16 years old group. Children exhibit different pattern of clinical features depending on the etiology and stage of their bone maturation. A dedicated team, who is competent in trauma and aware of the unique anatomy, physical and psychological characteristics of children, should manage pediatric patient with trauma.
Abd Rani Samsudin; Meor Zaidi Meor Kamal
The utilisation of vascularised and free bone autografts remain the goal standard in maxillofacial reconstructive surgery in Malaysia, but the use of freeze dried bone allograft is still widely practiced in many centres with variable results. This study evaluate the effectiveness and clinical efficacy of using radiation sterilised freeze dried bone allografts in oral and maxillofacial reconstructive surgery. The bone grafts were prepared at the Malaysian National Tissue Bank. Seventy eight patients who had undergone oral and Maxillofacial surgical procedures with reconstruction using bone allografts were included in this study. 50 patients were male and 28 patients were female and their age ranged from 14 to 75 years. Forty two patients underwent enucleation of benign cystic lesions in the jaws, 15 patients underwent repair of orbital floor fractures, 6 patients of jaw fractures with partial loss of bone while 8 patients underwent augmentation of depressed cheek bone. Another 4 patients had partial resection of the mandible because of cancer and 3 patients had facial osteotomies. A follow up period of 12 months up to 4 years was carried out. The patients were assessed both clinically and radiologically throughout their follow up visits. Clinical assessment showed no evidence of rejection of the implanted freeze dried allografts. Bone allografts implanted as inlay grafts demonstrated a better clinical performance than onlay grafts and the poorest results were obtained following bridging bony defects in the jaws. Radiation sterilised freeze dried bone allografts produced at the Malaysian National Tissue Bank are bio-compatible, functional, and provide predictable results when applied to selected areas of the facial skeleton
Preda, L; La Fianza, A; Di Maggio, E M; Dore, R; Schifino, M R; Mevio, E; Campani, R
Adequate radiologic assessment of the maxillofacial trauma patient is the basis for planning reparative surgery. We investigated the yield of the integration of axial CT with multiplanar (MP) and three-dimensional (3D) reconstructions with the Spiral technique. Thirty-five patients (21 men and 14 women, mean age: 31.2 years) with complex maxillofacial traumas were submitted to Spiral CT. Images were acquired with 2-3-mm collimation, 1:1 to 2:1 pitch, 210 mAs, 120 kV, 15-24 s Spiral scan, RI = 1. 3D reconstructions were always obtained and used to guide MPRs targeted on the single injury. The examinations were retrospectively given a score, namely 1 if 3D and MPR yielded no more important diagnostic information than axial CT, 2 if 3D and MPR permitted better detailing of some axial CT findings and thus improved image reading, and 3 if 3D and MPR showed new injuries missed on axial images. Then, a radiologist and a maxillofacial surgeon reviewed the 3D images together only to assess in which cases they were useful to optimize surgical planning. Nine cases (25.7%) scored 1, seventeen (48.6%) scored 2 and nine (25.7%) scored 3. MP and 3D reconstructions were useful or determinant (2 + 3) in over 74% of cases. 3D images made surgical planning easier in 15 of 32 surgical patients (46.8%), allowing the surgeon a better panoramic view of the complex fracture. The greatest advantage of multiplanar imaging is the improved depiction of skeletal injuries along a horizontal plane, paralleling that of axial scans. The depiction of fractures of cribrum and of orbital roof and floor was particularly useful from a clinical viewpoint. MPRs clearly depicted herniation and incarceration of the lower rectus muscle in blow-out fractures. MP and 3D reconstructions better defined the presence and grade of displaced bone fragments in nearly vertical structures, such as the upward branches and coronoid apophysis of the mandible. 3D images alone never showed any more fractures than those
Goth, Stephen; Sawatari, Yoh; Peleg, Michael
The pediatric mandible fracture is a rare occurrence when compared with the number of mandible fractures that occur within the adult population. Although the clinician who manages facial fractures may never encounter a pediatric mandible fracture, it is a unique injury that warrants a comprehensive discussion. Because of the unique anatomy, dentition, and growth of the pediatric patient, the management of a pediatric mandible fracture requires true diligence with a variance in treatment ranging from soft diet to open reduction and internal fixation. In addition to the variability in treatment, any trauma to the face of a child requires additional management factors including child abuse issues and long-term sequelae involving skeletal growth, which may affect facial symmetry and occlusion. The following is a review of the incidence, relevant anatomy, clinical and radiographic examination, and treatment modalities for specific fracture types of the pediatric mandible based on the clinical experience at the University of Miami/Jackson Memorial Hospital Oral and Maxillofacial Surgery program. In addition, a review of the literature regarding the management of the pediatric mandible fracture was performed to offer a more comprehensive overview of this unique subset of facial fractures.
Taiwo, Abdurrazaq Olanrewaju; Soyele, Olujide Oladele; Godwin, Ndubuizi Ugochukwu; Ibikunle, Adebayo Aremu
Background: Facial fracture is gradually become a public health problem in our community due to the attendant morbidity and mortality. Hence, the aim of this study was to determine the pattern of facial fracture in Dental and Maxillofacial Surgery Department of Usmanu Danfodiyo University Teaching Hospital. This cross-sectional study was undertaken to provide information regarding gender, age, etiology, and diagnosis of patients with maxillofacial fractures. Materials and Methods: A 1-year review of patients diagnosed and treated for facial fractures in Usmanu Danfodiyo University Teaching Hospital between January 2011 and December 2011. The diagnosis was based on radiographic data and clinical examination. The main analysis outcome measures were etiology, age, gender, site, and treatment. Data were organized and presented by means of descriptive statistics and Pearson's Chi-square test. The level of significance adopted was 5%. Results: A total of 40 patients were treated in this period. Over 95% were male, 81% were caused by road traffic crash (RTC) and 86.4% were in the 21-30 years group. Most patients (52%) had mandibular fractures, and the most common site was the body. Most patients with midfacial fractures had fractures of the zygomaticomaxillary region (36%), while fractures of the parasymphyseal region were more common in the mandible 156 (31%). The most common treatment for jaw fractures was mandibulomaxillary fixation (MMF). Stable zygomatic complex fractures were reduced (elevated) intraorally, and unstable ones were supported by antral packs. Conclusions: This study highlights facial fractures secondary to RTC as a serious public health problem in our environment. Preventive strategies remain the cheapest way to reduce direct and indirect costs of the sequelae of RTC. It also bring to the fore the necessity to shift to open reduction and internal fixation (ORIF) of fractures. PMID:24741422
Olusanya, Adeola Adenike; Adeleye, Amos Olufemi; Aladelusi, Timothy Olukunle; Fasola, Abiodun Olubayo
Many studies have been undertaken in Nigeria on maxillofacial trauma. However, only a few have considered both the skeletal and soft tissue injuries (in general) involving all the aspects of the maxillofacial region or considered other etiological sources of trauma apart from road traffic crashes. Fewer still have reviewed the outcome of management of facial injuries in our low-resource environment. This study sets out to examine the recent trends in both the clinical and epidemiological patterns of all facial injuries from all causes seen in a low-resource practice of a developing country. It also assessed the in-hospital treatment outcomes, and the levels of the patients' satisfaction with treatment received in this setting. Over a 12-month period, the clinical records of consecutive patients who were evaluated and treated for maxillofacial injuries in our unit were prospectively acquired, entered into predesigned forms and subsequently analyzed. There were 259 patients (79.5% males) during the study period. The mean age was 32.21( ± 16.588) years. Overall, motor bike crashes, 42.1%, were the commonest source of these traumas; and armed robbery was the commonest form (69.0%) of assault. Mandibular fractures were the commonest maxillofacial fractures (37.8%) whereas head injury had the highest frequency among the associated injuries (71.4%). Closed reduction and immobilization was deployed in 88.0% of those who had treatment and majority was satisfied with the esthetic outcome of the treatment received. Mean length of hospital stay was 12.6 ( ± 4.423) days. Maxillofacial trauma poses a significant socioeconomic burden on affected individuals in this study population. This is made worse by the presence of associated injuries in the other body systems. More local studies on the outcome of management of maxillofacial trauma will improve the available literature in this region.
Background: Oral and maxillofacial injuries have been shown worldwide to be a major cause of disability and orofacial deformity. The magnitude and causes of oral and maxillofacial injuries varies from one country to another or even within the same country depending on prevailing conditions such as socioeconomic, ...
OBJECTIVE: To evaluate Computed Tomographic findings in patients with gunshot injury (GSI) to the maxillofacial region. MATERIALS AND METHODS: A retrospective cohort study of patients who had Computed Tomography (CT) scanning done for GSI to the maxillofacial region at the University of Benin Teaching ...
Background: Several publications have presented pattern of maxillofacial surgical conditions based on data from hospital-based studies. The objective of this study is to present the spectrum of maxillofacial surgical conditions from the perspective of a community study. Methods: This is a prospective study of all patients ...
Objectives: The purpose of this article is to highlight the increasing occurrence of maxillofacial skeletal injuries from boat accidents in our environment and also to present our management modalities as experienced in our center. Materials and Methods: The case notes of the 6 maxillofacial skeletal injuries from boat ...
Background: Hard tissue defects in the maxillofacial region due to trauma or ablative surgery result in functional and cosmetic problems. State-of-theart methods for reconstruction include the use of vascularised tissue. Objective: To review our results with the use of non-vascularised rib grafts for maxillofacial reconstruction.
The oral and maxillofacial surgeon routinely treats patients with systemic diseases such as acute and chronic alcoholism, diabetes mellitus, hypertension, cardiovascular and pulmonary disease, neurological problems, as well as drug abusers. The new requirement for oral and maxillofacial surgery training programmes is ...
This information could also. Patterns, Severity, and Management of Maxillofacial. Injuries in a Suburban South Western Nigeria. Tertiary Center. Stella Aimiede Ogunmuyiwa, Olalere Omoyosola Gbolahan1,. Abiodun Abraham Ayantunde2, Adenike Abidemi Odewabi3. Department of Dental Services, Oral and Maxillofacial ...
Lübbers, Heinz-Theo; Matthews, Felix; Kruse, Astrid L
Modern technologies are influencing medicine everyday. The oral and maxillofacial surgery meet the worlds from medicine and dentistry. So technologies from both fields are utilized. This article provides an overview about technologies in clinical use, which are typical for the specialty. Their principles and indications are described as well as benefits and limitations. Based on Cone Beam Computed Tomography image fusion and mirroring techniques are explained as well as patient specific models and implants, template guided and free surgical navigation with and without intraoperative three-dimensional imaging. An overall assessment reveals further need of research regarding indications and patient benefit.
Full Text Available Oral Myiasis is a rare disease that is mostly reported in developing countries. It is primarily caused by the invasion of the human body by fly larvae. The phenomenon is well-documented in the skin, especially among animals. This case report describes the presentation of Oral Myiasis caused by Musca Nebulo (common house fly, in a 28-year-old patient, with recent maxillofacial trauma. The patient was treated by manual removal of the larvae, after topical application of turpentine oil, followed by surgical debridement and oral therapy with Ivermectin.
Zhao, Shan; Zhang, Zhen; Long, Qingqing; Ma, Yao; Lian, Xiaoqing; Yang, Yang; Gao, Wei; Chen, Zhong; Wang, Liansheng
To investigate the association between the time of day of sports-related physical activity and the onset of acute myocardial infarction (AMI) in a coronary artery disease (CAD) population in China. Between February 2014 and March 2015, a total of 696 patients from Nanjing, China, who had CAD were studied and divided into two groups (Non-AMI and AMI groups). The work-related activity and sports-related physical activity information were obtained from a self-reporting predesigned patient questionnaire. Sports-related physical activity was associated with a lower risk of the onset of AMI, after adjusting the established and potential confounders, with an adjusted odds ratio (OR) of 0.67 (95% CI, 0.47-0.94) compared with those who did not have any sports-related physical activity. A dose-response relationship was observed for intensity, duration, and frequency of sports-related physical activity. Further stratification analysis revealed that the protective effects of sports-related physical activity were significant in the morning and evening groups, and patients who exercised in the evening were at a lower risk of AMI than those doing sports-related physical activity in the morning. The adjusted ORs for doing sports-related physical activity in the morning and evening groups were 0.60(0.36-0.98) and 0.56(0.37-0.87), respectively, compared with inactivity (all Psports-related physical activity in the evening had an adjusted OR of 0.93 (95% CI, 0.54-1.64, P = 0.824) compared with in the morning group. Sports-related physical activity is associated with a lower risk of onset of AMI than inactivity in Chinese people. For CAD patients, we suggest they participate in sports-related physical activity of high intensity, long duration, and high frequency. Doing sports-related physical activity in the evening and in the morning have similar benefits on the prevention of the onset of AMI.
Cusimano, Michael D; Cho, Newton; Amin, Khizer; Shirazi, Mariam; McFaull, Steven R; Do, Minh T; Wong, Matthew C; Russell, Kelly
There is a gap in knowledge about the mechanisms of sports-related brain injuries. The objective of this study was to determine the mechanisms of brain injuries among children and youth participating in team sports. We conducted a retrospective case series of brain injuries suffered by children participating in team sports. The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) database was searched for brain injury cases among 5-19 year-olds playing ice hockey, soccer, American football (football), basketball, baseball, or rugby between 1990 and 2009. Mechanisms of injury were classified as "struck by player," "struck by object," "struck by sport implement," "struck surface," and "other." A descriptive analysis was performed. There were 12,799 brain injuries related to six team sports (16.2% of all brain injuries registered in CHIRPP). Males represented 81% of injuries and the mean age was 13.2 years. Ice hockey accounted for the greatest number of brain injuries (44.3%), followed by soccer (19.0%) and football (12.9%). In ice hockey, rugby, and basketball, striking another player was the most common injury mechanism. Football, basketball, and soccer also demonstrated high proportions of injuries due to contact with an object (e.g., post) among younger players. In baseball, a common mechanism in the 5-9 year-old group was being hit with a bat as a result of standing too close to the batter (26.1% males, 28.3% females). Many sports-related brain injury mechanisms are preventable. The results suggest that further efforts aimed at universal rule changes, safer playing environments, and the education of coaches, players, and parents should be targeted in maximizing prevention of sport-related brain injury using a multifaceted approach.
Michael D Cusimano
Full Text Available There is a gap in knowledge about the mechanisms of sports-related brain injuries. The objective of this study was to determine the mechanisms of brain injuries among children and youth participating in team sports.We conducted a retrospective case series of brain injuries suffered by children participating in team sports. The Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP database was searched for brain injury cases among 5-19 year-olds playing ice hockey, soccer, American football (football, basketball, baseball, or rugby between 1990 and 2009. Mechanisms of injury were classified as "struck by player," "struck by object," "struck by sport implement," "struck surface," and "other." A descriptive analysis was performed.There were 12,799 brain injuries related to six team sports (16.2% of all brain injuries registered in CHIRPP. Males represented 81% of injuries and the mean age was 13.2 years. Ice hockey accounted for the greatest number of brain injuries (44.3%, followed by soccer (19.0% and football (12.9%. In ice hockey, rugby, and basketball, striking another player was the most common injury mechanism. Football, basketball, and soccer also demonstrated high proportions of injuries due to contact with an object (e.g., post among younger players. In baseball, a common mechanism in the 5-9 year-old group was being hit with a bat as a result of standing too close to the batter (26.1% males, 28.3% females.Many sports-related brain injury mechanisms are preventable. The results suggest that further efforts aimed at universal rule changes, safer playing environments, and the education of coaches, players, and parents should be targeted in maximizing prevention of sport-related brain injury using a multifaceted approach.
MATSUMOTO, Hiroaki; YOSHIDA, Yasuhisa
A healthy 23-year-old man suffered helmet-to-helmet collisions with an opponent during American football game twice within 3 days. He then experienced continuous vomiting and dizziness. Magnetic resonance imaging revealed acute infarction in the right cerebellar hemisphere, and magnetic resonance angiography revealed transient stenosis of the right superior cerebellar artery. Although minor head injury is not usually accompanied by complications, posttraumatic ischemic stroke has been reported on rare occasions. We report a case of cerebellar infarction after repeated sports-related minor head injuries in a young adult and discuss the etiology. PMID:25746313
Risgaard, Bjarke; Winkel, Bo Gregers; Jabbari, Reza
BACKGROUND: Preparticipation screening programs have been suggested to reduce the numbers of sports-related sudden cardiac deaths (SrSCD). OBJECTIVE: The purpose of this study was to identify and characterize all SrSCD aged 12-49 years and to address the difference in incidence rates between...... competitive and noncompetitive athletes. METHODS: All deaths among persons aged 12-49 years from 2007-2009 were included. Death certificates were reviewed. History of previous admissions to hospital was assessed, and discharge summaries and autopsy reports were read. Sudden cardiac deaths (SCDs) and Sr...
Sasa, Takahiro; Sairyo, Koichi; Yoshida, Naoyuki; Ishikawa, Makoto; Fukunaga, Mari; Yasui, Natsuo
The purpose of this study was to evaluate the effects of ovariectomy on intramuscular energy metabolism in adult rats. Based on the results, we discussed the skeletal muscle metabolism in female athlete with sports related amenorrhea. Twenty-five adult (20-week-old) Sprague-Dawley female rats were used. Fifteen rats underwent ovariectomy (OVX group), and the other ten rats were sham-operated (Sham group). One and four weeks after surgery, muscular oxidative capacity was measured using 31P-MR ...
Carson, James D; Lawrence, David W; Kraft, Sari A; Garel, Alisha; Snow, Catherine L; Chatterjee, Ananda; Libfeld, Paula; MacKenzie, Heather M; Thornton, Jane S; Moineddin, Rahim; Frémont, Pierre
To determine what proportion of patients experience an exacerbation of their symptoms as a result of premature return to play (RTP) and return to learn (RTL) following sport-related concussions. Retrospective study of electronic medical records from the office-based practice of one family and sport medicine physician who had systematically provided recommendations for cognitive and physical rest based on existing consensus recommendations. Two blinded authors independently reviewed each chart, which included Sport Concussion Assessment Tool (SCAT) and SCAT2 symptom self-report forms to determine whether an athlete had returned to play or learn prematurely. If there was a discrepancy between the 2 reviewers then a third author reviewed the charts. A sport medicine and family practice in Ontario. The physician assessed sport-related concussions after self-referral or referral from other primary care physicians, teams, and schools. A total of 170 charts of 159 patients were assessed for sport-related concussion during a 5-year period (April 2006 to March 2011). All participants were students who were participating in sports at the time of injury. There were 41 concussions in elementary students, 95 concussions in high school students, and 34 concussions in college or university students. Premature RTP and RTL were defined as chart records documenting the recurrence or worsening of symptoms that accompanied the patients' RTP or RTL. Measures were compared using the earliest available SCAT forms and self-reporting. In 43.5% of concussion cases, the patient returned to sport too soon and in 44.7% of concussion cases, the patient returned to school too soon. Patients with a history of previous concussion required more days of rest before being permitted to participate in any physical activity than those patients without a previous history of concussion. Elementary school students required fewer days of rest before being permitted to return to any physical activity
Seppänen, Lotta; Rautemaa, Riina; Lindqvist, Christian; Lauhio, Anneli
Odontogenic maxillofacial infections occasionally require hospital care. Our aim was to study whether the number and the clinical features of patients hospitalized due to odontogenic abscesses in a large hospital district in Finland had changed in one decade. A retrospective analysis of two 12-month study cohorts one decade apart from the same population base was conducted. The first cohort comprised 71 patients and the second cohort comprised 101 patients. The incidence of odontogenic infections requiring hospital care increased from 5.3 to 7.2 per 100,000 inhabitants. The need for intensive care increased significantly from 15% to 32%, and the maximal C-reactive protein levels were significantly higher in the latter cohort, 127 mg/L, compared to the first cohort, 104 mg/L. The proportion of previously healthy patients decreased significantly from 83% to 65%. Odontogenic maxillofacial infections have become more prevalent and more severe during the decade in our hospital district. An increasing proportion of patients had underlying diseases.
Background: The purpose of this study was to analyze the pattern of mandibular fractures associated with domestic violence. Methods: This prospective study was carried out at the University of Calabar Teaching Hospital (UCTH) in the Accident and Emergency Centre and Dental and Maxillofacial Clinic between the ...
Norman, A.; Nelson, J.; Green, S.
Isolated fractures of the hamulus, formerly considered rare, are being seen more frequently. Many of these injuries are sports related, particularly in golf, tennis, racquetball and baseball players. Failure to make an early diagnosis can result in severe pain and sometimes incapacitating disability. The authors studied the clinical and radiological findings in 12 patients who had fracture of the hook of the hamate. The proposed three radiographic signs of fracture that are readily seen on routine PA projections: absence of the hook of the hamate; sclerosis of the hook; and lack of cortical density, i.e., barely visible outline, of the hamulus
Tirabassi, Jill; Brou, Lina; Khodaee, Morteza; Lefort, Roxanna; Fields, Sarah K; Comstock, R Dawn
Although rare, season- or career-ending injuries in young athletes are concerning because they can result in time lost from sport participation and school, social costs, and economic costs of medical care. To describe rates and patterns of medically disqualifying (MDQ) injuries among United States high school athletes overall and by sport, sex, type of athletic activity, and mechanism. Descriptive epidemiological study. Sports-related injury data on high school athletes were collected during the 2005-2006 through 2013-2014 academic years from a large national sample of United States high schools via High School Reporting Information Online (RIO). MDQ injuries were defined as season- or career-ending injuries. From 2005-2006 through 2013-2014, High School RIO captured 59,862 total injuries including 3599 MDQ injuries (6.0% of all injuries). Most MDQ injuries (60.4%) occurred in competition. Football had the highest injury rate (26.5 per 100,000 athlete-exposures), followed by gymnastics (18.6) and wrestling (17.9). MDQ injury rates were higher among girls in the sex-comparable sports of basketball (rate ratio [RR], 1.6; 95% CI, 1.3-2.0), cross-country (RR, 2.6; 95% CI, 1.0-7.5), soccer (RR, 1.6; 95% CI, 1.3-1.9), and track and field (RR, 2.6; 95% CI, 1.7-4.0). Player-player contact (48.2%) was the most common MDQ injury mechanism. The most commonly injured body site was the knee (33.7%). The most common MDQ injury diagnosis was sprains/strains (35.9%); the most common specific MDQ injury was knee sprains/strains (25.4%), with the anterior cruciate ligament being the most commonly injured knee structure. Among boys, fracture was the most common diagnosis in 3 sports, and sprain/strain was the most common in 6 sports. Among girls, sprain/strain was the most common diagnosis in 9 sports, and fracture was the most common only in softball. MDQ injuries vary by sport, sex, and type of athletic activity and occur most frequently as a result of player-player contact. These
Full Text Available The purpose of this study was to evaluate the effects of ovariectomy on intramuscular energy metabolism in adult rats. Based on the results, we discussed the skeletal muscle metabolism in female athlete with sports related amenorrhea. Twenty-five adult (20-week-old Sprague-Dawley female rats were used. Fifteen rats underwent ovariectomy (OVX group, and the other ten rats were sham-operated (Sham group. One and four weeks after surgery, muscular oxidative capacity was measured using 31P-MR spectra of the gastrocnemius-plantaris-soleus (GPS muscles group at rest and during electric stimulation. Wet weight and maximum tension of the whole GPS muscles group were also measured. From the MRS measurements, the muscle oxidative capacity in the OVX group was significantly lower than that in the Sham group (p < 0.05 at both one and four weeks after surgery. The muscle's wet weight one week after surgery in the OVX group was the same as the Sham group, while four weeks after surgery it was significantly greater than that in the Sham group (p < 0.05. There were no significant differences in maximum tension among the groups. In conclusion, in adult rats the oxidative capacity decreased due to ovariectomy despite the increase in muscle weight. It is suggested that the muscular endurance capacity in female adult athletes with sports related amenorrhea may deteriorate.
Stephens, Jaclyn A; Denckla, Martha B; McCambridge, Teri; Slomine, Beth S; Mahone, E Mark; Suskauer, Stacy J
Sensitive examination tools are needed to optimize evaluation after sport-related concussion (SRC). We preliminarily examined the Physical and Neurological Examination of Subtle Signs (PANESS) for sensitivity to motor changes in a pilot cohort of adolescents aged 13-17 with SRC. 15 Adolescents (5 females) with SRC were evaluated up to 3 times: within 2 weeks of injury, approximately 1 month later (mean 35 days between visits), and for those not recovered at the second visit, again following clinical recovery (mean 70 days between first and last visits for all participants). Comparison data were acquired from 20 age and sex-matched never-concussed healthy control athletes with no history of concussion who were evaluated twice (mean 32 days apart). Main effects of group, time, and interaction effects were evaluated with an analysis of covariance which controlled for socioeconomic status, times tested, and days between testing sessions. Adolescents with concussion had poorer PANESS performance than controls at all time points. Performance improved between visits within the concussion group with no change within the control group. These findings suggest that the PANESS merits additional study in larger cohorts and in combination with other markers of injury to facilitate an enhanced understanding of sports-related concussion and recovery.
Kale, Tejraj Pundalik; Kotrashetti, S M; Louis, Archana; Lingaraj, J B; Sarvesh, B U
To determine the incidence of mandibular ramus fractures in KLE's PK Hospital and to analyze the outcome of open reduction and internal fixation of these fractures. Using a retrospective study design, records of all trauma patients who reported to the Department of Oral and Maxillofacial Surgery, KLE's PK Hospital Belgaum, between the years January 2006 to October 2011 was obtained from the medical records office. The data variables that were analyzed were the name, age, sex, cause of injury, pretreatment occlusion, treatment given, period of MMF and post-treatment occlusion. Total number of mandibular fracture cases was 298. Ramus fractures were 10 in number which accounted for 3.3% of fractures. The age range of these 10 patients was seen to be between 20 to 80 years with the average age being 35.6 years. Of these 10 patients, 9 were male and 1 was female and 7 patients were treated by open reduction and internal fixation and the remaining 3 by closed reduction. The average period of MMF was 3 days for the patients who underwent open reduction and internal fixation. There was improvement in occlusion in all 10 patients post-treatment and there was no complication reported in any of the cases. Ramus fractures accounted for 3.3% of all mandibular fractures. Open reduction and internal fixation of ramus fractures ensures adequate functional and anatomic reduction. This study makes an attempt to throw a light on the increasing incidence of ramus fractures and a successful management of these fractures by open reduction and internal fixation. How to cite this article: Kale TP, Kotrashetti SM, Louis A, Lingaraj JB, Sarvesh BU. Mandibular Ramus Fractures: A Rarity. J Contemp Dent Pract 2013;14(1):39-42. Source of support: Nil Conflict of interest: None declared.
Norris, Olena; Mehra, Pushkar; Salama, Andrew
To analyze the current trends in the presentation and surgical treatment of patients admitted with facial gunshot wounds (GSWs) at an urban level 1 trauma center. Retrospective analysis of facial GSWs treated by the Department of Oral and Maxillofacial Surgery at Boston Medical Center from 2001 to 2011. The data were obtained from the institutional trauma registry and hospital records and analyzed with respect to the length of hospitalization, patient demographic data, treatment cost, and payments. During the study period, a total of 1,957 patients were admitted to the hospital with GSWs. Of these patients, 136 (6.9%) had injuries involving the facial region, 87% were men, and the most common injury was to neck zone III. Mandible fractures were encountered in 47% of the patients. The fractures were treated within 72 hours from admission for most patients; 22% of the patients required secondary surgical procedures, 20% of the patients had associated neurologic injuries, and 9% had cervical spine fractures. Angiography was performed in 60% of the patients, with 13% requiring embolization. Finally, 70% of the patients required airway management, and the overall patient mortality was 9%. Airway compromise was the most common life-threatening early problem. Patients admitted with higher stages of shock and lower mental status because of brain, vascular, and/or spinal cord injuries experienced prolonged hospitalization, increased treatment costs, and extended rehabilitation. Most of the facial GSWs presented as non-life-threatening injuries, but typically resulted in significant morbidity. The vast majority of injured patients relied on public aid or had no insurance. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Assael, Leon A
This article discusses the risk for wrong-site surgery in oral and maxillofacial surgery and the development and utility of checklists. The intent of checklists and the specific applicability of each of them to ambulatory oral and maxillofacial surgery are presented. Checklists and other considerations to mitigate the risk of wrong-site surgery are evaluated. The role of interprofessional teams in improving patient care outcomes with the checklist as a vehicle is evaluated. Recommendations for the use of checklists and related methods in the ambulatory oral and maxillofacial surgery setting are made. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available Gunshot injuries are rather serious but uncommon type of trauma in India. A 45-year-old male was presented with gunshot (pellets embedded in the maxillofacial area for 22 years. There is no consensus in the literature whether to attempt their removal or leave them in situ. Our patient had no long-term sequela like infection, fistula formation, carcinogenesis or metal poisoning to date except for chill feeling on cold days. Management of this patient presented a dilemma in treatment in view of the effects of foreign bodies in the maxillofacial area. Key words: Maxillofacial injuries; Wounds, gunshot; Firearms
Miceli, Ana Lucia Carpi; Pereira, Livia Costa; Torres, Thiago da Silva; Calasans-Maia, Mônica Diuana; Louro, Rafael Seabra
Autogenous bone grafts are the gold standard for reconstruction of atrophic jaws, pseudoarthroses, alveolar clefts, orthognathic surgery, mandibular discontinuity, and augmentation of sinus maxillary. Bone graft can be harvested from iliac bone, calvarium, tibial bone, rib, and intraoral bone. Proximal tibia is a common donor site with few reported problems compared with other sites. The aim of this study was to evaluate the use of proximal tibia as a donor area for maxillofacial reconstructions, focusing on quantifying the volume of cancellous graft harvested by a lateral approach and to assess the complications of this technique. In a retrospective study, we collected data from 31 patients, 18 women and 13 men (mean age: 36 years, range: 19-64), who were referred to the Department of Oral and Maxillofacial Surgery at the Servidores do Estado Federal Hospital. Patients were treated for sequelae of orthognathic surgery, jaw fracture, nonunion, malunion, pathology, and augmentation of bone volume to oral implant. The technique of choice was lateral access of proximal tibia metaphysis for graft removal from Gerdy tubercle under general anesthesia. The mean volume of bone harvested was 13.0 ± 3.7 mL (ranged: 8-23 mL). Only five patients (16%) had minor complications, which included superficial infection, pain, suture dehiscence, and unwanted scar. However, none of these complications decreases the result and resolved completely. We conclude that proximal tibia metaphysis for harvesting cancellous bone graft provides sufficient volume for procedures in oral and maxillofacial surgery with minimal postoperative morbidity.
Pelletier, Jacques C
Returning an athlete to play following a spinal or concussive injury remains a challenge for the health practitioner making the decision. Among the possible mechanisms responsible for such injuries in amateur football, the concept of "spearing" has attracted a great deal of attention in sport medicine. The purpose of this paper is to present a review of the diagnosis and treatment of the potentially catastrophic neck and head injuries caused by spearing in Canadian amateur football and to suggest the role the chiropractic profession can have in their prevention. It proposes to follow the recommendations advocated by the National Capital Amateur Football Association (NCAFA) athletic trainers group, led by a chiropractor. Information regarding the concepts and prevention of "spearing", concussion and spinal injuries at the amateur football level in both the United States and Canada was obtained using the following computerized search methods: PubMed - MeSH (via the National Center for Biotechnology Information (NCBI); The Index to Chiropractic Literature (ICL); Google Scholar Beta. Recent (2005) information on sports related spinal injuries and concussion were obtained by attendance at the 2005 Sports Related Concussion and Spine Injury Conference. Foxborough, Massachusetts. From a total of 698 references, 63 were retained. Literature search yields very little information regarding Canadian statistics for amateur football neck and head injuries. The author encourages such injury data collecting and proposes that original Canadian studies and statistical analyses be carried out, such as those from diverse sports groups in the United States and abroad.1, 2, 3 The NCAFA group of trainers recommends a changing of the rules for "spearing" within the league and advocates gathering of Canadian based sports injury statistics. It also recognizes the need for public presentations (of concussion/spinal injuries).5 This paper describes the different interpretations of spearing
Williams, Richelle M.; Welch, Cailee E.; Parsons, John T.; McLeod, Tamara C. Valovich
Context: Sport-related concussion can affect athletes' sport participation and academic success. With the recent emphasis on cognitive rest, student-athletes may benefit from academic accommodations (AA) in the classroom; however, athletic trainers' (ATs') perceived familiarity with, and use of, AA is unknown. Objective: To assess secondary school ATs' perceived familiarity with, attitudes and beliefs about, and incorporation of AA for student-athletes after sport-related concussion. A secondary purpose was to determine whether employment status altered familiarity and use of AA. Design: Cross-sectional study. Setting: Online survey. Patients or Other Participants: Of 3286 possible respondents, 851 secondary school ATs accessed the survey (response rate = 25.9%; 308 men [36.2%], 376 women [44.2%], 167 respondents [19.6%] with sex information missing; age = 37.3 ± 10.1 years). Main Outcome Measure(s): Participants were solicited via e-mail to complete the Beliefs, Attitudes and Knowledge Following Pediatric Athlete Concussion among Athletic Trainers employed in the secondary school setting (BAKPAC-AT) survey. The BAKPAC-AT assessed ATs' perceived familiarity, perceptions, and roles regarding 504 plans, Individualized Education Programs (IEPs), and returning student-athletes to the classroom. Independent variables were employment status (full time versus part time), employment model (direct versus outreach), years certified, and years of experience in the secondary school setting. The dependent variables were participants' responses to the AA questions. Spearman rank-correlation coefficients were used to assess relationships and Mann-Whitney U and χ2 tests (P athletes whose sport-related concussions they managed received AA. Respondents employed directly by the school were more familiar with 504 plans (P < .001) and IEPs (P < .001) and had a greater belief that ATs should have a role in AA. Both the number of years certified and the years of experience at the
Reddy, Krishna; Adalarasan, S; Mohan, Shanker; Sreenivasan, P; Thangavelu, A
Maxillofacial surgery is one of the most rapidly expanding specialities in India. There is however a very poor understanding of the scope of the speciality. This paper attempts to find out the awareness of the speciality in India. A questionnaire was given to 50 medical, dental undergraduate students, 50 medical and dental practitioners, and 50 lay persons giving us a total of 250 responses. 10 common anomalies were chosen and they were asked to choose the most appropriate speciality which they would ask to treat the problem. While trauma and facial deformity correction were recognised to be mainly treated by maxillofacial surgeons, the other maxillofacial problems were poorly recognised to be treated by our speciality. This study highlights the need to promote our speciality among the dentists, doctors and general public. and if need be even change the name of our speciality from oral and maxillofacial surgery to a more simple but more easily understood facial surgery.
Myer, Gregory D; Faigenbaum, Avery D; Chu, Donald A; Falkel, Jeff; Ford, Kevin R; Best, Thomas M; Hewett, Timothy E
As more children and adolescents participate in sports and conditioning activities (sometimes without consideration for cumulative workload), it is important to establish age-appropriate training guidelines that may reduce the risk of sports-related injury and enhance athletic performance. The purpose of this article is to review the scientific evidence on youth strength and conditioning and to provide age-appropriate recommendations for integrating different strength and conditioning activities into a well-designed program that is safe, effective, and enjoyable. Integrative training is defined as a program or plan that incorporates general and specific strength and conditioning activities that enhance both health- and skill-related components of physical fitness. The cornerstone of integrative training is age-appropriate education and instruction by qualified professionals who understand the physical and psychosocial uniqueness of children and adolescents.
Sontakke, Subodh Arun; Karjodkar, Freny R; Umarji, Hemant R
Purpose This study was to find the computed tomographic features of fibrous dysplasia of the maxillofacial region. Materials and Methods All eight cases included in the study reported either to Government Dental College and Hospital or Nair Hospital Dental College, Mumbai between 2003 and 2009. The patients were prescribed computed tomogram in addition to conventional radiographs of maxillofacial region which were studied for characteristic features of fibrous dysplasia. The diagnosis of fibr...
Omami, Galal [Oral Health Practice, University of Kentucky College of Dentistry, Lexington (United States)
Oral and maxillofacial radiologists may teach, practice, and/or conduct research with regard to any aspect of radiology. They are also responsible for establishing guidelines for radiographic selection criteria, radiation safety, and quality assurance. Some oral and maxillofacial radiologists have joint appointments in medical radiology. This provides a collaborative working environment with medical radiologists, who generally are not conversant with the diagnostic imaging of the jaws.
Herlin, Christian; Goudot, Patrick; Jammet, Patrick; Delaval, Christophe; Yachouh, Jacques
Oral and maxillofacial surgery has expanded rapidly over the past century. Recognition in France has grown since the first face transplantation in the world performed by Professor Bernard Devauchelle. This speciality, which seems to correspond to a narrow scope of services, actually involves oral, plastic, reconstructive, and cosmetic surgeries of the face. French training for maxillofacial surgeons differs from the Anglo-Saxon course of study. After examining surveys carried out in Great Britain, the United States, and Brazil, the perception of this speciality in the general public and among regular correspondents (general practitioners and dental practitioners) was ascertained. More than 4,000 questionnaires were sent to health care workers and patients attending dental practices. The returned questionnaires concerning recognition of this profession in France were analyzed. Evaluating awareness of maxillofacial surgery among practitioners and the public was of particular interest because it can overlap with several other specialities (ear, nose, and throat; plastic surgery; odontology). The questionnaire included the 20 items used in other similar studies so the results could be compared. Several fields of expertise were identified in maxillofacial surgery, in particular traumatology, surgery for facial birth defects, and orthognathic surgery. Moreover, dental practitioners were found to be the most regular correspondents of maxillofacial surgeons compared with general practitioners. Compared with Anglo-Saxon and Brazilian peers, French recognition of maxillofacial surgery was better. Despite encouraging results, maxillofacial surgery remains a somewhat obscure speciality for health care workers and the general public. Better awareness is necessary for this speciality to become the reference in facial surgery. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Юлия Владимировна Степанова
Full Text Available This article describes a rare case of congenital abnormality: a median facial cleft in combination with congenital complete bilateral cleft lip and palate. An integrated approach to the treatment of children with severe pathology of the maxillofacial area provides a good aesthetic and functional result. Surgical treatment in combination with orthodontic treatment, massage, myogymnastics, dynamic observation of the child contributes to the normal development of the maxillofacial area in a child with a rare congenital facial cleft.
Statement of Problem: Streptococcus viridans is one of the most important microorganisms in the establishment of infections leading to dental caries and heart valve damages. Therefore the diagnosis and prevention of these infections is critical in health care.Purpose: The aim of this in-vivo study was to determine the prevalence of viridans streptococci in abscesses occurring in the maxillofacial region.Materials and Methods: The study sample consisted of 39 patients with maxillofacial absces...
Full Text Available The past three decades have witnessed great advances in the field of diagnostic imaging. Many of these advances have greatly facilitated the diagnosis and treatment of a number of maxillofacial disorders. These modalities while employing different physical principles, are often complimentary, providing valuable information about different aspects of a given disease process. Computed Tomography, 3-D Computed Tomography, and Magnetic Resonance Imaging are some such valuable adjuncts, which have opened new dimensions in the diagnosis of maxillofacial disorders.
Campos, Giordano BP; Lucena, Eudes ES; da Silva, José Sandro P; Gomes, Petrus P; Germano, Adriano R
The study set out to evaluate the efficacy of two antibiotic prophylaxis regimens in patients with facial fractures admitted to the Oral and Maxillofacial Surgery and Traumatology services of the Onofre Lopes University Hospital attached to the Federal University of Rio Grande do Norte in the period from December 2011 to December 2012. The sample consisted of 74 patients divided into two groups, GI with forty-three patients and GII with 32. Both groups received 2 g of cefazolin, 20 minutes before surgery. The postoperative protocol for each group was randomly determined; group I (single dose) received no antibiotics after surgery but group II (24 h dosage) received 1 g of cefazolin every 6 hours for 24 hours. Postoperative infection incidence was 9.3% (seven patients), six patients in Group I and one in Group II. 85% of the infections were in mandibular fractures. Results were presented qualitatively and quantitatively and the Chi square test (taking the value for p to be < 0.05) showed no statistically significant differences in the efficacies of the two regimens in the comparisons made between the cases of fractures in the upper and middle thirds of the face with those in the lower third (mandibular fractures). Considering mandibular fractures alone, Group II proved to be more efficacious with a p value of 0.02. However, to confirm the tendency shown in the mandibular fracture treatments whereby prolonging antibiotic administration for 24 hours appeared to be beneficial, research needs to be done with much larger sample groups. PMID:25932244
Tremblay, Sebastien; Henry, Luke C; Bedetti, Christophe; Larson-Dupuis, Camille; Gagnon, Jean-François; Evans, Alan C; Théoret, Hugo; Lassonde, Maryse; De Beaumont, Louis
Sports-related concussions have been shown to lead to persistent subclinical anomalies of the motor and cognitive systems in young asymptomatic athletes. In advancing age, these latent alterations correlate with detectable motor and cognitive function decline. Until now, the interacting effects of concussions and the normal ageing process on white matter tract integrity remain unknown. Here we used a tract-based spatial statistical method to uncover potential white matter tissue damage in 15 retired athletes with a history of concussions, free of comorbid medical conditions. We also investigated potential associations between white matter integrity and declines in cognitive and motor functions. Compared to an age- and education-matched control group of 15 retired athletes without concussions, former athletes with concussions exhibited widespread white matter anomalies along many major association, interhemispheric, and projection tracts. Group contrasts revealed decreases in fractional anisotropy, as well as increases in mean and radial diffusivity measures in the concussed group. These differences were primarily apparent in fronto-parietal networks as well as in the frontal aspect of the corpus callosum. The white matter anomalies uncovered in concussed athletes were significantly associated with a decline in episodic memory and lateral ventricle expansion. Finally, the expected association between frontal white matter integrity and motor learning found in former non-concussed athletes was absent in concussed participants. Together, these results show that advancing age in retired athletes presenting with a history of sports-related concussions is linked to diffuse white matter abnormalities that are consistent with the effects of traumatic axonal injury and exacerbated demyelination. These changes in white matter integrity might explain the cognitive and motor function declines documented in this population. © The Author (2014). Published by Oxford University
Haran, Harini P; Bressan, Silvia; Oakley, Ed; Davis, Gavin A; Anderson, Vicki; Babl, Franz E
On-field management and return-to-play guidelines aim to ensure the identification and appropriate management of the concussed athlete. Compliance with current guidelines in many settings is unknown. We assessed whether key components of current concussion guidelines are being followed in child athletes. Prospective observational study. Data were collected from children (5-18 years) presenting to a paediatric emergency department with sport-related concussion via researcher-administered surveys in the emergency department and during a follow up phone call. On hospital discharge all patients received a return to sports fact sheet based on the International Concussion in Sports Group. Ninety-three had sustained a concussion (mean age 12.7 (±0.27) years, 83% male). Sports played included Australian Football (47%), soccer (12%), rugby (9%) basketball (8%), other (25%). 82% participated in organised sports. Concussive signs or symptoms included loss of consciousness (41%), disorientation (36%), vomiting (23%), amnesia (30%), headache (60%). For concussive injury in organised sports (n=76), overall 42% were not managed according to recommended guidelines: 19% were not immediately removed from play, 29% were allowed to return to play on the same day and 27% were not assessed by qualified personnel. 93% of parents and 96% of patients were unaware of concussion or return-to-play guidelines from their organisations. Overall, 72% were compliant with provided return-to-play guidelines. Many children with sports related-concussion are not formally assessed on-field and continue to play. On-field concussion management and return to play practices are often suboptimal. Awareness and education of coaches, teachers, parents and children need to be improved. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Nelson, Lindsay D; Guskiewicz, Kevin M; Barr, William B; Hammeke, Thomas A; Randolph, Christopher; Ahn, Kwang Woo; Wang, Yanzhi; McCrea, Michael A
Younger age has been hypothesized to be a risk factor for prolonged recovery after sport-related concussion, yet few studies have directly evaluated age differences in acute recovery. To compare clinical recovery patterns for high school and collegiate athletes. Prospective cohort study. Large, multicenter prospective sample collected from 1999-2003 in a sports medicine setting. Concussed athletes (n = 621; 545 males and 76 females) and uninjured controls (n = 150) participating in high school and collegiate contact and collision sports (79% in football, 15.7% in soccer, and the remainder in lacrosse or ice hockey). Participants underwent evaluation of symptoms (Graded Symptom Checklist), cognition (Standardized Assessment of Concussion, paper-and-pencil neuropsychological tests), and postural stability (Balance Error Scoring System). Athletes were evaluated preinjury and followed serially at several time points after concussive injury: immediately, 3 hours postinjury, and at days 1, 2, 3, 5, 7, and 45 or 90 (with neuropsychological measures administered at baseline and 3 postinjury time points). Comparisons of concussed high school and collegiate athletes with uninjured controls suggested that high school athletes took 1 to 2 days longer to recover on a cognitive (Standardized Assessment of Concussion) measure. Comparisons with the control group on other measures (symptoms, balance) as well as direct comparisons between concussed high school and collegiate samples revealed no differences in the recovery courses between the high school and collegiate groups on any measure. Group-level recovery occurred at or before 7 days postinjury on all assessment metrics. The findings suggest no clinically significant age differences exist in recovery after sport-related concussion, and therefore, separate injury-management protocols are not needed for high school and collegiate athletes.
Padmanabhan, M Y; Pandey, R K; Aparna, R
Tooth development may be hampered following traumatic injuries to maxilla or mandible. The developmental deviations that occur in a tooth bud in the line of a jaw fracture range from agenesis to hamartomatous proliferation. Odontomas are benign odontogenic hard tissue tumors, which are hamartomas characterized by slow growth and non-aggressive behavior. 'Erupted odontoma' is a term used to specifically denote odontomas, which are exposed into the oral cavity. These are rare entities with only 25-30 cases being reported so far in the dental literature. This clinical report is pertaining to a rare case of an erupted odontoma in an adolescent patient which was presenting as a hard tissue outgrowth along with an extra-oral sinus in the posterior mandibular region. The surgical excision of the odontoma along with the associated malformed teeth resulted in resolution of pain and sinus discharge associated with this lesion. Erupted odontomas need to be considered in the differential diagnosis of hard tissue projections or outgrowths in the site of past maxillofacial injuries. Surgical excision of these lesions enable resolution of patient symptoms associated with this condition as evidenced in the present case and in other cases cited in the literature. The erupted odontoma attached to malformed molars and presenting with signs and symptoms suggestive of osteomyelitis is a rare combination of developmental aberrations following maxillofacial injury.
Bhargava, Darpan; Thomas, Shaji; Chakravorty, Nupur; Dutt, Ashutosh
The purpose of this paper was to undertake a review of literature on trigeminocardiac reflex in oral and maxillofacial online data-base and discuss the pathophysiology, risk factor assessment, presentation of the reflex, prevention, management with emphasis on the role of the attending anaesthetist and the maxillofacial surgeon. The available literature relevant to oral and maxillofacial surgery in online data-base of the United States National Library of Medicine: Pubmed (http://www.ncbi.nlm.nih.gov/pubmed/) was searched. The inclusion criterion was to review published clinical papers, abstracts and evidence based reviews on trigeminocardiac reflex relevant to oral and maxillofacial surgery. Sixty-five articles were found with the search term "trigeminocardiac reflex" in the literature searched. Eighteen articles met the inclusion criteria for this study. The relevant data was extracted, tabulated and reviewed to draw evidence based conclusions for the management of trigeminocardiac reflex. Conclusions were drawn and discussed based on the reviewed maxillofacial literature with emphasis on the anaesthetist's and the surgeon's role in the management of this detrimental event in maxillofacial surgical practice.
To understand the current status of the discipline and work out the developmental tactics of oral and maxillofacial surgery in China. A questionnaire on the status of oral and maxillofacial surgery was designed and dispatched to the departments of stomatology in general hospitals at the level of prefecture or higher, stomatological hospitals and schools of stomatology. The contents of the questionnaire included the scale, manpower, professional extent, amount of clinical work and professional training of oral and maxillofacial surgery. The current status was compared with the previous status 5 and 10 years ago. In the most institutions which were surveyed, the number of oral and maxillofacial surgeons, beds and out-patients increased, the professional extent enlarged, and the clinical level improved. However, the above-mentioned clinical parameters decreased in some basic level institutions. The number of graduate students and trainees of oral and maxillofacial surgery decreased in one-third of institutions. The discipline of oral and maxillofacial surgery is continuously developing, but it is weakened in some basic level institutions. An effective developmental tactics should be carried on to improve the competition capability of the discipline.
Wu, P; Yang, Z Y; Liu, Y; Li, Y; Tan, Y H
To analyze the impact of maxillofacial injury on skull base. A three-dimensional(3D)finite-element model of cranio-maxillofacial bone was established by CT scan data. A lead cylinder in base diameter of 3 cm was designed as an impactor. There regions(upper right maxilla, left infraorbital margin and left zygomatic body)subjected to an impact at the speed of 8.6 m/s(about 30 km/h)was simulated. Thirteen landmarks at the skull base were selected. The values of stress at the end of 0.5, 1.0, 1.5, 2.0 ms were obtained, and the results were analyzed. The dynamic process of the fracture of the jaw and the stress distribution and conduction of the skull base were successfully simulated in three parts of the face. When the impact was on the right maxillary bone region, the stress values of the three points(medial foramen rotundum, medial foramen rotundum, anterior clivus reached the peak at each time point, 26.2, 22.4, 21.5 MPa(t=0.5 ms)and 70.0, 55.0, 45.0 MPa(t=1.0 ms)and 38.0, 26.5, 39.5 MPa(t=1.5 ms)and 26.0, 19.0, 23.0 MPa(t=2.0 ms), respectively. When the impact was on the left margo infraorbitalis orbitaeta region, the stress values of the two points(medial left foramen rotundum, posterior clivus)reached the peak at each time point, 8.8, 16.0 MPa(t=0.5 ms)and 10.0, 18.0 MPa(t=1.0 ms)and 5.5, 6.0 MPa(t=1.5 ms)and 11.5, 12.5 MPa(t=2.0 ms), respectively. When the impact was on the body of left zygomatic bone, the stress values of posterior clivus were 45.0 MPa(t=0.5 ms), 40.0 MPa(t=1.0 ms), 12.0 MPa(t=1.5 ms), 42.5 MPa(t= 2.0 ms), respectively. According to the difference of stress distribution and conduction of maxillofacial and skull base bone, the speed and the path of force transfer to the skull base were different. Finite-element dynamic simulation can be used for the biomechanics research on maxillofacial trauma.
Pohlenz, Philipp; Blessmann, Marco; Blake, Felix; Heinrich, Sven; Schmelzle, Rainer; Heiland, Max
Intraoperative cone-beam computerized tomography (CBCT) imaging has been introduced in oral and maxillofacial surgery. Using midfacial fractures as the pioneer model, this study describes the spectrum of further promising clinical indications for intraoperative CBCT and a clinical combination with intraoperative navigation. One hundred seventy-nine patients admitted for surgical treatment of the facial skeleton were included in the study. Intraoperatively, 3-dimensional images were generated with the mobile CBCT scanner Arcadis Orbic 3D, obtained from Siemens Medical Solutions, in a variety of indications. The acquisition of the data sets was uncomplicated, and image quality was sufficient to assess the postoperative result in all cases. In the example of a facial gunshot injury, a navigation system for intraoperative localization of the metal foreign bodies was used.
Full Text Available Objective: The aim of this study is to investigate the importanceof the initial radiographies of patients whose firstmedical intervention was made outside the country bordersand recovered after treatment in our hospital.Methods: The patients with maxillofacial trauma due togunshot and shrapnel injuries who were treated by Departmentof Otolaryngology in the last year were examinedretrospectively. Twenty two patients were includedto the study, who had injuries in another country and whowere received initial medical treatments there. The maxillofacialcomputed tomographies of patients which wereperformed before the treatment were evaluated accordingto the direction of movement of bone fracture fragments.Results: The youngest patient was 17 years old and theoldest one was 43 years old. All the patients were male. Itwas observed that all of the patients were referred to ourhospital after the first intervention had been made in othermedical centers. There was no reliable information aboutthe event of injury and type of used weapon. According tothe findings of the radiological images, the directions ofshootings were determined by the evaluation of the directionsof bone fragments in 19 (86.4% patients.Conclusion: The initial radiographic images of dead ormedically treated patients with bone fractures due to gunshotinjuries, in cases with unidentified origins and injurymechanisms, play an important role in the determinationof the direction of shooting. The wounds have been identifiedwhether they are entry or exit wounds when the directionsof fire are determined.Key words: Gunshot, direction of fire, bone fracture
Krishna Priya Vellore
Full Text Available The treatment of pediatric maxillofacial fractures is unique due to the psychological, physiological, developmental, and anatomical characteristics of children. Method. This case report describes the management of symphysis fracture of mandible in a 5-year-old boy. The fracture was treated by acrylic splint with circummandibular wiring. Results. The splint was removed after 3 weeks. The patient had no complaints, and radiograph revealed a healed fracture. Conclusion. The clinical outcome in the present case indicates the management of mandibular fractures in pediatric patients using acrylic splint with circummandibular wiring.
Hassfeld, S.; Brief, J.; Muehling, J.; Krempien, R.; Mende, U.; Raczkowsky, J.; Muenchenberg, J.; Woern, H.; Giess, H.; Meinzer, H.P.
Background: Methods from the area of virtual reality are used in oral and maxillofacial surgery for the planning and three-dimensional individual simulation of surgeries. Simulation: In order to simulate complex surgeries with the aid of a computer, the diagnostic image data and especially various imaging modalities (CT, MRT, US) must be arranged in relation to each other, thus enabling rapid switching between the various modalities as well as the viewing of mixed images. Segmenting techniques for the reconstruction of three-dimensional representations of soft-tissue and osseous areas are required. We must develop ergonomic and intuitively useable interaction methods for the surgeon, thus allowing for precise and fast entry of the planned surgical intervention in the planning and simulation phase. Surgery: During the surgical phase, instrument navigation tools offer the surgeon interactive support through operation guidance and control of potential dangers. This feature is already available today. Future intraoperative assistance will take the form of such passive tools for the support of intraoperative orientation as well as so-called tracking systems (semi-active systems) which accompany and support the surgeons' work. The final form are robots which execute specific steps completely autonomously. Discussion: The techniques of virtual reality keep gaining in importance for medical applications. Many applications are still being developed or are still in the form of a prototype. However, it is already clear that developments in this area will have a considerable effect on the surgeon's routine work. (orig.) [de
Pedroletti, Fred; Johnson, Brad S; McCain, Joseph P
Oral and maxillofacial surgery is entering a new era. Surgeons can use the latest technological advances in equipment in an attempt to improve patient outcomes. Minimally invasive surgery with the use of the endoscope has improved in recent years because of technological advancements in optics and associated instrumentation. Trauma, orthognathic, sialoendoscopy, and temporomandibular joint surgery are commonly performed with the assistance of the endoscope. From an educational standpoint, surgical anatomy and various other principles can easily be taught to trainees with the assistance of the endoscope. The operating surgeon can visualize an area via the endoscope, and instruct regarding the surgical maneuvers on the monitor, without obstructions to view. This technique also allows others in and out of the room to view the image. Endoscopically assisted surgery is gaining popularity and is becoming a tool frequently used by surgeons to assist in and simplify some of the more difficult techniques that often require more extensive surgical exposure for visualization. Copyright (c) 2010 Elsevier Inc. All rights reserved.
Kim, Eun Kyung
To implement the database system of oral and maxillofacial radiological images using a commercial medical image management software with personally developed classification code. The image database was built using a slightly modified commercial medical image management software, Dr. Image v.2.1 (Bit Computer Co., Korea). The function of wild card '*' was added to the search function of this program. Diagnosis classification codes were written as the number at the first three digits, and radiographic technique classification codes as the alphabet right after the diagnosis code. 449 radiological films of 218 cases from January, 2000 to December, 2000, which had been specially stored for the demonstration and education at Dept. of OMF Radiology of Dankook University Dental Hospital, were scanned with each patient information. Cases could be efficiently accessed and analyzed by using the classification code. Search and statistics results were easily obtained according to sex, age, disease diagnosis and radiographic technique. Efficient image management was possible with this image database system. Application of this system to other departments or personal image management can be made possible by utilizing the appropriate classification code system.
Haider, Mohammad Nadir; Leddy, John J; Pavlesen, Sonja; Kluczynski, Melissa; Baker, John G; Miecznikowski, Jeffrey C; Willer, Barry S
The Concussion in Sport Group guidelines recommend a multifaceted approach to help clinicians make return to sport decisions. The purpose of this study was to identify the most common multifaceted measures used to define clinical recovery from sport-related concussion in young athletes (high school and/or college level) and to summarise existing knowledge of criteria used to make return to sport decisions. Systematic review. The PubMed (MEDLINE), SPORTDiscus and Embase electronic databases were searched from 1 January 2000 to 1 March 2017 by three independent reviewers. Inclusion criteria: elementary, high school and college age groups, and a specific definition of clinical recovery that required two or more measures. review articles, articles using the same sample population, case studies, non-English language and those that used one measure only or did not specify the recovery measures used. Study quality was assessed using the Downs and Black Criteria. Of 2023 publications, 43 met inclusion criteria. Included articles reported the following measures of recovery: somatic symptom resolution or return to baseline (100%), cognitive recovery or return to baseline (86%), no exacerbation of symptoms on physical exertion (49%), normalisation of balance (30%), normal special physical examination (12%), successful return to school (5%), no exacerbation of symptoms with cognitive exertion (2%) and normalisation of cerebral blood flow (2%). Follow-up to validate the return to sport decision was reported in eight (19%) articles. Most studies were case-control or cohort (level of evidence 4) and had significant risk of bias. All studies of sport-related concussion use symptom reports to define recovery. A minority of studies used multiple measures of outcome or had clearly defined recovery criteria, the most common being a combination of a self-reported symptom checklist and a computerised neurocognitive test. Future studies ideally should define recovery a priori using
Howell, David Robert; Buckley, Thomas; Lynall, Robert C; Meehan, William
Prior studies suggest that concussion may lead to an increased risk of a subsequent time-loss sport-related injury, but the mechanisms responsible are unknown. We measured the symptom and dual-task gait outcomes for athletes initially post-concussion and after clinical recovery. Participants then self-reported any additional injuries incurred in the year after their concussion. Forty-two athletes (52% female, mean age=16.8±3.2 years) completed the study. They underwent a dual-task gait evaluation and symptom inventory within 21 days post-concussion, and again after they were deemed clinically recovered. Approximately one year later, participants documented if they had sustained any subsequent sport-related injuries. Repeated measures ANOVAs were used to evaluate changes in dual-task gait and symptoms across time and between groups. A significant group*time interaction (p=0.02) indicated that the group who went on to sustain a subsequent time-loss injury after returning to sports (n=15) demonstrated significant average walking speed dual-task cost worsening across time (-17.9±9.1% vs. -25.1±12.5%; p=0.007). In contrast, the group who did not sustain an additional injury walked with consistent dual-task cost values across time (-25.2±9.2% vs. -24.6±8.4%; p=0.76). Symptoms improved for all participants (main effect of time p<0.001; PCSS= 25.0±16.9 vs. 2.8±7.5; p<0.001), but did not differ between groups (p=0.77). Significant dual-task gait cost worsening throughout concussion recovery was associated with time-loss injuries during sports in the year after a concussion. These findings indicate that worsening ability to execute a concurrent gait and cognitive task may relate to the risk of incurring an injury during sports after clinical concussion recovery.
Carey, Elinor; Payne, Karl Frederick Braekkan; Ahmed, Nabeela; Goodson, Alexander
The use of smartphones has soared among healthcare professionals in recent years, with estimated figures reporting that the majority of clinicians own and use smartphones in the workplace. Smartphones allow the clinician to carry textbooks in their pocket, write documents on the move and use email and internet to enhance productivity and clinical decision making. These advances in smartphone technology have enabled access to healthcare information for the clinician and transfer of data between team members, giving rise to the phenomenon of telemedicine. With the ability to instantly transfer clinical data to the off-site surgeon, combined with purpose-built medical apps, the smartphone is rapidly becoming an invaluable tool for the modern surgeon. Many studies have linked the benefits of smartphones and apps in other surgical specialities, but no article to date has highlighted the merits and full scope of this technology to the Oral and Maxillofacial Surgeon. We report that 94 % of British maxillofacial surgery trainees own a smartphone, with 61 % owning an iPhone. 89 % of trainees questioned had downloaded medical apps and used them regularly during clinical activities. We discuss the clinical application of the smartphone in the field of oral and maxillofacial surgery and review a list of useful and relevant apps for the modern maxillofacial surgeon using the iPhone as an example platform.
Fattahi, Tirbod; Fernandes, Rui
The specialty of oral and maxillofacial surgery has witnessed a large trend of inclusion of maxillofacial oncology and microvascular reconstructive surgery within its scope of practice in recent years. The purpose of this report is to describe the authors' experience with a very active oncologic and microvascular reconstructive surgical service within an academic oral and maxillofacial surgical program at a large university teaching hospital. The operative log from July 1, 2010, to June 30, 2011, of 325 operations devoted to head and neck oncology and reconstruction was examined. Thirty-nine patients (group A) received a pedicled flap for head and neck reconstruction. Sixty-three patients (group B) received a microvascular free tissue transfer for head and neck reconstruction. Financial records of 20 consecutive patients who underwent simultaneous ablative and reconstructive procedures in each group were then reviewed for total hospital charges, including direct (surgical fees) and indirect (hospital stay, operating room expenses, and ancillary services) charges, and length of stay. Total hospital charges and direct surgical fees, were higher for the microvascular reconstruction group (group B). Length of hospital stay was not statistically different between the two groups. Microvascular reconstructive surgery performed within an academic oral and maxillofacial surgical program has many financial and intangible benefits within a medical center. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
BACKGROUND: Femoral neck stress fractures are relatively rare and may present as sports-related injuries. The presentation is variable, and prompt diagnosis facilitates the earliest return to pre-morbid functional activity levels. Delayed detection may precipitate femoral non-union or avascular necrosis, resulting in long-term functional deficit. AIMS: We present the case of a basicervical femoral neck stress fracture occurring in a 23-year-old marathon runner. The pathophysiology and practical management issues related to this unusual injury pattern are discussed. CONCLUSION: The growing interest in amateur athletic activities should raise the index of suspicion for stress fractures of the femoral neck in healthy adults with atypical hip pain. Increased levels of patient education and physician awareness can reduce the incidence of long-term morbidity in cases of this unusual sports-related injury.
Skorpil, N.E.; van den Bergh, B.; Heymans, M.W.; Forouzanfar, T.
This study was designed to investigate retrospectively the incidence of venous thromboembolism (VTE) and the need for thromboembolism prophylaxis in patients undergoing surgery for oral and maxillofacial trauma. Data were obtained from all patients treated under general anaesthesia for maxillofacial
Malfliet, Anneleen; Leysen, Laurence; Pas, Roselien; Kuppens, Kevin; Nijs, Jo; Van Wilgen, Paul; Huysmans, Eva; Goudman, Lisa; Ickmans, Kelly
In the last decade, evidence regarding chronic pain has developed exponentially. Numerous studies show that many chronic pain populations show specific neuroplastic changes in the peripheral and central nervous system. These changes are reflected in clinical manifestations, like a generalized hypersensitivity of the somatosensory system. Besides a hypersensitivity of bottom-up nociceptive transmission, there is also evidence for top-down facilitation of pain due to malfunctioning of the endogenous descending nociceptive modulatory systems. These and other aspects of modern pain neuroscience are starting to be applied within daily clinical practice. However, currently the application of this knowledge is mostly limited to the general adult population with musculoskeletal problems, while evidence is getting stronger that also in other chronic pain populations these neuroplastic processes may contribute to the occurrence and persistence of the pain problem. Therefore, this masterclass article aims at giving an overview of the current modern pain neuroscience knowledge and its potential application in post-cancer, paediatric and sports-related pain problems. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.
Davis, G A; Iverson, G L; Guskiewicz, K M; Ptito, A; Johnston, K M
To review the diagnostic tests and investigations used in the management of sports concussion, in the adult and paediatric populations, to (a) monitor the severity of symptoms and deficits, (b) track recovery and (c) advance knowledge relating to the natural history and neurobiology of the injury. Qualitative literature review of the neuroimaging, balance testing, electrophysiology, blood marker and concussion literature. PubMed and Medline databases were reviewed for investigations used in the management of adult and paediatric concussion, including structural imaging (computerised tomography, magnetic resonance imaging, diffusion tensor imaging), functional imaging (single photon emission computerised tomography, positron emission tomography, functional magnetic resonance imaging), spectroscopy (magnetic resonance spectroscopy, near infrared spectroscopy), balance testing (Balance Error Scoring System, Sensory Organization Test, gait testing, virtual reality), electrophysiological tests (electroencephalography, evoked potentials, event related potentials, magnetoencephalography, heart rate variability), genetics (apolipoprotein E4, channelopathies) and blood markers (S100, neuron-specific enolase, cleaved Tau protein, glutamate). For the adult and paediatric populations, each test has been classified as being: (1) clinically useful, (2) a research tool only or (3) not useful in sports-related concussion. The current status of the diagnostic tests and investigations is analysed, and potential directions for future research are provided. Currently, all tests and investigations, with the exception of clinical balance testing, remain experimental. There is accumulating research, however, that shows promise for the future clinical application of functional magnetic resonance imaging in sport concussion assessment and management.
Vassilyadi, Michael; Macartney, Gail; Barrowman, Nick; Anderson, Peter; Dube, Karen
Sports are a major cause of concussions, and little is known about the symptom experience and health-related quality of life (HRQL) in children who remain symptomatic for over 3 months following such head injuries. A cross-sectional study of children aged 10-18 years was performed who were referred to the Neurosurgery Clinic at our centre following a head injury. Symptom experience was measured using the modified Concussion Symptom Scale, and HRQL was measured using the Pediatric Quality of Life Inventory (PedsQL). The Immediate Postconcussion Assessment and Cognitive Test (ImPACT) was administered to assess neurocognitive and neurobehavioural sequelae. Symptoms with the highest mean symptom scores on a Likert scale of 0-6 in 35 children at the time of assessment included headaches (3.1), poor concentration (2.7), memory problems (2.1), fatigue (2.1) and sensitivity to noise (2.0). Compared with normative data, children in this study had ImPACT summary scores between the 28th and 38th percentiles and a comparably low Cognitive Efficiency Index score. Mean scores for females were consistently statistically significantly lower (p Children continue to experience many symptoms at least 3 months following sport-related head injuries that significantly impact their HRQL and neurocognitive abilities. © 2015 S. Karger AG, Basel.
Weaver, Cameron C; Martens, Matthew P; Cadigan, Jennifer M; Takamatsu, Stephanie K; Treloar, Hayley R; Pedersen, Eric R
Intercollegiate athletes report greater alcohol consumption and more alcohol-related problems than their non-athlete peers. Although college athletes share many of the same problems faced by non-athletes, there are some consequences that are unique to athletes. Studies have demonstrated that alcohol negatively affects athletic performance including increased dehydration, impeded muscle recovery, and increased risk for injury. Beyond risk factors for alcohol misuse that may affect college students in general, research has begun to examine risk factors that are unique to collegiate athletes. For example, research has found that off-season status, the leadership role, and athlete-specific drinking motives are associated with increased alcohol use. Given these findings, it is possible that other athlete-specific variables influence alcohol misuse. One such variable may be sport achievement orientation. The purpose of the current study was to examine the relationship between sport achievement orientation and alcohol outcomes. Given previous research regarding seasonal status and gender, these variables were examined as moderators. Varsity athletes (n=263) completed the Sport Orientation Questionnaire, which assesses sport-related achievement orientation on three scales (Competitiveness, Win Orientation, and Goal Orientation). In addition, participants completed measures of alcohol use and alcohol-related problems. Results indicated that Competitiveness, Win Orientation, and Goal Orientation were all significantly associated with alcohol use, but not alcohol-related problems. Moreover, these relationships were moderated by seasonal status and gender. These interactions, clinical implications, and limitations are discussed. © 2013.
Lanfranchi, M-C; Maïano, C; Morin, A J S; Therme, P
Very few studies examined the prevalence and sport-related predictors of disturbed eating attitudes and behaviors (DEABs) among adolescents involved in sport practice, and their results are mixed and inconclusive. These inconsistencies are most likely due to their methodological heterogeneity and to the fact that none of these studies took into consideration the potentially relevant characteristics of the sport practice context. This study attempts to answer this limitation among French adolescents not involved or involved in various sports contexts defined based on their organization, leanness-centration, and competitive level. Participants were 335 adolescents involved in sport practice, and 435 adolescents not involved in any form of regular sport practice. The DEABs were measured using the Eating Attitudes Test-26. Global results do not showed any significant association between the status of the participants and DEAB. However, these results drastically changed when we considered the potential moderating role of sex and age on these relations. Indeed, sports involvement in general, and involvement in leanness and competitive sports were found to exert sex- and age-differentiated effects on the risks of presenting clinically significant levels of DEAB. This study suggests the importance of monitoring, preventive, and early intervention mechanisms within the context of practice, particularly for adolescent girls. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Murdaugh, Donna L; Ono, Kim E; Reisner, Andrew; Burns, Thomas G
To determine the relation between sleep quantity and sleep disturbances on symptoms and neurocognitive ability during the acute phase (sports-related concussion (SRC; >21d). Prospective inception cohort study. General community setting of regional middle and high schools. A sample (N=971) including youth athletes with SRC (n=528) and controls (n=443) (age, 10-18y). Not applicable. Athletes completed the Immediate Post-Concussion Assessment and Cognitive Testing battery. Partial correlation analyses and independent t tests were conducted to assess sleep quantity the night before testing. Multivariate analysis of covariance was used to assess sleep disturbances and their interaction with age. Less sleep quantity was correlated with greater report of cognitive (P=.001) and neuropsychological (P=.024) symptoms specific to prolonged recovery from SRC. Sleep disturbances significantly affect each migraine, cognitive, and neuropsychological symptoms (Psleep disturbances and age (P=.04) at >21 days post-SRC. Findings emphasize that the continued presence of low sleep quantity and sleep disturbances in youth athletes with SRC should be a specific indicator to health professionals that these athletes are at an increased risk of protracted recovery. Further research should identify additional factors that may interact with sleep to increase the risk of protracted recovery. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Myer, Gregory D; Faigenbaum, Avery D; Ford, Kevin R; Best, Thomas M; Bergeron, Michael F; Hewett, Timothy E
Regular participation in organized youth sports does not ensure adequate exposure to skill- and health-related fitness activities, and sport training without preparatory conditioning does not appear to reduce risk of injury in young athletes. Current trends indicate that widespread participation in organized youth sports is occurring at a younger age, especially in girls. Current public health recommendations developed to promote muscle strengthening and bone building activities for youth aged 6 yr and older, along with increased involvement in competitive sport activities at younger ages, has increased interest and concern from parents, clinicians, coaches, and teachers regarding the optimal age to encourage and integrate more specialized physical training into youth development programs. This review synthesizes the latest literature and expert opinion regarding when to initiate neuromuscular conditioning in youth and presents a how-to integrative training conceptual model that could maximize the potential health-related benefits for children by reducing sports-related injury risk and encouraging lifelong, regular physical activity.
Holst, Anders Gaarsdal; Winkel, Bo Gregers; Theilade, Juliane
death (n = 4), and coronary artery disease (n = 2). The incidence of SCD in the general population age 12 to 35 was 3.76 (95% CI: 3.42 to 4.14) per 100,000 person-years. CONCLUSION: In Denmark, SrSCD is a rare occurrence and the incidence rate is lower than that of SCD in the general population......BACKGROUND: Studies on incidences of sports-related sudden cardiac death (SrSCD) are few and data are needed for the discussion of preparticipation screening for cardiac disease. OBJECTIVE: We sought to chart the incidence and etiology of SrSCD in the young in Denmark (population 5.4 million...... reports, selected hospital records, and multiple registries was used to identify cases of SCD and SrSCD. SrSCD was defined as SCD occurring during or within 1 hour after exercise in a competitive athlete. The size of the athlete population was estimated from national survey data. RESULTS: Fifteen (range 0...
Ramesh, Aruna; Ganguly, Rumpa [Dept. of Diagnostic Sciences, Div. of Oral and Maxillofacial Radiology, Tufts University School of Dental Medicine, Boston (United States)
The use of electronic tools in teaching is growing rapidly in all fields, and there are many options to choose from. We present one such platform, Learning Catalytics (LC) (Pearson, New York, NY, USA), which we utilized in our oral and maxillofacial radiology course for second-year dental students. The aim of our study was to assess the correlation between students' performance on course exams and self-assessment LC quizzes. The performance of 354 predoctoral dental students from 2 consecutive classes on the course exams and LC quizzes was assessed to identify correlations using the Spearman rank correlation test. The first class was given in-class LC quizzes that were graded for accuracy. The second class was given out-of-class quizzes that were treated as online self-assessment exercises. The grading in the self-assessment exercises was for participation only and not accuracy. All quizzes were scheduled 1-2 weeks before the course examinations. A positive but weak correlation was found between the overall quiz scores and exam scores when the two classes were combined (P<0.0001). A positive but weak correlation was likewise found between students' performance on exams and on in-class LC quizzes (class of 2016) (P<0.0001) as well as on exams and online LC quizzes (class of 2017) (P<0.0001). It is not just the introduction of technological tools that impacts learning, but also their use in enabling an interactive learning environment. The LC platform provides an excellent technological tool for enhancing learning by improving bidirectional communication in a learning environment.
Ramesh, Aruna; Ganguly, Rumpa
The use of electronic tools in teaching is growing rapidly in all fields, and there are many options to choose from. We present one such platform, Learning Catalytics (LC) (Pearson, New York, NY, USA), which we utilized in our oral and maxillofacial radiology course for second-year dental students. The aim of our study was to assess the correlation between students' performance on course exams and self-assessment LC quizzes. The performance of 354 predoctoral dental students from 2 consecutive classes on the course exams and LC quizzes was assessed to identify correlations using the Spearman rank correlation test. The first class was given in-class LC quizzes that were graded for accuracy. The second class was given out-of-class quizzes that were treated as online self-assessment exercises. The grading in the self-assessment exercises was for participation only and not accuracy. All quizzes were scheduled 1-2 weeks before the course examinations. A positive but weak correlation was found between the overall quiz scores and exam scores when the two classes were combined (P<0.0001). A positive but weak correlation was likewise found between students' performance on exams and on in-class LC quizzes (class of 2016) (P<0.0001) as well as on exams and online LC quizzes (class of 2017) (P<0.0001). It is not just the introduction of technological tools that impacts learning, but also their use in enabling an interactive learning environment. The LC platform provides an excellent technological tool for enhancing learning by improving bidirectional communication in a learning environment
Full Text Available Background. Panfacial fractures involves fractures of several bones of face. They are associated with malocclusion, dish face deformity, enopthalmos, diplopia, cerebrospinal fluid leak and soft tissue injuries. Purpose. The purpose of this paper is to present a case of minimizing surgical wound and morbidity. Case. A 40 year old female presented with severe maxillofacial injuries caused by motor vehicle collisions about 5 days prior to admission. The assessment of the patient is mild head injury, panfacial fractures, lacerated wound at face, rupture of globe of occular sinistra. An open reduction and internal fixation (ORIF and enucleation of globe occular sinistra was performed. Intraoral vestibular incision is made in the upper and lower vestibular region. Mucoperiosteal flap elevation of vestibular will exposure of the anterior maxilla and mandibular fractures. Intermaksilary fixation within 3 week and restore aesthetic with prosthesis fitting eyeball and denture. Discusion. The goal of treatment of panfacial fracture is to restore both the functions and pre-injury 3-dimensional facial contours. To achieve this goal two common sequences of management of Panfacial fractures are proposed, “Bottom up and inside out” or “Top down and outside in”. Other sequences exist but there are variations of these two major approaches. Conclusion. A minimally invasive approach to the fracture site is an alternative method to manage panfacial fracture with a simple, effective and lower complication rate.
Qiu, Luwen; Zhou, Zhongwei; Guo, Jixiang; Lv, Jiancheng
3D image registration aims at aligning two 3D data sets in a common coordinate system, which has been widely used in computer vision, pattern recognition and computer assisted surgery. One challenging problem in 3D registration is that point-wise correspondences between two point sets are often unknown apriori. In this work, we develop an automatic algorithm for 3D maxillofacial models registration including facial surface model and skull model. Our proposed registration algorithm can achieve a good alignment result between partial and whole maxillofacial model in spite of ambiguous matching, which has a potential application in the oral and maxillofacial reparative and reconstructive surgery. The proposed algorithm includes three steps: (1) 3D-SIFT features extraction and FPFH descriptors construction; (2) feature matching using SAC-IA; (3) coarse rigid alignment and refinement by ICP. Experiments on facial surfaces and mandible skull models demonstrate the efficiency and robustness of our algorithm.
Kawachi, Homare; Kawachi, Yasuyuki; Ikeda, Chihaya; Takagi, Ryo; Katakura, Akira; Shibahara, Takahiko
Intraoperative computer-assisted navigation has gained acceptance in maxillofacial surgery with applications in an increasing number of indications. We adapted a commercially available wireless passive marker system which allows calibration and tracking of virtually every instrument in maxillofacial surgery. Virtual computer-generated anatomical structures are displayed intraoperatively in a semi-immersive head-up display. Continuous observation of the operating field facilitated by computer assistance enables surgical navigation in accordance with the physician's preoperative plans. This case report documents the potential for augmented visualization concepts in surgical resection of tumors in the oral and maxillofacial region. We report a case of T3N2bM0 carcinoma of the maxillary gingival which was surgically resected with the assistance of the Stryker Navigation Cart System. This system was found to be useful in assisting preoperative planning and intraoperative monitoring.
Weapon and Sighting System Compatibility Assessment for Prototype Maxillofacial Protection Devices by Frank Morelli and William H. Harper...ARL-TR-6367 March 2013 Weapon and Sighting System Compatibility Assessment for Prototype Maxillofacial Protection Devices Frank Morelli...Compatibility Assessment for Prototype Maxillofacial Protection Devices 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S
Priya Shirish Joshi
Full Text Available Background: Many diseases present themselves in oral and maxillofacial regions and various modalities may be applied for their diagnosis, including intraoral and panoramic radiography, ultrasonography (USG, computer tomography, magnetic resonance imaging, and nuclear medicine methods such as positron emission tomography. Of these modalities, USG is easy to-use for the detection of non-invasive and soft tissue related diseases in oral and maxillofacial regions. USG plays an important role in analyzing normal and abnormal structures. In particular, in oral and maxillofacial regions, the USG may be clinically applied to evaluate lymph nodes, subcutaneous, and oral cavity-related diseases. Aims: The aim was to correlate the findings of USG and histopathology for the diagnosis of oral and maxillofacial pathology and to evaluate whether USG can be used as an adjunct in diagnosing oral and maxillofacial pathology. Materials and Methods: A total of 10 clinically diagnosed patients with intraoral cancerous growths, swellings in maxillary and neck region were included in this study. Incision biopsy was obtained for confirming provisional clinical diagnosis. The selected cases were advised USG. All patients were then posted either for hemi-glossectomy, hemi-mandibulectomy, and partial maxillectomy with or without radical neck dissection. Statistical Analysis: Student′s t-test and coefficient of correlation was used to statistically analyze significant relationship of both the methods. Result: In all 10 cases, USG correlated well with histopathology findings, it could also delineate tumor extent and measure tumor thickness. Conclusion: USG is an excellent method for the diagnosis of soft tissue lesions and can be used as an adjunct in diagnosing oral and maxillofacial pathology.
Cheong, Yuseon; Kang, Seong Sik; Kim, Minsoo; Son, Hee Jeong; Park, Jaewoo; Kim, Jeong-Mo
Airway management in patients with complex maxillofacial injuries is a challenge to anesthesiologists. Submental intubation is a useful technique that is less invasive than tracheostomy in securing the airways where orotracheal and nasotracheal intubation cannot be performed. This procedure avoids the use of tracheostomy and bypasses its associated morbidities. A flexible and kink-resistant reinforced endotracheal tube with detachable universal connector is commonly used for submental intubation. Herein, we report cases involving submental intubation using a reinforced endotracheal tube with a non-detachable universal connector in patients with complex maxillofacial injuries. PMID:27924286
Normal anatomy of the maxillofacial regions is clearly shown by both CT and MRI. The use of dental devices causes deterioration in CT and MRI of the tongue and oral floor. A high-resolution bone window display is highly useful in examining bony structures. Contrast CT is useful in diagnosis of tumorous, inflammatory, and vascular lesions. MRI shows the extensions of tumors more clearly than CT, and MRI enhanced with Gd-DTPA is very useful in determining tumor extensions into bony structures. Both CT and MRI should be used in diagnosis of maxillofacial lesions.
Guevara, Carlo; Pirgousis, Phillip; Steinberg, Barry
To compare military with civilian gunshot wounds (GSWs) in the maxillofacial region in order to establish differences in presentation, morbidity, and surgical management. A cross-sectional study design was used. The University of Florida at Jacksonville oral and maxillofacial surgery operating room census and hospital trauma registry were both reviewed to identify maxillofacial GSW cases from 2005 through 2011. Military GSW data (2005 through 2011) were obtained from the US Department of Defense (DOD). The predictor variables were civilian versus military GSW events. The outcome variables of interest included the region of the face involved, race, gender, death during admission, hospital length of stay, and number of days in the intensive care unit (ICU). Descriptive statistics were computed. The sample was divided into military maxillofacial GSWs (n = 412) and civilian maxillofacial GSWs (n = 287 treated of 2,478 presented). A significant difference was measured between study groups regarding the region of the face involved (P = .0451), gender (P ≤ .0001), and race (P ≤ .0001). No significant relationship was measured regarding deaths during admission (P = .6510) for either study group. No standard deviation values for hospital length of stay or number of ICU days were provided by the DOD. The mean hospital length of stay for the military group was within the 95% confidence interval of the civilian group findings (6.0-7.6). The mean number of ICU days for the military group was not within the civilian group's 95% confidence interval (1.9-2.9). These data showed important differences in anatomic location, gender, and race distribution of maxillofacial GSWs between military and civilian populations. Limited analysis of hospital length of stay and number of ICU days might indicate no meaningful difference in hospital length of stay, although there was a statistical difference in the number of ICU days between the 2 populations. Future research comparing
Olayemi, Akinbami Babatunde; Adeniyi, Akadiri Oladimeji; Samuel, Udeabor; Emeka, Obiechina Ambrose
Background: The pattern of craniofacial soft-tissue injuries occurring either in isolation or in association with fractures vary in different societies and is multiply influenced. The effects are enormous because of the prominence of the face; therefore, the purpose of this study was to document any changing pattern, severity and management of these craniofacial injuries in our center. Patients and Method: Cranio-maxillofacial region was classified into upper, middle and lower face. The cause, type, and site of the injuries were documented. Gunshot injuries were further categorized as penetrating, perforating or avulsions. Further, classification of injuries into mild, moderate, and severe was carried out based on multiple factors. Result: A total of 126 patients with soft-tissue injuries presented to our hospital out of which 85 (67.5%) were males and 41 (32.5) were females. The age range of the patients was between 10 months and 90 years with a mean ± SD of 26.4 ± 15.5 years. Road traffic accident was the most common etiology of which vehicular accidents constituted 50 (54.9%) and the motorcycle was 2 (2.2%). Assault contributed 16 (17.6%) while cases due to gun shots were 13 (14.3%). A total of 19 (15.1%) patients had associated head injuries, 11 (8.7%) patients had craniofacial fractures involving any of the bones while 3 (2.4%) patients had limb fractures and 2 (1.6%) patients had rib fractures. There were 51 (41.8%) cases classified as mild injuries, 37 (30.3%) cases as moderate injuries and 24 (19.7%) cases as severe injuries. Total of 126 cases managed, 121 (96.0%) received primary closure of the wounds while 5 (4.0%) received delayed closure under general anesthesia. PMID:24339654
Akinbami Babatunde Olayemi
Full Text Available Background: The pattern of craniofacial soft-tissue injuries occurring either in isolation or in association with fractures vary in different societies and is multiply influenced. The effects are enormous because of the prominence of the face; therefore, the purpose of this study was to document any changing pattern, severity and management of these craniofacial injuries in our center. Patients and Method: Cranio-maxillofacial region was classified into upper, middle and lower face. The cause, type, and site of the injuries were documented. Gunshot injuries were further categorized as penetrating, perforating or avulsions. Further, classification of injuries into mild, moderate, and severe was carried out based on multiple factors. Result: A total of 126 patients with soft-tissue injuries presented to our hospital out of which 85 (67.5% were males and 41 (32.5 were females. The age range of the patients was between 10 months and 90 years with a mean ± SD of 26.4 ± 15.5 years. Road traffic accident was the most common etiology of which vehicular accidents constituted 50 (54.9% and the motorcycle was 2 (2.2%. Assault contributed 16 (17.6% while cases due to gun shots were 13 (14.3%. A total of 19 (15.1% patients had associated head injuries, 11 (8.7% patients had craniofacial fractures involving any of the bones while 3 (2.4% patients had limb fractures and 2 (1.6% patients had rib fractures. There were 51 (41.8% cases classified as mild injuries, 37 (30.3% cases as moderate injuries and 24 (19.7% cases as severe injuries. Total of 126 cases managed, 121 (96.0% received primary closure of the wounds while 5 (4.0% received delayed closure under general anesthesia.
Del Buono, Angelo; Smith, Rebecca; Coco, Manuela; Woolley, Laurence; Denaro, Vincenzo; Maffulli, Nicola
This review aims to provide information on the time athletes will take to resume sports activity following ankle fractures. We systematically searched Medline (PubMED), EMBASE, CINHAL, Cochrane, Sports Discus and Google scholar databases using the combined keywords 'ankle fractures', 'ankle injuries', 'athletes', 'sports', 'return to sport', 'recovery', 'operative fixation', 'pinning', 'return to activity' to identify articles published in English, Spanish, French, Portuguese and Italian. Seven retrospective studies fulfilled our inclusion criteria. Of the 793 patients, 469 (59%) were males and 324 (41%) were females, and of the 356 ankle fractures we obtained information on, 338 were acute and 18 stress fractures. The general principles were to undertake open reduction and internal fixation of acute fractures, and manage stress fractures conservatively unless a thin fracture line was visible on radiographs. The best timing to return to sports after an acute ankle fracture is still undefined, given the heterogeneity of the outcome measures and results. The time to return to sports after an acute stress injury ranged from 3 to 51 weeks. When facing athletes with ankle fractures, associated injuries have to be assessed and addressed to improve current treatment lines and satisfy future expectancies. The best timing to return to sports after an ankle fracture has not been established yet. The ideas of the return to activity parameter and surgeon databases including sports-related information could induce research to progress.
Igor V. Timofeev
Full Text Available Introduction. The frequency of patellar fractures is approximately 0.5% to 1.5% of all skeletal injuries. The following types of fractures can be distinguished: avulsive, transverse, longitudinal, and comminuted. In cases of displacement of more than 2–3 mm and quadriceps tendon injuries open reduction and internal fixation with the restoration of the articular surface is more preferable. In cases of longitudinal fractures, arthroscopy is regarded as a highly effective method of surgical treatment. Materials and methods. Using arthroscopy, we have operated on 4 patients with longitudinal fracture of the patella. The average age of the injured persons was 15.4 years (14–17. These were 3 males and 1 female. All patients had sport-related injuries. Because of the longitudinal fracture of the patella, the lateral knee extensor mechanism remained intact, and arthrosopy-assisted surgical intervention with closed reposition of fragments and transcutaneous wire fixation was performed without wire suturing. Results and discussion. Minimal invasiveness, the possibility of visual control over the recovery quality of patellar surface, the reliability of fragment fixation, and a significant reduction in the subsequent rehabilitation make arthroscopy a highly effective method of surgical treatment for patellar fractures.
... hip fractures in people of all ages. In older adults, a hip fracture is most often a result of a fall from a standing height. In people with very weak bones, a hip fracture can occur simply by standing on the leg and twisting. Risk factors The rate of hip fractures increases substantially with ...
The objective of this study was to evaluate the association between severity of maxillofacial injuries determined by trauma scoring systems and its economic burden to patients in terms of cost and duration of hospitalization. Following ethical approval a retrospective chart review was undertaken at Meenakshi Ammal Dental College and Hospital to identify patients admitted with maxillofacial injuries between January 2006 and December 2008. Patients with incomplete records, associated injuries, debilitating systemic diseases and patients treated under local anesthesia were excluded. Details regarding the nature and severity of injury and treatment were recorded in addition to the total treatment cost and duration of hospitalization. Maxillofacial injury severity was scored using maxillofacial injury severity score (MFISS) and facial injury severity scale (FISS). The MFISS and FISS scores were correlated with two surrogate markers of the economic burden namely cost and duration of hospitalization. A total of 162 patients with maxillofacial injuries were identified (108 males, 54 females; mean age = 32.4 years). Road traffic accidents were the cause of injury in 114 patients (70.4%) and only 29 patients (17.9%) had medical insurance coverage. The mean MFISS and FISS scores were 14.04 (standard deviation [SD] = 9.19; range = 3-42) and 4.40 (SD = 3.17; range = 1-14), respectively. The mean cost and duration of hospitalization of the patients were Indian rupees (INR) 13877.28 (SD = 8252.59; range = INR 5250-42960) and 4.12 days (SD = 1.5; range = 2-8 days) respectively. Pearson's correlation between the MFISS and FISS scores and the cost and duration of hospitalization, revealed statistically significant correlations (MFISS vs. cost - R = 0.862, P maxillofacial injury severity measured by MFISS and FISS scores are predictable indicators of the economic burden to the patients.
Schneiders, Anthony G; Sullivan, S John; Kvarnström, Johan; Olsson, Maria; Ydén, Tobias; Marshall, Stephen
The Sport Concussion Assessment Tool (SCAT) is a standardised global assessment for the identification of sport-related concussion (SRC). An integral component of the SCAT is the neurological screen, which contains the assessment of motor performance including gait evaluation. However, it is not known how performance of gait is affected by the surface/footwear interactions encountered in various sporting environments. The purpose of this study was to investigate the effect of footwear and sporting surface on the time to perform a standardised Tandem Gait (TG) task. One hundred and eight amateur athletes were recruited, and three common sports-surfaces (grass, hardwood court, artificial turf) were compared. All groups were tested barefoot and with sports-surface specific footwear. Mixed model ANOVA, controlling for covariates and including a post hoc Bonferroni procedure, was used to investigate the influence of footwear and sports-surface on TG time. The study demonstrated that times for a defined TG task in healthy athletes depended on footwear, sports-surface, and the specific athletic population. The study demonstrated a significant interaction (F(2,104)=3.35, p=0.039) between groups (grass, hardwood court and artificial turf), and times were faster wearing footwear compared to barefoot (F(2,138)=26.31, p=0.001). In contrast to the footwear conditions, there was no statistical difference between the barefoot conditions on any of the sport-surfaces. These findings suggest that clinicians should standardise footwear and the testing surface at baseline in order to accurately assess motor performance tests when SRC is suspected. Copyright 2010 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
McCrea, Michael; Meier, Timothy; Huber, Daniel; Ptito, Alain; Bigler, Erin; Debert, Chantel T; Manley, Geoff; Menon, David; Chen, Jen-Kai; Wall, Rachel; Schneider, Kathryn J; McAllister, Thomas
To conduct a systematic review of published literature on advanced neuroimaging, fluid biomarkers and genetic testing in the assessment of sport-related concussion (SRC). Computerised searches of Medline, PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Scopus and Cochrane Library from 1 January 2000 to 31 December 2016 were done. There were 3222 articles identified. In addition to medical subject heading terms, a study was included if (1) published in English, (2) represented original research, (3) involved human research, (4) pertained to SRC and (5) involved data from neuroimaging, fluid biomarkers or genetic testing collected within 6 months of injury. Ninety-eight studies qualified for review (76 neuroimaging, 16 biomarkers and 6 genetic testing). Separate reviews were conducted for neuroimaging, biomarkers and genetic testing. A standardised data extraction tool was used to document study design, population, tests employed and key findings. Reviewers used a modified quality assessment of studies of diagnostic accuracy studies (QUADAS-2) tool to rate the risk of bias, and a modified Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to rate the overall level of evidence for each search. Results from the three respective reviews are compiled in separate tables and an interpretive summary of the findings is provided. Advanced neuroimaging, fluid biomarkers and genetic testing are important research tools, but require further validation to determine their ultimate clinical utility in the evaluation of SRC. Future research efforts should address current gaps that limit clinical translation. Ultimately, research on neurobiological and genetic aspects of SRC is predicted to have major translational significance to evidence-based approaches to clinical management of SRC, much like applied clinical research has had over the past 20 years. © Article author(s) (or their employer(s) unless otherwise
Papa, Linda; Ramia, Michelle M; Edwards, Damyan; Johnson, Brian D; Slobounov, Semyon M
The aim of this study was to systematically review clinical studies examining biofluid biomarkers of brain injury for concussion in athletes. Data sources included PubMed, MEDLINE, and the Cochrane Database from 1966 to October 2013. Studies were included if they recruited athletes participating in organized sports who experienced concussion or head injury during a sports-related activity and had brain injury biomarkers measured. Acceptable research designs included experimental, observational, and case-control studies. Review articles, opinion papers, and editorials were excluded. After title and abstract screening of potential articles, full texts were independently reviewed to identify articles that met inclusion criteria. A composite evidentiary table was then constructed and documented the study title, design, population, methods, sample size, outcome measures, and results. The search identified 52 publications, of which 13 were selected and critically reviewed. All of the included studies were prospective and were published either in or after the year 2000. Sports included boxing (six studies), soccer (five studies), running/jogging (two studies), hockey (one study), basketball (one study), cycling (one study), and swimming (one study). The majority of studies (92%) had fewer than 100 patients. Three studies (23%) evaluated biomarkers in cerebrospinal fluid (CSF), one in both serum and CSF, and 10 (77%) in serum exclusively. There were 11 different biomarkers assessed, including S100β, glial fibrillary acidic protein, neuron-specific enolase, tau, neurofilament light protein, amyloid beta, brain-derived neurotrophic factor, creatine kinase and heart-type fatty acid binding protein, prolactin, cortisol, and albumin. A handful of biomarkers showed a correlation with number of hits to the head (soccer), acceleration/deceleration forces (jumps, collisions, and falls), postconcussive symptoms, trauma to the body versus the head, and dynamics of different sports
Ono, Kim E; Burns, Thomas G; Bearden, Donald J; McManus, Susan M; King, Harold; Reisner, Andrew
To date, few studies have delineated clear sex-based differences in symptom resolution after a sports-related concussion (SRC), and equivocal results have been identified in sex-based differences on baseline assessments. To assess whether female athletes displayed prolonged recovery and more symptoms at baseline and after an SRC compared with male athletes. Cohort study; Level of evidence, 3. The current study assessed 135 male and 41 female athletes (10-18 years old) who participated in high-impact sports in metropolitan Atlanta middle and high schools. All athletes completed a baseline assessment and at least 1 postconcussion assessment from the Immediate Post-Concussion Assessment and Cognitive Testing battery. Longitudinal hierarchical linear modeling was employed to examine individual-level variables and their associations with adolescents' rates of recovery in concussive symptoms after controlling for age and number of prior concussions. Aggregate symptoms were rated as higher in female athletes compared with male athletes at baseline (mean ± SD: females, 13.49 ± 11.20; males, 4.88 ± 8.74; F(1,175) = 10.59, P concussion (females: 16.75 ± 18.08; males: 10.58 ± 14.21; F(1,175) = 3.99, P = .05). There were no group differences in the slope of recovery between male and female athletes, indicating generally similar trajectories of change for both groups. Post hoc analyses revealed higher baseline levels of migraine and neuropsychological symptoms in female athletes. Although female athletes in the current study reported increased symptoms, identical recovery patterns were observed in both sexes, suggesting that sex-based differences in concussion recovery are better explained by increased symptom frequency among female athletes when compared with their male counterparts. © 2015 The Author(s).
A questionnaire was designed to assess the knowledge of the community of the specialties of Oral and Maxillofacial Surgery, Ear, Nose and Throat (ENT), and plastic Surgery. They were asked some questions on their choice of surgeon to treat them if they or a member of their families had an identified surgical problem.
... of treatment was successful in 18(90%) and satisfactory in 17(85%) cases. Conclusion: Secondary repair is more relevant than delayed repair in portions of the face that have less sufficient blood supply that sustain gunshot injuries. Keywords: Gunshot, Injury, repair, Maxillofacial Nigerian Journal of Plastic Surgery Vol.
Objective: The study was undertaken to document the pattern of maxillofacial emergencies presenting to the accident and emergency unit of the Obafemi Awolowo University Teaching hospital, Ile-Ife between January 2001 and December 2002. Method: The patients' demographics, the time of presentation, duration of ...
Bacground: Tumours that affect the oral and maxillofacial region originate from odontogenic or non odontogenic tissues. They possess varying clinical and histopathological characteristics based upon which they are regarded as either benign or malignant. Objective: To report on the demographic, diagnosis, treatment and ...
Lassila, Lippo V.J.; Tolvanen, Mimmi; Valittu, Pekka K.
PURPOSE Maxillofacial silicone elastomer is usually colored intrinsically with color pigments to match skin colors. The purpose of this study was to investigate the color stability of a maxillofacial silicone elastomer, colored with a thermochromic, color changing pigment. MATERIALS AND METHODS Disc-shaped maxillofacial silicone specimens were prepared and divided into 3 groups: a conventionally colored control group, one group additionally colored with 0.2 wt% thermochromic pigment , and one group with 0.6 wt% thermochromic pigment. Half of the surface of each specimen was covered with an aluminium foil. All of the specimens were exposed to UV radiation in 6 hour cycles over 46 days. In between the UV exposures, half of the specimens were stored in darkness, at room temperature, and the other half was stored in an incubator, at a humidity of 97% and a temperature of +37℃. Color measurements were made with a spectrophotometer and registered according to the CIELAB L*a*b* color model system. The changes in L*, a* and b* values during artificial aging were statistically analyzed by using paired samples t-test and repeated measures ANOVA. P-values maxillofacial prostheses. PMID:23755330
Objective: To establish the aetiology, pattern and methods of management of oral and Maxillofacial injuries (OMFIs) seen at the Oral and Jaw injuries unit of Mulago National Referral Hospital (MNRH) Kampala, Uganda, over a ten year period. Design: A descriptive retrospective study. Setting: Oral and jaw injury unit of ...
Dec 5, 2017 ... relative contributions of each surgical condition to the average workload of the oral and maxillofacial surgeon. However, the few hospital-based studies complimented by the present one could give a fair idea of the present workload pattern in Nigeria. Figure 3: A group of TMJ ankylosis patients presenting ...
Nov 27, 2014 ... believe the greatest challenge facing oncological maxillofacial surgery in Nigeria was late presentation of patients. Conclusion: The scope of .... by most respondents (93.8%, n = 30) was late presentation of patients, 21.9% (n = 7) also .... Though the sample size is small, it is a fair reflection of the size of the ...
This work examined phenotypic expressions in the anatomy of the mandible and maxillofacial region of the Red Sokoto and Sahel goats in Nigeria. The infraorbital foramen was placed above premolar two (PM2) in Red Sokoto but above premolar one (PM1) in Sahel. The Red Sokoto displayed interdigital septa (ruggae) ...
Background: Oral and maxillofacial surgery is still evolving, with the scope of practice in Nigeria inadequately determined. Aims and Objectives: This study aims to ascertain the level of practice in various parts of the country vis‑a‑vis the global trend and factors influencing the scope in Nigeria. Design of the Study: ...
Head injury (55.8%) was the commonest associated injury. Conclusion: The low utilization of safety devices like seat belts and air bags as well as the absence and non-enforcement of road traffic legislation were identified as aetiological factors. Keywords: Aetiologic factors, maxillofacial trauma, road traffic accidents
Wood, Eric W; Strauss, Robert A; Janus, Charles; Carrico, Caroline K
To determine the perceived utility and demand for the application of telemedicine for improved patient care between nonsurgical dental practitioners (GPs) and oral and maxillofacial surgeons (OMS). Two distinct questionnaires were made, one for GPs and one for OMSs. The GP questionnaire was sent to practicing Virginia Dental Association members on an e-mail list (approximately 2,200). The OMS questionnaire was sent by the Virginia Society of Oral Maxillofacial Surgery to members on an e-mail list (approximately 213). Questionnaires included questions about access to care, benefits of telemedicine consultations, reliability of telemedicine consultations, and perceived barriers against and opportunities for the implementation of telemedicine. The questionnaire was completed by 226 GP and 41 OMS respondents. There was a significant difference among responses of GPs based on practice location: rural patients had a longer average time from referral to OMS consultation (P = .003), rural patients traveled longer distances (P oral and maxillofacial surgery. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Oomens, M.A.E.M.; Heymans, M.W.; Forouzanfar, T.
The risk of bias is important in the interpretation of the results of research. The aim of this review was to evaluate the risk of bias in randomised controlled trials (RCTs) in oral and maxillofacial surgery (OMFS) over a 10-year period. We searched databases of publications for RCTs published
Hoffmann, Pablo F.; Gosselin, Florian; Taha, Farid
Auditory feedback can have a great potential in surgical simulators that aim at training skills associated to the correct interpretation of acoustic information. Here, we present a preliminary analysis of the sound that is produced by the drilling procedure in a maxillo-facial surgery when perfor...
patients. Discussion. A literature search found few mortality studies carried out in maxillofacial surgery units, (Fahad et al. ). Although Verco et al  studied only .... immobilization. 1 (2.2). Aggressive jaw tumors. Jaw resection and reconstruction. 5 (10.9). Assymetric face ±. TMJ ankylosis. Placement of distractors. 1 (2.2).
SUMMARY. This work examined phenotypic expressions in the anatomy of the mandible and maxillofacial region of the Red Sokoto and Sahel goats in Nigeria. The infraorbital foramen was placed above premolar two (PM2) in Red Sokoto but above premolar one. (PM1) in Sahel. The Red Sokoto displayed interdigital ...
the surgeon and the anesthetist is naturally a challenge for both specialists. In addition to this, when traumatic maxillofacial injury results in the disruption of the normal anatomy from edema or structural damage to tissues, bleeding, unstable skeletal structures, and foreign bodies that can interfere with instrumentation or ...
Zulian, M A; Chisum, J W; Mosby, E L; Hiatt, W R
An overview is presented of some of the factors that should be considered before extubating a patient who has undergone an oral and maxillofacial surgical procedure. A discussion of the possible preoperative assessment of the patient, complications of intubation, effects of narcotics and muscle relaxants, assessment of airway edema, and criteria for extubation is included.
It discusses the development of optimum preplanning for maxillofacial surgery using selective laser sintering process. It involves identifying the optimum value of various parameters like threshold value, gantry tilt angle, resolution, layer thickness and interval thickness of CT scan image. The 3D model of the CT scan image ...
Rastenienė, Rūta; Pūrienė, Alina; Aleksejūnienė, Jolanta; Pečiulienė, Vytautė; Zaleckas, Linas
To analyze treatment modalities and results in patients with severe odontogenic maxillofacial infections during a 10-y period. Medical records of 1,077 patients hospitalized because of severe odontogenic maxillofacial infections during 2003-2012 were reviewed. The sample consisted of the records that matched inclusion criteria. For each patient the following data were collected: Age, gender, presence of systemic diseases, length of hospital stay, causal tooth, location of inflammation, treatment, results of bacteriologic sampling, and anti-bacterial susceptibility. Male to female ratio was 1.4:1. Two or more anatomic spaces were involved in 42.9% of cases, 37.3% of which involved the floor of the mouth. Penicillin in combination with gentamicin or metronidazole was prescribed in 69% of cases. Sixty-two different micro-organism species were identified with predominance of Streptococcus haemolyticus (42.9%). The microbial analysis showed the highest susceptibility of predominant micro-organisms to penicillin was 76.9% and the highest resistance was to metronidazole (27.9%). The frequency of odontogenic maxillofacial infection remained almost unchanged during a 10-y period. Single-space infections were more common (57.1%) than infections involving two or more spaces. Susceptibility to penicillin remains relatively high; therefore, penicillin can remain part of the armamentarium for treatment of odontogenic maxillofacial infections.
occurring sarcoma (29.7%), followed by Kaposi's sarcoma (KS) (28.7%), fibrosarcoma (FBS) (18.8%), and rhabdomyosarcoma (RMS) (9.9%). Sarcomas peaked in the third decade with 70% occurring below the age of 40 years. The maxilla and the mandible were the most afflicted sites in the maxillofacial region accounting ...
Twenty-two patients with haemangiomas of the oro-facial region who presented at the department of Oral and Maxillofacial Surgery, UBTH, were studied. There was a preponderance of females (72.7%) over males (27.3%) and most (59.1%) patients were in the 11-31-year age group, with a median age of 25.0 years.
Azarmehr, Iman; Stokbro, Kasper; Bell, R Bryan; Thygesen, Torben
This systematic review investigates the most common indications, treatments, and outcomes of surgical navigation (SN) published from 2010 to 2015. The evolution of SN and its application in oral and maxillofacial surgery have rapidly developed over recent years, and therapeutic indications are discussed. A systematic search in relevant electronic databases, journals, and bibliographies of the included articles was carried out. Clinical studies with 5 or more patients published between 2010 and 2015 were included. Traumatology, orthognathic surgery, cancer and reconstruction surgery, skull-base surgery, and foreign body removal were the areas of interests. The search generated 13 articles dealing with traumatology; 5, 6, 2, and 0 studies were found that dealt with the topics of orthognathic surgery, cancer and reconstruction surgery, skull-base surgery, and foreign body removal, respectively. The average technical system accuracy and intraoperative precision reported were less than 1 mm and 1 to 2 mm, respectively. In general, SN is reported to be a useful tool for surgical planning, execution, evaluation, and research. The largest numbers of studies and patients were identified in the field of traumatology. Treatment of complex orbital fractures was considerably improved by the use of SN compared with traditionally treated control groups. SN seems to be a very promising addition to the surgical toolkit. Planning details of the surgical procedure in a 3-dimensional virtual environment and execution with real-time guidance can significantly improve precision. Among factors to be considered are the financial investments necessary and the learning curve. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. All rights reserved.
Full Text Available Cone beam computed tomography is a state-of-the-art imaging tool, initially developed for dental and maxillofacial application. With its high resolution and low radiation dose, cone beam tomography has been expanding its application fields, for example, to diagnosis of traumata and fractures in the head and neck area. In this study, we demonstrate superior and satisfactory performance of cone beam tomography for the imaging of a calcaneus fracture in comparison to conventional and computed tomography.
Carman, Aaron J; Ferguson, Rennie; Cantu, Robert; Comstock, R Dawn; Dacks, Penny A; DeKosky, Steven T; Gandy, Sam; Gilbert, James; Gilliland, Chad; Gioia, Gerard; Giza, Christopher; Greicius, Michael; Hainline, Brian; Hayes, Ronald L; Hendrix, James; Jordan, Barry; Kovach, James; Lane, Rachel F; Mannix, Rebekah; Murray, Thomas; Seifert, Tad; Shineman, Diana W; Warren, Eric; Wilde, Elisabeth; Willard, Huntington; Fillit, Howard M
Sports-related concussions and repetitive subconcussive exposure are increasingly recognized as potential dangers to paediatric populations, but much remains unknown about the short-term and long-term consequences of these events, including potential cognitive impairment and risk of later-life dementia. This Expert Consensus Document is the result of a 1-day meeting convened by Safe Kids Worldwide, the Alzheimer's Drug Discovery Foundation, and the Andrews Institute for Orthopaedics and Sports Medicine. The goal is to highlight knowledge gaps and areas of critically needed research in the areas of concussion science, dementia, genetics, diagnostic and prognostic biomarkers, neuroimaging, sports injury surveillance, and information sharing. For each of these areas, we propose clear and achievable paths to improve the understanding, treatment and prevention of youth sports-related concussions.
Aziz, Shahid R
Health care disparity in the United States is a significant problem. Part of the solution is to improve the diversity of health care providers. The purpose of this study is to review the racial demographic of American oral and maxillofacial surgery as it compares with the racial demographic of the United States. Additionally, the racial demographic of the American dental and medical professions are reviewed. Databases from the American Association of Oral and Maxillofacial Surgeons, American Dental Association, and Association of American Medical Colleges were analyzed, specifically reviewing racial demographic data of academic oral and maxillofacial surgery, dentistry, and medicine. Of the 349 full-time faculty, 248 were white (71.1%), 24 black (6.9%), 18 Hispanic (5.1%), 30 Asian (8.6%), and 29 other/unknown (8.3%); there were no full-time faculty of American Indian or Alaska Native descent. Of the 991 oral and maxillofacial surgery residents, whites comprised 701 (70.7%), blacks 43 (4.3%), Hispanics 42 (4.2%), Asians 197 (19.9%), and unknown 8 (0.8%). There are currently no residents of American Indian/Alaska Native origin. A 2006 American Dental Association survey of the distribution of race among the 179,594 professionally active dentists in the United States revealed 86.2% white, 3.4% black, 3.4% Hispanic, 6.9% Asian, and 0.12% American Indian. In 2004, whites comprised 36.7% (344,821) of US physicians, blacks 3.3% (30,598), Hispanics 2.8% (26,094), and Asians 5.7% (53,799); 27.6% (258,950) of US physicians were listed as unknown, and 23.6% (221,633) were listed as international medical graduates without demographic information. American oral and maxillofacial surgery's racial demographic (just as dentistry and medicine) does not remotely resemble the racial demographic of the United States. To improve health care disparity in this nation, diversifying the health care professional workforce is essential. Oral and maxillofacial surgery, a unique surgical
Al-Arfaj, Ibrahim; Al-Shammari, Ahmad; Al-Subai, Turki; Al-Absi, Ghanim; AlJaffari, Mohammad; Al-Kadi, Ahmad; El Tantawi, Maha; Al-Ansari, Asim
The risk of dental trauma may increase during sports participation. The purpose of this study was to evaluate the knowledge, attitude, and practices of sports participants concerning sports-related dental trauma and associated emergency/preventive practices. The study included 124 male subjects over 18 years of age participating in contact and non-contact sports in three clubs in the Eastern Province, Saudi Arabia. A questionnaire was used to assess past experience of dental trauma related to...
Cobein, M V; Coto, N P; Crivello Junior, O; Lemos, J B D; Vieira, L M; Pimentel, M L; Byrne, H J; Dias, R B
We describe the techniques available for retention of implant-supported prostheses: bar-clips, O-rings, and magnets. We present reported preferences and, although this is limited by the heterogeneity of methods used and patients studied, we hope we have identified the best retention systems for maxillofacial prosthetic implants. If practitioners know the advantages and disadvantages of each system, they can choose the most natural and comfortable prosthesis. We searched the PubMed and Scopus databases, and restricted our search to papers published 2001-13. MeSH terms used were Maxillofacial prosthesis and Craniofacial prosthesis OR Craniofacial prostheses. We found a total of 2630 papers, and after duplicates had been removed we analysed the rest and found 25 papers for review. Of these, 12 were excluded because they were case reports or non-systematic reviews. Of the remaining 13, 10 described group analyses and seemed appropriate to find practitioner's choices, as cited in the abstract (n=1611 prostheses). Three papers did not mention the type of prosthetic connection used, so were excluded. The most popular choices for different conditions were analysed, though the sites and retention systems were not specified in all 10 papers. The bar-clip system was the most used in auricular (6/10 papers) and nasal prostheses (4/10). For the orbital region, 6/10 favoured magnets. Non-osseointegrated mechanical or adhesive retention techniques are the least expensive and have no contraindications. When osseointegrated implants are possible, each facial region has a favoured system. The choice of system is influenced by two factors: standard practice and the abilities of the maxillofacial surgeon and maxillofacial prosthetist. Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Bao, Zhen-ying; Lin, Qin; Meng, Yan-hong; He, Chun; Su, Jia-zeng; Peng, Xin
To investigate the distribution and drug resistance of anaerobic bacteria in the patients with oral and maxillofacial infection. Aerobic and anaerobic bacteria cultures from 61 specimens of pus from the patients with oral and maxillofacial infection in the Department of Oral and Maxillofacial Surgery, Peking University School of Stomatology were identified. The culture type was evaluated by API 20A kit and drug resistance test was performed by Etest method. The clinical data and antibacterial agents for the treatment of the 61 cases were collected, and the final outcomes were recorded. The bacteria cultures were isolated from all the specimens, with aerobic bacteria only in 6 cases (9.8%), anaerobic bacteria only in 7 cases (11.5%), and both aerobic and anaerobic bacteria in 48 cases (78.7%). There were 55 infected cases (90.2%) with anaerobic bacteria, and 81 anaerobic bacteria stains were isolated. The highest bacteria isolation rate of Gram positive anaerobic bacteria could be found in Peptostreptococcus, Bifidobacterium and Pemphigus propionibacterium. No cefoxitin, amoxicillin/carat acid resistant strain was detected in the above three Gram positive anaerobic bacteria. The highest bacteria isolation rate of Gram negative anaerobic bacteria could be detected in Porphyromonas and Prevotella. No metronidazole, cefoxitin, amoxicillin/carat acid resistant strain was found in the two Gram negative anaerobic bacteria. In the study, 48 patients with oral and maxillofacial infection were treated according to the results of drug resistance testing, and the clinical cure rate was 81.3%. Mixed aerobic and anaerobic bacteria cultures are very common in most oral and maxillofacial infection patients. Anaerobic bacteria culture and drug resistance testing play an important role in clinical treatment.
Farré-Guasch, Elisabet; Wolff, Jan; Helder, Marco N; Schulten, Engelbert A J M; Forouzanfar, Tim; Klein-Nulend, Jenneke
Additive manufacturing is the process of joining materials to create objects from digital 3-dimensional (3D) model data, which is a promising technology in oral and maxillofacial surgery. The management of lost craniofacial tissues owing to congenital abnormalities, trauma, or cancer treatment poses a challenge to oral and maxillofacial surgeons. Many strategies have been proposed for the management of such defects, but autogenous bone grafts remain the gold standard for reconstructive bone surgery. Nevertheless, cell-based treatments using adipose stem cells combined with osteoconductive biomaterials or scaffolds have become a promising alternative to autogenous bone grafts. Such treatment protocols often require customized 3D scaffolds that fulfill functional and esthetic requirements, provide adequate blood supply, and meet the load-bearing requirements of the head. Currently, such customized 3D scaffolds are being manufactured using additive manufacturing technology. In this review, 2 of the current and emerging modalities for reconstruction of oral and maxillofacial bone defects are highlighted and discussed, namely human maxillary sinus floor elevation as a valid model to test bone tissue-engineering approaches enabling the application of 1-step surgical procedures and seeding of Good Manufacturing Practice-level adipose stem cells on computer-aided manufactured scaffolds to reconstruct large bone defects in a 2-step surgical procedure, in which cells are expanded ex vivo and seeded on resorbable scaffolds before implantation. Furthermore, imaging-guided tissue-engineering technologies to predetermine the surgical location and to facilitate the manufacturing of custom-made implants that meet the specific patient's demands are discussed. The potential of tissue-engineered constructs designed for the repair of large oral and maxillofacial bone defects in load-bearing situations in a 1-step surgical procedure combining these 2 innovative approaches is
Garg, Ravi K; Afifi, Ahmed M; Gassner, Jennifer; Hartman, Michael J; Leverson, Glen; King, Timothy W; Bentz, Michael L; Gentry, Lindell R
The broad spectrum of frontal bone fractures, including those with orbital and skull base extension, is poorly understood. We propose a novel classification scheme for frontal bone fractures. Maxillofacial CT scans of trauma patients were reviewed over a five year period, and frontal bone fractures were classified: Type 1: Frontal sinus fracture without vertical extension. Type 2: Vertical fracture through the orbit without frontal sinus involvement. Type 3: Vertical fracture through the frontal sinus without orbit involvement. Type 4: Vertical fracture through the frontal sinus and ipsilateral orbit. Type 5: Vertical fracture through the frontal sinus and contralateral or bilateral orbits. We also identified the depth of skull base extension, and performed a chart review to identify associated complications. 149 frontal bone fractures, including 51 non-vertical frontal sinus (Type 1, 34.2%) and 98 vertical (Types 2-5, 65.8%) fractures were identified. Vertical fractures penetrated the middle or posterior cranial fossa significantly more often than non-vertical fractures (62.2 v. 15.7%, p = 0.0001) and had a significantly higher mortality rate (18.4 v. 0%, p fractures with frontal sinus and orbital extension, and fractures that penetrated the middle or posterior cranial fossa had the strongest association with intracranial injuries, optic neuropathy, disability, and death (p fractures carry a worse prognosis than frontal bone fractures without a vertical pattern. In addition, vertical fractures with extension into the frontal sinus and orbit, or with extension into the middle or posterior cranial fossa have the highest complication rate and mortality. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Wang, Chunguang; Li, Hao; Chen, Kang; Wu, Bing; Liu, Haifeng
It has been reported that the single nucleotide polymorphism (SNP) rs1800012 in COL1A1 might be associated with the susceptibility to sports-related tendon and ligament injuries such as ACL injuries, Achilles tendon injuries, shoulder dislocations and tennis elbow. But the data from different studies have been conflicting. Here we attempted to systematically summarize and clarify the association between the SNP and sports-related tendon and ligament injuries risk. Six eligible studies including 933 cases and 1,381 controls were acquired from PubMed, Web Of Science and Cochrane library databases. Significant association was identified in homozygote model (TT versus GG: OR=0.17, 95%CI 0.08-0.35, PH=0.00) and recessive model (TT versus GT/GG: OR=0.21, 95%CI 0.10-0.44, PH=0.00). Our results indicated that COL1A1 rs1800012 polymorphism may be associated with the reduced risk of sports-related tendon or ligament injuries, especially in ACL injuries, and that rare TT may played as a protective role. PMID:28206959
Collins, C L; Fields, S K; Comstock, R D
To compare sport and gender differences in injury rates and proportions of injuries related to illegal activity and to describe the epidemiology of injuries related to illegal activity. Descriptive epidemiology study. 100 US high schools. Athletes participating in nine sports: boys' football, soccer, basketball, wrestling, and baseball plus girls' soccer, volleyball, basketball, and softball. Illegal activity-related injuries were analyzed using data from the 2005-06 and 2006-07 National High School Sports-Related Injury Surveillance Study. Nationally, an estimated 98 066 injuries were directly related to an action that was ruled illegal activity by a referee/official or disciplinary committee, giving an injury rate of 0.24 injuries per 1000 athletic competition-exposures. Boys' and girls' soccer had the highest rates of injuries related to illegal activity, and girls' volleyball, girls' softball, and boys' baseball had the lowest. Overall, 6.4% of all high school sports-related injuries were related to illegal activity, with the highest proportion in girls' basketball (14.0%), girls' soccer (11.9%), and boys' soccer (11.4%). A greater proportion of injuries related to illegal activity were to the head/face (32.3%) and were concussions (25.4%) than injuries not related to illegal activity (13.8% (injury proportion ratio 2.35; 95% CI 1.82 to 3.04; preferees/officials may reduce sports-related injuries.
Full Text Available The purpose of the study was to test the utility of unique panel of blood biomarkers as a means to reflect one’s recovery process after sport-related neurotrauma. We established a panel of biomarkers that reacted positive with CD81 (extracellular vesicle marker and various neuron- and glia-specific antigens [e.g., neurofilament light polypeptide (NF-L, tau, synaptosome-associated protein 25 (SNAP25, glial fibrillary acidic protein, and myelin basic protein]. We first evaluated test–retest reliabilities of brain-derived exosome markers, followed by an application of these markers in eight professional ice hockey players to detect cumulative neuronal burden from a single ice hockey season. During the season, two players were diagnosed with concussions by team physician based on an exhibition of symptoms as well as abnormality in balance and ocular motor testing. One player reached symptom-free status 7 days after the concussion, while the other player required 36 days for symptoms to completely resolve. Blood samples and clinical assessments including balance error scoring system and near point of convergence throughout recovery process were obtained. Biomarkers indicative of axonal damage, neuronal inflammation, and glial activation showed excellent test–retest reliabilities (intraclass correlation coefficient: 0.713–0.998, p’s < 0.01. There was a statistically significant increase in the NF-L marker at post-season follow-up compared to pre-season baseline (Z = −2.100, P = 0.036; however the statistical significance did not withstand Bonferroni correction for multiple comparisons. In concussion cases, neuronal and microglia markers notably increased after concussions, with the unique expression patterns being similar to that of concussion recovery process. These longitudinal data coupled with excellent test–retest reliabilities of novel array of blood biomarkers potentially reflect the damage in neural cell
Moor, Heather M; Eisenhauer, Rita C; Killian, Kathleen D; Proudfoot, Nick; Henriques, Ashley A; Congeni, Joseph A; Reneker, Jennifer C
Adherence to rehabilitation is widely accepted as vital for recovery and return to play following sports injuries. Medical management of concussion is centered around physical and cognitive rest, a theory largely based on expert opinion, not empirical evidence. Current research on this topic focuses on factors that are predictive of adherence to rehabilitation, but fails to examine if patient adherence leads to a better outcome. The purpose of this study was to determine the adherence tendencies of adolescents to treatment recommendations provided by a sports-medicine physician after a concussion and to determine if adherence to each recommendation was a predictor of treatment duration. Observational. Participants were enrolled in the study at their initial visit to the Sports-Medicine Center for medical care after a sports-related concussion. Individual treatment recommendations provided by a sports-medicine physician for concussion were recorded over the course of each participant's care. Once released from medical care, each participant was contacted to complete an online questionnaire to measure self-reported adherence tendencies to each treatment recommendation. Adherence was measured by two constructs: 1) the reported receptivity to the recommendation and 2) the frequency of following the recommendation. Exploratory univariate Poisson regression analyses were used to describe the relationship between adherence behaviors and the number of days of treatment required before the participant was returned to play. Fifty-six questionnaires were completed, by 30 male and 26 female adolescent athletes. The self-reported adherence tendencies were very high. None of the measures of adherence to the treatment recommendations were significant predictors of the number of days of treatment; however, there was a clear tendency in five of the six rest parameters (physical rest, cognitive rest with restrictions from electronics, and cognitive rest with restrictions from school
W. Alan C. Mutch
Full Text Available BackgroundPreliminary studies suggest that sports-related concussion (SRC is associated with alterations in cerebral blood flow (CBF regulation. Here, we use advanced magnetic resonance imaging (MRI techniques to measure CBF and cerebrovascular responsiveness (CVR in individual SRC patients and healthy control subjects.Methods15 SRC patients (mean age = 16.3, range 14–20 years and 27 healthy control subjects (mean age = 17.6, range 13–21 years underwent anatomical MRI, pseudo-continuous arterial spin labeling (pCASL MRI and model-based prospective end-tidal targeting (MPET of CO2 during blood oxygenation level-dependent (BOLD MRI. Group differences in global mean resting CBF were examined. Voxel-by-voxel group and individual differences in regional CVR were examined using statistical parametric mapping (SPM. Leave-one-out receiver operating characteristic curve analysis was used to evaluate the utility of brain MRI CO2 stress testing biomarkers to correctly discriminate between SRC patients and healthy control subjects.ResultsAll studies were tolerated with no complications. Traumatic structural findings were identified in one SRC patient. No significant group differences in global mean resting CBF were observed. There were no significant differences in the CO2 stimulus and O2 targeting during BOLD MRI. Significant group and patient-specific differences in CVR were observed with SRC patients demonstrating a predominant pattern of increased CVR. Leave-one-out ROC analysis for voxels demonstrating a significant increase in CVR was found to reliably discriminate between SRC patients and healthy control subjects (AUC of 0.879, p = 0.0001. The optimal cutoff for increased CVR declarative for SRC was 1,899 voxels resulting in a sensitivity of 0.867 and a specificity of 0.778 for this specific ROC analysis. There was no correlation between abnormal voxel counts and Postconcussion Symptom Scale scores among SRC patients
Pearce, Kelly L; Sufrinko, Alicia; Lau, Brian C; Henry, Luke; Collins, Michael W; Kontos, Anthony P
Convergence insufficiency (CI) is a common binocular vision deficit after a sport-related concussion (SRC). CI may result in visual discomfort and vision-mediated functional difficulties such as slowed reading and compromised attention, leading to impaired academic, work, and sport performance. To test the reliability of repeated near point of convergence (NPC) measurements in a sample of athletes after an SRC; compare the symptoms and cognitive impairment of athletes with normal NPC to those with CI after an SRC; and explore the relationship among age, sex, learning disability, migraine history, and CI. Cross-sectional study; Level of evidence, 3. A total of 78 athletes (mean age, 14.31 ± 2.77 years) who were seen a mean 5.79 ± 5.63 days after an SRC were administered 3 trials of an NPC assessment, along with neurocognitive (Immediate Post-Concussion Assessment and Cognitive Testing [ImPACT]) and symptom assessments. Patients were divided into normal NPC (NPC ≤ 5 cm; n = 45) and CI (NPC >5 cm; n = 33) groups. Intraclass correlation coefficients (ICCs) and repeated-measures analyses of variance (ANOVAs) assessed the consistency of NPC across the 3 trials. The ANOVAs were employed to examine differences on neurocognitive composites and symptoms between the normal NPC and CI groups. Stepwise regressions (controlling for age and symptom scores on the Post-Concussion Symptom Scale [PCSS]) were conducted to evaluate the predictive utility of the NPC distance for neurocognitive impairment. Groups did not differ on demographic or injury characteristics. NPC differed between trial 1 and trials 2 (P = .02) and 3 (P = .01) for the CI group but not the normal NPC group. Internal consistency was high across NPC measurements (ICC range, 0.95-0.98). Patients with CI performed worse on verbal memory (P = .02), visual motor speed (P = .02), and reaction time (P = .001, η(2) = .13) and had greater total symptom scores (P = .02) after the injury. Results of hierarchical
Abeare, Christopher A; Messa, Isabelle; Zuccato, Brandon G; Merker, Bradley; Erdodi, Laszlo
Estimated base rates of invalid performance on baseline testing (base rates of failure) for the management of sport-related concussion range from 6.1% to 40.0%, depending on the validity indicator used. The instability of this key measure represents a challenge in the clinical interpretation of test results that could undermine the utility of baseline testing. To determine the prevalence of invalid performance on baseline testing and to assess whether the prevalence varies as a function of age and validity indicator. This retrospective, cross-sectional study included data collected between January 1, 2012, and December 31, 2016, from a clinical referral center in the Midwestern United States. Participants included 7897 consecutively tested, equivalently proportioned male and female athletes aged 10 to 21 years, who completed baseline neurocognitive testing for the purpose of concussion management. Baseline assessment was conducted with the Immediate Postconcussion Assessment and Cognitive Testing (ImPACT), a computerized neurocognitive test designed for assessment of concussion. Base rates of failure on published ImPACT validity indicators were compared within and across age groups. Hypotheses were developed after data collection but prior to analyses. Of the 7897 study participants, 4086 (51.7%) were male, mean (SD) age was 14.71 (1.78) years, 7820 (99.0%) were primarily English speaking, and the mean (SD) educational level was 8.79 (1.68) years. The base rate of failure ranged from 6.4% to 47.6% across individual indicators. Most of the sample (55.7%) failed at least 1 of 4 validity indicators. The base rate of failure varied considerably across age groups (117 of 140 [83.6%] for those aged 10 years to 14 of 48 [29.2%] for those aged 21 years), representing a risk ratio of 2.86 (95% CI, 2.60-3.16; P validity indicator and the age of the examinee. The strong age association, with 3 of 4 participants aged 10 to 12 years failing validity indicators, suggests that
Fracture in metallic glasses. What are the connections between nano- and micro- mechanisms and toughness? Metallic glasses are schizophrenic in the fracture sense. PDF Create! 5 Trial www.nuance.com ...
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... a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Wrist Fractures Email to a friend * required fields From * To * DESCRIPTION A wrist fracture is a medical term for a broken wrist. The wrist is made up of eight ...
Andreasen, Jens Ove; Christensen, Søren Steno Ahrensburg; Tsilingaridis, Georgios
The purpose of this study was to analyze tooth loss after root fractures and to assess the influence of the type of healing and the location of the root fracture. Furthermore, the actual cause of tooth loss was analyzed.......The purpose of this study was to analyze tooth loss after root fractures and to assess the influence of the type of healing and the location of the root fracture. Furthermore, the actual cause of tooth loss was analyzed....
... as shown on an x-ray. Selection of treatment depends upon the patient’s activity level, the location of the fracture and the severity of the fracture. Recovery Shoulder fractures may leave a patient with permanent shoulder stiffness, regardless of ...
Stress fractures Overview Stress fractures are tiny cracks in a bone. They're caused by repetitive force, often from overuse — such as repeatedly jumping up and down or running long distances. Stress fractures can also arise from normal use of ...
... follow bicycle safety recommendations. Do not drink and drive. Do not allow yourself to be driven by someone who may have been drinking alcohol or is otherwise impaired. Alternative Names Basilar skull fracture; Depressed skull fracture; Linear skull fracture Images Skull of an adult Skull ...
Radabaugh, J Paul; Horn, Adam Van; Chan, Stephen A; Shelton, Jared M; Gal, Thomas J
Compliance with postoperative care in the maxillofacial trauma population often is considered poor. This lack of follow-up does not seem to be a function of decreased access to care but rather its anticipated lack of utilization. The goal of this study is to identify what factors are associated with increased compliance in postoperative management of mandible fractures. Retrospective cohort study. Using Current Procedural Terminology codes to identify maxillofacial injuries requiring operative repair, a subset of isolated mandibular fractures was identified. Age, gender, race, insurance type, travel distance, mandible fracture location, surgical approach, and complications were used as variables in univariate regression modeling to examine factors associated with compliance to postoperative care. Between 2010 and 2013, 344 isolated mandible fractures were identified. A total of 83.1% of patients made their first postoperative follow-up visit. Demographic data, fracture location, distance to medical center (odds ratio [OR] = 1, P = 0.75), type of repair, use of drains (OR = 1.27, P = 0.61), or nonabsorbable suture (OR = 1.44, P = 0.32) did not appear to be associated with compliance. No association between complications and postoperative compliance was observed (OR = 2.37, P = 0.17). Trends toward improved compliance were observed when evaluating insurance type and use of temporary fixation hardware. The presence of current tobacco use was found to be negatively associated with patient compliance (OR = 0.33, P compliance after surgical repair is better than what is currently represented in the literature. It appears that postoperative compliance is dependent on patient-related factors more so than what can be modified by the surgeon. 4. Laryngoscope, 127:2230-2235, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.
Konstantinović, Vitomir S; Puzović, Dragana; Anicić, Boban; Jelovac, Drago B
The aim of this article was the epidemiological, clinical, and forensic evaluation of the chainsaw, circular saw, and grinding saw maxillofacial injuries. A retrospective analysis of the medical records at the Clinic of Maxillofacial Surgery, School of Dentistry, University of Belgrade, was performed. A total of 133 patients were treated during a period of 19 years (1989-2008). Grinding saw injuries were more frequent (62%) in comparison to chainsaw and circular saw injuries that were present in 23% and 15% of patients, respectively. All injured individuals were men, and most of them were aged 31 to 40 years. Accident by self injuring was the only mechanism of all the analyzed injuries. There were no suicide or homicide attempts. Isolated injuries of the facial soft tissues, which were mainly lacerations, were present in most patients. Less frequently, soft tissues injuries were compounded with bone fractures of the face and teeth injuries. Surgical debridement, revision, and suturing were performed in all patients where only soft tissues were injured. Patients with compound injuries of the soft tissues, facial bones, and teeth were treated according to the common surgical protocol for the type of the injuries. Most often, these injuries were accidental without fatalities. The number of these injuries increased in the recent years owing to the "do-it-yourselfers" for home hobbies. To avoid these types of injuries, users should be carefully instructed, and attention should be paid to the use of accurately guarded saws and appropriate safety equipment.
Jauhar, Preeti; Handley, Thomas; Hammersley, Nicholas
Orofacial infections following dental extractions are a common referral to an oral and maxillofacial department as an emergency, especially when combined with swelling and limited mouth opening. The case presented demonstrates a rare complication of chronic suppurative osteomyelitis with bilateral pathological fractures of the mandible, which occurred following a staged dental clearance. CPD/Clinical Relevance: Dental extractions are one of the most common treatments carried out by oral surgeons and general dental practitioners. This case highlights a rare but encountered complication of routine oral surgery and demonstrates when it is necessary to make an immediate referral to the local oral and maxillofacial surgery unit.
Cillo, Joseph E; Aghaloo, Tara; Basi, David; Bouloux, Gary F; Campbell, Joshua A; Chou, Joli; Dodson, Thomas; Edwards, Sean P; Kademani, Deepak; Peacock, Zachary
The sixth biennial Clinical and Scientific Innovations in Oral and Maxillofacial Surgery, formerly the Research Summit, of the American Association of Oral and Maxillofacial Surgeons and its Committee on Research Planning and Technology Assessment was held in Rosemont, Illinois from April 28 to 30, 2017. The goal of the symposium is to provide a forum for the latest clinical and scientific advances to be brought to the specialty. It also nurtures collaboration and the development of relationships between oral and maxillofacial surgeons and researchers to bridge the gap between clinical and basic science. The goal is to improve the care of oral and maxillofacial surgical patients through the advancement of translational and clinical research. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Kelvin Uchenna Omeje
Full Text Available Background. An analysis of maxillofacial mortality was done in a Nigerian tertiary health care centre to determine the major causes of mortality and identify possible predisposing factors in our environment. Materials and methods. A retrospective analysis of mortality in maxillofacial surgery department of Aminu Kano Teaching Hospital from January 2005 to December 2014 was done. Data were analyzed using statistical package for social sciences (SPSS version 15.0 (SPSS Inc, Chicago, IL. Results. A mortality rate of 1.8% (46 deaths from 2,540 admissions was recorded. There were 35 males (76.1% and 11 (23.9% females. The mean age of the deceased patients was 40.0±13.0years. Orofacial infections (41.3% and advanced (stage IV orofacial malignancies (28.3% accounted for most deaths. Conclusion. Fascial space infections and orofacial malignancies contribute largely to mortality in our setting. Late presentation was a major factor predisposing to mortality.
Robiony, M; Demitri, V; Costa, F; Politi, M
Personal experience in percutaneous maxillary nerve block anesthesia in association with transmucosal anesthesia of the sphenopalatine ganglion in oral and maxillofacial surgery, is presented. Six Caldwell-Luc, 9 anthrotomies and biopsies of maxillary sinus, 8 removals of extensive odontogenic cysts and 12 surgical maxillary expansions were performed from 1994 to 1996 at our Department. Maxillary transcutaneous nerve block in association with transmucosal anesthesia of the sphenopalatine ganglion were performed. Carbocaine without adrenaline in association with NaCO3 1/10 for maxillary nerve block anesthesia and lidocaineoprilocaine cream (EMLA) for transmucosal anesthesia were employed. Intra- and post-operative pain were evaluated by visual analogue scale in all the patients. Anesthesiological procedures revealed to be effective in all surgical interventions and postoperative analgesia allowed easier pain control. The simplicity of execution, the effective pre- and postoperative anesthesia and the absence of side effects make this procedure particularly indicated in oral and maxillofacial surgery.
Luke Nandu Kale
Full Text Available With the advent of new and developing technology into the field of dentistry, it becomes increasingly important for dentists to become familiar with these developing techniques. The use of lasers in oral and maxillofacial surgery has seen a substantial increase in both, applications of lasers for different techniques, and also the number of surgeons opting to use them on a regular basis. This article serves to update practitioners on the development and current applications of these modern tools in regular practice so as to efficiently perform dental treatment and minimize complications associated with conventional techniques. The authors have reviewed articles on the subject from PubMed, Science Direct, and relevant textbooks so as to compile an accurate history of the evolution of lasers, its introduction to the field of dentistry and also its current applications in the field of oral and maxillofacial surgery.
De Sousa, Avinash
Many psychological problems affect patients who have oral and maxillofacial operations. This article reviews these problems among patients with craniofacial conditions, facial injuries, facial cancer, and those having orthognathic surgery. Facial cosmetic surgery is not addressed. Problems such as depression, anxiety, low self-esteem, poor social relationships, and changes in body image are considered. The roles of mental health professionals is emphasised to enhance postoperative satisfaction and to provide a better quality of life for these patients.
Full Text Available Idiopathic orbital pseudotumor (IOP is a benign inflammatory condition of the orbit without identifiable local or systemic causes. Bilateral massive orbital involvement and extraorbital extension of the IOP is very rare. We present an unusual case of IOP with bilateral massive orbital infiltration extending into maxillofacial regions and discuss its distinctive magnetic resonance imaging (MRI features that help to exclude other entities during differential diagnoses.
Toma, M; Busam, A; Ortmaier, T; Raczkowsky, J; Höpner, C; Marmulla, R
This paper presents our research in medical workflow modeling for computer- and robot-based surgical intervention in maxillofacial surgery. Our goal is to provide a method for clinical workflow modeling including workflow definition for pre- and intra-operative steps, analysis of new methods for combining conventional surgical procedures with robot- and computer-assisted procedures and facilitate an easy implementation of hard- and software systems.
Suzuki, Shinichiro; Kaneko, Hiroshi; Higashi, Tomomitsu; Takenaka, Eiichi.
As CT values of hard tissues would pose problems in the application of CT to the maxillofacial area, attenuation coefficients of each oral hard tissue were examined based on the existing data, and the linearity in the area of high x-ray attenuation was examined. We thought that a new contrast scale suitable for each area should be established for measurements of CT values of tissues of high x-ray attenuation such as teeth. (Chiba, N.)
Senthoor Pandian, S; Srinivasan, P; Mohan, Shanker
The latest mobile phone in addition to being a communication device now is also able to do most functions of a computer. These mobile devices are now called smartphones. These smartphones can use various applications (called apps) which have revolutionized the use of these devices. We discuss the uses of smartphones in maxillofacial surgery and how they have made the work of the maxfac surgeon easier.
Luke Nandu Kale; Janardan Bhagwat Garde; Swapnil Shivdas Garde; Preetika Gupta
With the advent of new and developing technology into the field of dentistry, it becomes increasingly important for dentists to become familiar with these developing techniques. The use of lasers in oral and maxillofacial surgery has seen a substantial increase in both, applications of lasers for different techniques, and also the number of surgeons opting to use them on a regular basis. This article serves to update practitioners on the development and current applications of these modern to...
Weisová, Drahomíra; Salášek, Martin; Pavelka, Tomáš
Hip fractures are ranked among the frequent injuries. These fractures have been often coupled with high energy trauma in children and in patients with normal bone structure, low energy trauma and osteoporotic fracture (fragility fracture) is typical in elder patients. Hip fractures are divided into five groups: femoral head fracture, femoral neck fracture, pertrochanteric, intertrochateric and subtrochanteric fracture. Surgical treatment is indicated in all patients unless contraindications are present. Long bed rest has been accompanied by a high risk of development of thromboembolic disease, pneumonia and bed sore. Healing in the wrong position and nonunions are often the result of conservative treatment. Screw osteosynthesis is performed in isolated femoral head factures. Three cannulated screws or a DHS plate (dynamic hip screw) are used in fractures of the femoral neck with normal femoral head perfusion, total hip replacement is recommended in elder patients and in case of loss of blood supply of the femoral head. Pertrochanteric and intertrochanteric fractures can be stabilized by the femoral nails (PFN, PFN A, PFH - proximal femoral nail), nails are suitable for minimally invasive insertion and provide higher stability in the shaft, or plates (DHS) designed for stable pertronchanteric and intertrochanteric fractures. Subtrochanteric fractures can be fixed also intramedullary (nails - PFN long, PFN A long) and extramedullary (plates - DCS dynamic condylar screw, proximal femoral LCP - locking compression plate). Open reduction with internal plate fixation is advantageous for pathological fractures, as biopsy sampling can be performed. Hip fracture rehabilitation is integral part of the treatment, including walking on crutches or with a walker with partial weight bearing for at least six weeks.
Nabil, S; Samman, N
This review examines the effect of publishing case reports on journal impact factor and future research. All case reports published in the four major English language oral and maxillofacial surgery journals in the two year period, 2007-2008, were searched manually. The citation data of each case report were retrieved from the ISI online database. The number, percentage and mean citations received by case reports and their relation to the 2009 journal impact factor were analysed. Case reports which received more than 5 citations were also identified and all of the citing articles retrieved and analysed. Thirty-one percent of all articles published in major oral and maxillofacial journals in 2007-2008 were case reports. Case reports had a low citation rate with a mean citation of less than 1. There were 38 (7.2%) case reports with more than 5 citations and 30% of the citing articles were also case reports. The publication of case reports negatively affected journal impact factor which correlated directly with the percentage of case reports published within a journal. Case reports reporting recent topics, describing new treatment/diagnosis method and with a literature review were more likely to receive citations. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Kuroyanagi, N; Nagao, T; Sakuma, H; Miyachi, H; Ochiai, S; Kimura, Y; Fukano, H; Shimozato, K
Oral and maxillofacial surgery, which involves several sharp instruments and fixation materials, is consistently at a high risk for cross-contamination due to perforated gloves, but it is unclear how often such perforations occur. This study aimed to address this issue. The frequency of the perforation of surgical gloves (n=1436) in 150 oral and maxillofacial surgeries including orthognathic surgery (n=45) was assessed by the hydroinsufflation technique. Orthognathic surgery had the highest perforation rate in at least 1 glove in 1 operation (91.1%), followed by cleft lip and palate surgery (55.0%), excision of oral soft tumour (54.5%) and dental implantation (50.0%). The perforation rate in scrub nurses was 63.4%, followed by 44.4% in surgeons and first assistants, and 16.3% in second assistants. The odds ratio for the perforation rate in orthognathic surgery versus other surgeries was 16.0 (95% confidence interval: 5.3-48.0). The protection rate offered by double gloving in orthognathic surgery was 95.2%. These results suggest that, regardless of the surgical duration and blood loss in all fields of surgery, orthognathic surgery must be categorized in the highest risk group for glove perforation, following gynaecological and open lung surgery, due to the involvement of sharp objects. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Full Text Available Statement of Problem: Streptococcus viridans is one of the most important microorganisms in the establishment of infections leading to dental caries and heart valve damages. Therefore the diagnosis and prevention of these infections is critical in health care.Purpose: The aim of this in-vivo study was to determine the prevalence of viridans streptococci in abscesses occurring in the maxillofacial region.Materials and Methods: The study sample consisted of 39 patients with maxillofacial abscesses, referred to the Department of Oral Surgery Faculty of Dentistry Tehran University of Medical Sciences and Dr. Shariati Hospital, Tehran University of Medical Sciences. Extra-oral incision, drainage and pus collection followed by culture, staining and biochemical and sugar fermentation tests were carried out for all participants.Results: In the present study %53.84 and 46.16% of the patients had negative and positive culture results, respectively. In the positive culture group, %2.5 of the viridans streptococci were streptococcus salivarius, %4.6 streptococcus sanguis and %17.9 were streptococcus mutans.Conclusion: The findings of this study showed that viridans streptococci are an important factor in the development of metastatic and maxillofacial infections which can pose a significant threat to the patient’s life.
Choi, Soon Chul
Although x-ray had been used in Dental Clinic and taught as Roentgenology as a part of other lectures, the independent lecture was established at Seoul National University in 1953. The first independent Department was separated from the Department of Oral Surgery at Seoul National University in 1963. Nowadays, there are 6 national and 5 private dental schools in South Korea. Each dental school has a Department of Oral and Maxillofacial Radiology, which fulfills its role in student education and clinical service. What is specially noteworthy is that 8 of the 11 dental schools have changed or will change from the 2+4 year system to 4+4 year system (postgraduate course). The curriculum has also been or is being amended according to this change. Although the contents of courses for Oral and Maxillofacial Radiology are not much different among dental schools, the methods and structure of education are various. We have to do a systematic and comprehensive analysis of the present educational methods and structure of Oral and Maxillofacial Radiology and need to seek the new and more suitable ones based on competency.
Rolski, D.; Zawadzki, P.; Życińska, K.; Mierzwińska-Nastalska, E.
Morphological and functional disturbances induced by postsurgical defects and loss of tissues in the stomatognathic system due to the treatment of tumors in the maxillofacial region determine the therapeutic needs of patients. The study aimed at clinical and epidemiological evaluation of patients under prosthetic treatment in order to establish the algorithm for rehabilitation. The study group was composed of the patients after midface surgery (45.74%); surgery in a lower part of the face (47.38%); mixed postoperative losses (3.44%); loss of face tissues and surgery in other locations in the head and neck region (3.44%). The supplementary treatment was applied in 69.63% of patients. Clinical and additional examinations were performed to obtain the picture of postoperative loss, its magnitude, and location to plan the strategy of prosthetic rehabilitation. The management algorithm for prosthetic rehabilitation in patients after surgical treatment of maxillofacial neoplasms was based on its division in stages. The location and magnitude of postoperative losses, as well as the implementation of supplementary treatment of the patients after treatment of maxillofacial tumors, influence the planning of prosthetic rehabilitation that plays a key role and facilitates the patients' return to their prior living situation, occupational and family lives. PMID:27747229
Full Text Available Morphological and functional disturbances induced by postsurgical defects and loss of tissues in the stomatognathic system due to the treatment of tumors in the maxillofacial region determine the therapeutic needs of patients. The study aimed at clinical and epidemiological evaluation of patients under prosthetic treatment in order to establish the algorithm for rehabilitation. The study group was composed of the patients after midface surgery (45.74%; surgery in a lower part of the face (47.38%; mixed postoperative losses (3.44%; loss of face tissues and surgery in other locations in the head and neck region (3.44%. The supplementary treatment was applied in 69.63% of patients. Clinical and additional examinations were performed to obtain the picture of postoperative loss, its magnitude, and location to plan the strategy of prosthetic rehabilitation. The management algorithm for prosthetic rehabilitation in patients after surgical treatment of maxillofacial neoplasms was based on its division in stages. The location and magnitude of postoperative losses, as well as the implementation of supplementary treatment of the patients after treatment of maxillofacial tumors, influence the planning of prosthetic rehabilitation that plays a key role and facilitates the patients’ return to their prior living situation, occupational and family lives.
Choi, Soon Chul [Department of Oral and Maxillofacial Radiology, Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of)
Although x-ray had been used in Dental Clinic and taught as Roentgenology as a part of other lectures, the independent lecture was established at Seoul National University in 1953. The first independent Department was separated from the Department of Oral Surgery at Seoul National University in 1963. Nowadays, there are 6 national and 5 private dental schools in South Korea. Each dental school has a Department of Oral and Maxillofacial Radiology, which fulfills its role in student education and clinical service. What is specially noteworthy is that 8 of the 11 dental schools have changed or will change from the 2+4 year system to 4+4 year system (postgraduate course). The curriculum has also been or is being amended according to this change. Although the contents of courses for Oral and Maxillofacial Radiology are not much different among dental schools, the methods and structure of education are various. We have to do a systematic and comprehensive analysis of the present educational methods and structure of Oral and Maxillofacial Radiology and need to seek the new and more suitable ones based on competency.
Reintsema, H; van Oort, R P; Stellingsma, C
Maxillofacial prosthodontics is a specialization in dental health practiced in centers for special dental care in The Netherlands by a limited number of dentists and technicians. The necessary skills, which are largely unique in the field of dentistry, were described in 2001 in a training program by the Dutch Association for Gnathology and Prosthodontics. Multidisciplinary diagnostics, treatment planning, and care delivery are taught in a modular system. A shortage of maxillofacial prosthodontists and maxillofacial technicians calls for a structural training of young colleagues.
Sullivan, Lindsay; Thomas, Audrey Alforque; Molcho, Michal
Sports-related concussions are now recognized as a major public health concern. However, despite the association of concussion with short- and long-term health consequences, many young athletes still lack basic knowledge about concussion and seem to believe that concussions may be "toughed out" and do not require medical attention. This study assessed self-reported practice of playing in training or a match while concussed among Gaelic Athletic Association (GAA) athletes in Ireland aged 13-25 years old (M=19.19, SD=3.54). This study also assessed knowledge about and attitudes towards sports-related concussion in GAA players in Ireland. Using a self-report questionnaire, data were captured electronically on GAA athletes aged 13-25 years old (n=80) regarding knowledge about the detection, assessment and management of sports-related concussion, as well as participant's attitudes towards concussion and self-reported practice of playing in training or a match while concussed. Data were collected from June to August 2013. This study revealed that approximately one in four athletes reported having played while concussed in practice or during a match. Males were significantly more likely to play while concussed than females (40.9% and 17.2%, respectively). Results from this study indicated participants lack a complete understanding of concussion, as common misconceptions about concussion prevailed. Analyses revealed that participants generally have safe attitudes towards concussion and concussion management. Generating awareness of the potential short- and long-term health consequences of concussion, coupled with the promotion of safer attitudes towards this injury, could minimize the number of players who return-to-play pre-maturely and promote a more safety-conscious sports culture in Ireland.
Dougan, Brooke K; Horswill, Mark S; Geffen, Gina M
The objective of this study is to determine which pre-existing athlete characteristics, if any, are associated with greater deficits in functioning following sports-related concussion, after controlling for factors previously shown to moderate this effect (e.g., time since injury). Ninety-one independent samples of concussion were included in a fixed+systematic effects meta-analysis (n = 3,801 concussed athletes; 5,631 controls). Moderating variables were assessed using analogue-to-ANOVA and meta-regression analyses. Post-injury assessments first conducted 1-10 days following sports-related concussion revealed significant neuropsychological dysfunction, postural instability and post-concussion symptom reporting (d = -0.54, -1.10, and -1.14, respectively). During this interval, females (d = -0.87), adolescent athletes competing in high school competitions (d = -0.60), and those with 10 years of education (d = -1.32) demonstrated larger post-concussion neuropsychological deficits than males (d = -0.42), adults (d = -0.25), athletes competing at other levels of competition (d = -0.43 to -0.41), or those with 16 years of education (d = -0.15), respectively. However, these sub-groups' differential impairment/recovery beyond 10 days could not be reliably quantified from available literature. Pre-existing athlete characteristics, particularly age, sex and education, were demonstrated to be significant modifiers of neuropsychological outcomes within 10 days of a sports-related concussion. Implications for return-to-play decision-making and future research directions are discussed.
Full Text Available History of present illness: A 77-year-old female presented to her primary care physician (PCP with right hip pain after a mechanical fall. She did not lose consciousness or have any other traumatic injuries. She was unable to ambulate post-fall, so X-rays were ordered by her PCP. Her X-rays were concerning for a right acetabular fracture (see purple arrows, so the patient was referred to the emergency department where a computed tomography (CT scan was ordered. Significant findings: The non-contrast CT images show a minimally displaced comminuted fracture of the right acetabulum involving the acetabular roof, medial and anterior walls (red arrows, with associated obturator muscle hematoma (blue oval. Discussion: Acetabular fractures are quite rare. There are 37 pelvic fractures per 100,000 people in the United States annually, and only 10% of these involve the acetabulum. They occur more frequently in the elderly totaling an estimated 4,000 per year. High-energy trauma is the primary cause of acetabular fractures in younger individuals and these fractures are commonly associated with other fractures and pelvic ring disruptions. Fractures secondary to moderate or minimal trauma are increasingly of concern in patients of advanced age.1 Classification of acetabular fractures can be challenging. However, the approach can be simplified by remembering the three basic types of acetabular fractures (column, transverse, and wall and their corresponding radiologic views. First, column fractures should be evaluated with coronally oriented CT images. This type of fracture demonstrates a coronal fracture line running caudad to craniad, essentially breaking the acetabulum into two halves: a front half and a back half. Secondly, transverse fractures should be evaluated by sagittally oriented CT images. By definition, a transverse fracture separates the acetabulum into superior and inferior halves with the fracture line extending from anterior to posterior
Brooke, Sebastian M; Goyal, Neerav; Michelotti, Brett F; Guedez, Henry Montilla; Fedok, Fred G; Mackay, Donald R; Samson, Thomas D
Evidence supports short-term perioperative prophylaxis for facial fractures. It is unknown, however, whether there is any professional consensus on how to manage these injuries. No multidisciplinary evaluation of the prophylactic antibiotic prescribing patterns for neither operative nor nonoperative facial fractures has been performed. To evaluate the prophylactic antibiotic prescribing patterns of multiple specialties in operative and nonoperative facial fractures. A 14 question anonymous online-based survey was distributed to members of the American Society of Maxillofacial Surgeons (ASMS) and the American Association of Facial Plastic Surgeons to evaluate current practices. 205 respondents, including 89 plastic surgeons, 98 otolaryngologists, 12 oral and maxillofacial surgeons, and 7 with double board certification practicing throughout the United States with ranging experience from 11 to 30 years. As expected, preoperative, perioperative, or postoperative prophylactic antibiotics are either "always" or "sometimes" prescribed, 100% of the time with more varied practice upon further inspection. A total of 85.1% either "always" or "sometimes" use antibiotics while awaiting surgery. Dentate segment fractures are the most frequent type of facial fractures to receive prophylactic antibiotics for both operative (90.5%) and nonoperative (84.1%) fractures. Duration of antibiotic use is more varied with the majority providing 3 to 7 days despite current evidence. First generation cephalosporins alone are prescribed by 49% of respondents, which may not adequately cover oral flora. There is no multidisciplinary consensus for prophylactic antibiotics for specific operative fracture types or nonoperative facial fractures, an area with little published evidence.
Objective The purpose of this study was to examine the causality and severity of maxillofacial trauma (MFT) among patients referred to a tertiary heath care center in the Southern Aseer region of Saudi Arabia. Materials and methods The charts of all MFT patients referred to the tertiary care center from September 2010 to November 2011 were retrospectively reviewed. Pertinent data, including patient age, gender, and cause of injury, were obtained from 101 selected charts. Results Male patients comprised 91% of the 101 selected cases. The highest percentage of MFT cases (88.7%) were caused by road traffic accidents (RTAs) while physical altercations and sports injuries accounted for approximately 6% and 2.8% of MFT cases, respectively. A high fracture: patient ratio of 2.4:1 was observed, which was likely due to vehicular speeding (high energy trauma) involved in RTAs in the mountain regions. Conclusion RTAs are a major cause of MFT in the southern region of Saudi. These accidents cause a heavy burden on the health care sector. PMID:24179319
Vadepally, Ashwant Kumar; Sinha, Ramen; Kumar, A V S S Subramanya
Patients with limited mouth opening (LMO) often associated with difficult intubation. Retrograde intubation is an alternative technique of establishing definitive airway in these patients when blind nasal intubation fails and fiberoptic bronchoscope is not available. We tested the retrograde intubation through nasal route in patients with LMO less than 2 cm. The procedure was performed with some modification with regard to retrograde guide on 18 patients requiring maxillofacial surgical procedures to increase mouth opening. Indications for this technique were mandibular fracture (n = 6), oral submucous fibrosis (OSMF; n = 6), temporomandibular joint (TMJ) ankylosis (n = 4) and internal derangement of TMJ (n = 2). All patients were assessed for preoperative interincisal opening; during intubation through specific parameters and; also postoperative findings were observed. Mean time taken for successful intubation was 5.6 min ± 1.66. One patient had subcutaneous emphysema which was managed conservatively. Postoperatively, four patients had sore throat which resolved in few days. No other complications were encountered. In conclusion, retrograde nasotracheal intubation is an effective and useful technique for airway control in patients with LMO and with only a small risk potential.
Sánchez León, Belisario
Our expertise is the study of more than 2,000 cases of Colles' fractures. Colles name should in this case to synthesize the type of fractures of the lower end of the radius. There have been various proposed classifications according to the different fracture lines can be demonstrated radiologically in the region of the wrist. We believe that these ratings should only be retained if the concept of the articular fracture or not in the classical sense, since it has great value in the functional ...
Clare, M P; Sanders, R W
Fractures of the calcaneus generally occur in the setting of high-energy trauma, resulting in complex, three-dimensionally oriented fracture patterns. Surgical treatment is typically indicated for displaced intra-articular fractures, permitting restoration of calcaneal height, width and overall morphology, in addition to the posterior facet articular surface where possible, and enabling late in situ arthrodesis as a means of salvage in the event of post-traumatic arthritis. The present article briefly discusses our preferred methods for the management of calcaneal fractures. An English full text version of this article is available at SpringerLink as supplemental.
Fareedi Mukram Ali
CONCLUSION: There is low awareness toward the scope of oral and maxillofacial surgery in the medical community. Knowledge and awareness of the scope of oral and maxillofacial surgery can improve the success and promptness of delivery of health services.
Ghosh, Rajarshi; Gopalkrishnan, Kulandaswamy
The aim of this study is to retrospectively analyze the incidence of facial fractures along with age, gender predilection, etiology, commonest site, associated dental injuries, and any complications of patients operated in Craniofacial Unit of SDM College of Dental Sciences and Hospital. This retrospective study was conducted at the Department of OMFS, SDM College of Dental Sciences, Dharwad from January 2003 to December 2013. Data were recorded for the cause of injury, age and gender distribution, frequency and type of injury, localization and frequency of soft tissue injuries, dentoalveolar trauma, facial bone fractures, complications, concomitant injuries, and different treatment protocols.All the data were analyzed using statistical analysis that is chi-squared test. A total of 1146 patients reported at our unit with facial fractures during these 10 years. Males accounted for a higher frequency of facial fractures (88.8%). Mandible was the commonest bone to be fractured among all the facial bones (71.2%). Maxillary central incisors were the most common teeth to be injured (33.8%) and avulsion was the most common type of injury (44.6%). Commonest postoperative complication was plate infection (11%) leading to plate removal. Other injuries associated with facial fractures were rib fractures, head injuries, upper and lower limb fractures, etc., among these rib fractures were seen most frequently (21.6%). This study was performed to compare the different etiologic factors leading to diverse facial fracture patterns. By statistical analysis of this record the authors come to know about the relationship of facial fractures with gender, age, associated comorbidities, etc.
Full Text Available Sports-related maxillofacial traumas, nasal fractures and auricular hematomas situations like have important role due to encounter frequency in ENT clinic's patient population. The aim of article is defining the incidence of sports-related injuries , mostly seen traumas according to the sport types, conditions that needs treatment , different treatment approaches and interventions that should be done for prevention of these injuries.
Full Text Available An extremely rare case of combined transverse and vertical fracture of sacrum with neurological deficit is reported here with a six month follow-up. The patient also had an L1 compression fracture. The patient has recovered significantly with conservative management.
... occur commonly in children and in the elderly. Nerve and/or artery injuries can be associated with these types of fractures and must be carefully evaluated by your doctor. These fractures usually require surgical repair with plates and/or screw, unless they are ...
McDonald, C; Hennedige, A; Henry, A; Dawoud, B; Kulkarni, R; Gilbert, K; Kyzas, P; Morrison, R; McCaul, J A
Cervicofacial infections are common emergency presentations to maxillofacial departments in the UK, there is no consensus about their management and, in particular, the role of corticosteroids is not clear. Our aim was to find out the current practice of UK maxillofacial surgeons in managing these infections using a multicentre questionnaire study. The questionnaire was designed, piloted, and revised before distribution, and questions were asked to assess preoperative, operative, and postoperative management. It was distributed to maxillofacial surgeons throughout the UK through the Maxillofacial Research Trainee Collaborative (MTReC) network, and at the 2016 British Association of Oral and Maxillofacial Surgeons (BAOMS) Junior Trainees Group conference. A total of 350 questionnaires were distributed to 17 maxillofacial units. Eighty-six questionnaires were distributed at the BAOMS Junior Trainee conference. An overall response rate of 92% (n=324) was achieved. The results showed that there were important differences in reported practice between and within maxillofacial units in the UK in managing these infections. The antibiotic regimens and use of steroids varied widely. Twenty-three per cent of respondents had to wait over 24hours for access to emergency theatres. However, these results provide no hard evidence for or against the use of corticosteroids in cervicofacial infections. Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. All rights reserved.
Five cases of machete cut injuries to the maxillofacial region seen over a period of 8 months (January‑September, 2012), at the Maxillofacial Unit of Ahmadu Bello University Teaching Hospital, Zaria, Nigeria, are presented. The severity of the injuries is evident from the extent of tissue disruption as shown in the pictures.
Dhuvad, Jigar M; Dhuvad, Mukesh M; Kshirsagar, Rajesh A
Dental surgeons who encounter complex situations, such as those in unscheduled care, often have limited resources to provide a structured and specialty care. Therefore, there is always a need for cost-effective, easy to handle, easy to carry "Smartphones". The purpose of this paper was to undertake a review of literature on "Smartphone in Oral and Maxillofacial Surgery" online data-base and discuss the case series with emphasis on the role of attending dental surgeon and the maxillofacial surgeon. The available literature relevant to oral and maxillofacial surgery in online data-base of the United States National Library of Medicine: PubMed (http://www.ncbi.nlm.nih.gov/pubmed/) was searched. The inclusion criterion was to review the published clinical papers, abstracts and evidence based reviews on 'Uses of Smartphone in Oral and Maxillofacial Surgery'. Six articles were found with the search term "Smartphone in Oral and Maxillofacial Surgery" in the literature searched. Five articles met the inclusion criteria for the study. The relevant data was extracted, tabulated, and reviewed to draw evidence-based conclusions for uses of smartphone in oral and maxillofacial surgery. Utilization of smartphones in oral and maxillofacial surgery facilitate in differential diagnosis, treatment, follow up, prevention of the disease further and thereby improve the quality of patient care without requiring the presence of the maxillofacial surgeon in remote areas.
Gorter, R.C.; Jacobs, B.L.T.H.; Allard, R.H.B.
Little is known about the well-being of oral and maxillofacial surgeons. The aim of this study was to measure the levels of burnout risk and the demanding work aspects of Dutch oral and maxillofacial surgeons, as well as the levels of positive work engagement and stimulating aspects of the work
van Diermen, D.E.; van der Waal, I.; Hoogvliets, M.W.; Ong, F.N.; Hoogstraten, J.
The aim was to evaluate the management strategies of Dutch oral and maxillofacial surgeons when performing invasive dental or oral surgery in patients using oral antithrombotic medication (OAM). In November 2009 a survey was mailed to all 213 members of the Dutch Society for Oral and Maxillofacial
Visscher, J.G. de; Smitt, J.H.; Stoelinga, P.J.W.; Baat, C. de; Vissink, A.
In 2006, it was 50 years ago that the oral and maxillofacial surgery was officially recognized as a dental speciality in The Netherlands. During those five decades, oral and maxillofacial surgery significantly evolved, which is nicely reflected by the changes in the name of the scientific society
Background: The world wide pattern of OMFS conditions has been rarely reported despite its significance in the head and neck medicine; maxillofacial trauma and tumors. The main objective of this study was to audit oral and maxillofacial surgical (OMFS) conditions admitted for interventional treatment at Muhimbili National ...
The etiology of maxillofacial injuries varies from one country to another and even within the same country depending on the prevailing socioeconomic, cultural, and environmental factors.[1-4] Road traffic crashes (RTC), assaults, sports, falls occupational hazards are documented causes of oral and maxillofacial injuries.
Background: This paper reviews the types, prevalence and demographic distribution of maxillofacial tumors, cysts and tumor-like lesions in a Nigerian population. Patients and Methods: A retrospective analysis of the medical records and histological reports of patients with oral and maxillofacial tumors and cystic lesions ...
Arnheiter, C.; Scarfe, W.C.; Farman, A.G.
Cone-beam computed tomography (CBCT) is making inroads into dental practice worldwide, both in terms of adding the third dimension to diagnosis, and also in terms of enabling image-guided treatment strategies. This article reports trends in the early referral pattern of patients to a CBCT facility in the United States. With institutional review board approval, a retrospective study was made of sequential CBCT radiographic reports made by a specialist oral and maxillofacial radiology service from May 2004 through January 2006 (n=329). Demographic and referral data were extracted from the reports. Descriptive statistics identified referral patterns, trends, and indications for CBCT. Comparisons were made with the Rogers' Product Innovation Adoption curve. The mean age of referred patients was 45±21 years, and there was a predominance of women (62%). Oral and maxillofacial surgeons (51%) and periodontology specialists (17%) made most patient referrals. The listed reasons for CBCT referrals were dental implant planning (40%), suspected surgical pathology (24%), and temporomandibular joint analysis (16%). Other uses included planning extraction of impacted teeth and orthodontic assessment. Over the period of the study, the numbers of pathology diagnosis cases remained relatively constant, while adoption of CBCT for dental implant planning followed closely the first three stages of the Rogers' Product Innovation Adoption curve. Alongside this increased CBCT adoption for dental implant planning, there was an associated increased demand for use of Digital Imaging and Communications in Medicine (DICOM) i