How safe is your motorcycle helmet?

PURPOSE: Motorcycle crash helmets do not totally prevent head and facial trauma. The aim of this study was to investigate if protection offered by helmets differs according to helmet type. MATERIALS AND METHODS: In this retrospective cohort study, outpatient records of motorcyclists were analyzed for the Facial Injury Severity Scale (FISS), traumatic brain injury (TBI), facial fractures, and helmet use. Statistical analysis was conducted using the Fisher and Bonferroni tests, bivariate regression analysis, and 1-way analysis of variance. RESULTS: There were 253 motorcyclists who sustained craniomaxillofacial injuries and were referred for outpatient treatment (men, 88.9%; mean age, 29.64 ± 11.6 yr); 60.1% had up to 9 years of formal education; 156 patients reported not using crash helmets, 51 were using open-face helmets, and 46 were using full-face helmets. The mean FISS score was significantly higher for unhelmeted riders compared with full-face helmet riders (P = .047), with no difference between unhelmeted riders and open-face helmet users (P = 1.00). Results for TBI were statistically greater for those wearing open-face helmets compared with full-face helmets (P = .035). CONCLUSION: In this study, a large percentage of motorcyclists had facial fractures and TBI, and crash helmets did not always offer adequate protection against craniomaxillofacial injury, especially open-face helmets. Thus, further investigation into helmet types and quality of protection offered is recommended.

A lei seca cumpriu sua meta em reduzir acidentes relacionados à ingestão excessiva de álcool? / Reducing accidents related to excessive alcohol intake? A retrospective study of polytraumatized patients undergoing surgery at a Brazilian University Hospital

OBJETIVO: avaliar se a Lei Seca cumpriu sua meta após três anos da promulgação. MÉTODOS: estudo retrospectivo dos pacientes com fraturas craniofaciais submetidos a tratamento cirúrgico em um hospital universitário, em dois períodos: antes (2005 a 2008) e após a implantação da lei (2008 a 2011). RESULTADOS:foram operados 265 pacientes (220 homens e 45 mulheres) nesse período sendo, 149 (56%) antes da lei e 116 (44%) após a lei, indicando redução no número de traumatismos (p=0,04). Houve predomínio da faixa etária entre 19 e 40 anos, em ambos os períodos. As principais causas dos traumas foram os acidentes automobilísticos, as agressões físicas e as quedas. O abuso de álcool foi identificado em 15,4% dos pacientes antes e 19% após a lei. A mandíbula e o complexo maxilozigomático foram os ossos mais acometidos. CONCLUSÃO:a redução no número de politraumatizados operados ficou aquém do esperado e almejado.

OBJECTIVE: To assess whether the Brazilian Driving Dry Law reached its goal after the three years following its enactment. METHODS: We onnducted a retrospective study of patients with craniofacial fractures who underwent surgery at a university hospital in two periods: before the Law (2005 to 2008) and after the Law (2008 to 2011). RESULTS: 265 patients (220 men and 45 women) were operated on during this period, 149 (56%) before and 116 (44%) after the Law, which indicates a reduction in the number of traumatisms (p=0.04). The age range between 19 and 40 years predominated in both periods. The main causes of traumas were car accidents, physical aggression and falls. Alcohol abuse was identified in 15.4% patients before and 19% patients after the enactment. The jaw and the maxillo-zygomatic complex were the most affected bones. CONCLUSION: The drop in the number of polytraumatized patients operated on at this institution in the three years following the Driving Dry Law was 22%, which is below the expected and desired percentage. These results must be compared to those of different services offering the same attendance type in order to compile data and enlarge statistics. The low index of reduction in the number of traumatisms and the report of alcohol abuse by several patients at the moment of trauma, even after the law, evidence the need of adopting stricter measures to control and punish violators.

Reducing accidents related to excessive alcohol intake? A retrospective study of polytraumatized patients undergoing surgery at a Brazilian University Hospital.

OBJECTIVE: To assess whether the Brazilian Driving Dry Law reached its goal after the three years following its enactment. METHODS: We conducted a retrospective study of patients with craniofacial fractures who underwent surgery at a university hospital in two periods: before the Law (2005 to 2008) and after the Law (2008 to 2011). RESULTS: 265 patients (220 men and 45 women) were operated on during this period, 149 (56%) before and 116 (44%) after the Law, which indicates a reduction in the number of traumatisms (p=0.04). The age range between 19 and 40 years predominated in both periods. The main causes of traumas were car accidents, physical aggression and falls. Alcohol abuse was identified in 15.4% patients before and 19% patients after the enactment. The jaw and the maxillo-zygomatic complex were the most affected bones. CONCLUSION: The drop in the number of polytraumatized patients operated on at this institution in the three years following the Driving Dry Law was 22%, which is below the expected and desired percentage. These results must be compared to those of different services offering the same attendance type in order to compile data and enlarge statistics. The low index of reduction in the number of traumatisms and the report of alcohol abuse by several patients at the moment of trauma, even after the law, evidence the need of adopting stricter measures to control and punish violators.

Assessment of nose protector for sport activities: finite element analysis.

There has been a significant increase in the number of facial fractures stemming from sport activities in recent years, with the nasal bone one of the most affected structures. Researchers recommend the use of a nose protector, but there is no standardization regarding the material employed. Clinical experience has demonstrated that a combination of a flexible and rigid layer of ethylene vinyl acetate (EVA) offers both comfort and safety to practitioners of sports. The aim of the present study was the investigation into the stresses generated by the impact of a rigid body on the nasal bone on models with and without an EVA protector. For such, finite element analysis was employed. A craniofacial model was constructed from images obtained through computed tomography. The nose protector was modeled with two layers of EVA (1 mm of rigid EVA over 2 mm of flexible EVA), following the geometry of the soft tissue. Finite element analysis was performed using the LS Dyna program. The bone and rigid EVA were represented as elastic linear material, whereas the soft tissues and flexible EVA were represented as hyperelastic material. The impact from a rigid sphere on the frontal region of the face was simulated with a constant velocity of 20 m s(-1) for 9.1 µs. The model without the protector served as the control. The distribution of maximal stress of the facial bones was recorded. The maximal stress on the nasal bone surpassed the breaking limit of 0.13-0.34 MPa on the model without a protector, while remaining below this limit on the model with the protector. Thus, the nose protector made from both flexible and rigid EVA proved effective at protecting the nasal bones under high-impact conditions.

A utilizaçäo do cinto de segurança na prevençäo das fraturas da face / Usefulness of seat belts in the prevention of facial fractures

Os autores apresentam estudo retrospectivo do número de pacientes com fraturas da face, admitidos no Pronto Socorro do Hospital das Clínicas da FMUSP no primeiro trimestre de 1984, 1985 e 1986, notando-se que no primeiro trimestre de 1985 o uso do cinto de segurança era obrigatório por lei. Observou-se reduçäo no número de casos de fraturas da face no primeiro trimestre de 1985, bem como da gravidade das lesöes. Reduçäo significativa ocorreu nas fraturas nasais e fronto-orbitárias, durante este período. Houve, em conclusäo, significativa relaçäo entre a gravidade da fratura e a näo utilizaçäo do cinto de segurança

[Usefulness of seat belts in the prevention of facial fractures]. / A utilidade do cinto de segurança na prevenção das fraturas da face.

In the first quarter of 1985, the use of the seat belts in every car was compulsory as disposed by law and it was discontinued afterwards. The authors correlate the number and type of facial fractures in patients admitted to the Emergency unit of the Hospital das Clínicas of University of São Paulo Medical School, during the first quarter of 1984, 1985 and 1986. A significant decrease of the number of cases and the severity of the facial fractures during the 1985 period was observed and, more important, a decrease was noted on the proportion of the nasal and fronto-orbital fractures among the overall number of fractures of the face. There was thus a significant relationship between the use of belts and the number and severity of the facial fractures.