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      Helmet shielding effect in mandibular fractures during road traffic accident

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          Abstract

          Objective:

          The objectives of this study are to evaluate the proportion of helmeted and nonhelmeted patients sustaining mandibular fractures.

          Materials and Methods:

          A retrospective study was conducted on 200 patients reporting to oral and maxillofacial surgery (OMFS) unit, trauma center, and department of OMFS. A predesigned questionnaire was used to collect the necessary data. Patients were evaluated for age, gender, mode of transport (2/4 wheeler), presence of safety measure at the time of accident (helmet/seatbelt), maxillofacial injury in two wheeler (with helmet and without helmet), type of impact, and its association to maxillofacial fractures, particularly site of maxillofacial fractures. The association between mode of injury, presence of safety measures, impact type, and site of maxillofacial injuries was assessed using the Chi-square test. P < 0.5 was considered statistically significant.

          Results:

          The mean age of patients was 30 years, and approximately 92.5% of accidents patients were male. In this study, 35% nonhelmeted riders were reported head injury and 5% of the helmeted rider reported head injury. 54.5% of the patients suffered frontal impact, 28% collision, and 17.5% lateral slide collision. Head injuries are the main cause of death among the riders of all two wheelers. Lateral sliding collision injuries (17.5%) resulted 60.6% of the fractures mandible, 24.2% midface injury, and associated injury (15.15%).

          Conclusion:

          The use of helmet is strongly recommended to prevent head injuries and facial injuries. In the nonhelmeted riders in motorcycle accidents, the incidence of mandible fractures increases proportionally.

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          Most cited references31

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          Helmets for preventing injury in motorcycle riders.

          Motorcycle crash victims form a high proportion of those killed or injured in road traffic crashes. Injuries to the head, following motorcycle crashes, are a common cause of severe morbidity and mortality. It seems intuitive that helmets should protect against head injuries but it has been argued that motorcycle helmet use decreases rider vision and increases neck injuries. This review will collate the current available evidence on helmets and their impact on mortality, and head, face and neck injuries following motorcycle crashes. To assess the effects of wearing a motorcycle helmet in reducing mortality and head and neck injury following motorcycle crashes. We searched the Cochrane Injuries Group Specialised Register, Cochrane Central Register of Controlled Trials (The Cochrane Library issue 2, 2007), MEDLINE (up to April 2007), EMBASE (up to April week 16, 2007), CINAHL (January 1982 to February 2003), TRANSPORT (up to issue 12, 2006) (TRANSPORT combines the following databases: Transportation Research Information Services (TRIS) International Transport Research Documentation (ITRD) formerly International Road Research Documentation (IRRD), ATRI (Australian Transport Index) (1976 to Feb 2003), Science Citation Index were searched for relevant articles. Websites of traffic and road safety research bodies including government agencies were also searched. Reference lists from topic reviews, identified studies and bibliographies were examined for relevant articles. We considered studies that investigated a population of motorcycle riders who had crashed, examining helmet use as an intervention and with outcomes that included one or more of the following: death, head, neck or facial injury. We included any studies that compared an intervention and control group. Therefore the following study designs were included: randomised controlled trials, non-randomised controlled trials, cohort, case-control and cross-sectional studies. Ecological and case series studies were excluded. Two authors independently screened reference lists for eligible articles. Two authors independently assessed articles for inclusion criteria. Data were abstracted by two independent authors using a standard abstraction form. Sixty-one observational studies were selected of varying quality. Despite methodological differences there was a remarkable consistency in results, particularly for death and head injury outcomes. Motorcycle helmets were found to reduce the risk of death and head injury in motorcyclists who crashed. From four higher quality studies helmets were estimated to reduce the risk of death by 42% (OR 0.58, 95% CI 0.50 to 0.68) and from six higher quality studies helmets were estimated to reduce the risk of head injury by 69% (OR 0.31, 95% CI 0.25 to 0.38). Insufficient evidence was found to estimate the effect of motorcycle helmets compared with no helmet on facial or neck injuries. However, studies of poorer quality suggest that helmets have no effect on the risk of neck injuries and are protective for facial injury. There was insufficient evidence to demonstrate whether differences in helmet type confer more or less advantage in injury reduction. Motorcycle helmets reduce the risk of death and head injury in motorcycle riders who crash. Further well-conducted research is required to determine the effects of helmets and different helmet types on mortality, head, neck and facial injuries. However, the findings suggest that global efforts to reduce road traffic injuries may be facilitated by increasing helmet use by motorcyclists.
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            Road traffic injury mortality and its mechanisms in India: nationally representative mortality survey of 1.1 million homes

            Objectives To quantify and describe the mechanism of road traffic injury (RTI) deaths in India. Design We conducted a nationally representative mortality survey where at least two physicians coded each non-medical field staff's verbal autopsy reports. RTI mechanism data were extracted from the narrative section of these reports. Setting 1.1 million homes in India. Participants Over 122 000 deaths at all ages from 2001 to 2003. Primary and secondary outcome measures Age-specific and sex-specific mortality rates, place and timing of death, modes of transportation and injuries sustained. Results The 2299 RTI deaths in the survey correspond to an estimated 183 600 RTI deaths or about 2% of all deaths in 2005 nationally, of which 65% occurred in men between the ages 15 and 59 years. The age-adjusted mortality rate was greater in men than in women, in urban than in rural areas, and was notably higher than that estimated from the national police records. Pedestrians (68 000), motorcyclists (36 000) and other vulnerable road users (20 000) constituted 68% of RTI deaths (124 000) nationally. Among the study sample, the majority of all RTI deaths occurred at the scene of collision (1005/1733, 58%), within minutes of collision (883/1596, 55%), and/or involved a head injury (691/1124, 62%). Compared to non-pedestrian RTI deaths, about 55 000 (81%) of pedestrian deaths were associated with less education and living in poorer neighbourhoods. Conclusions In India, RTIs cause a substantial number of deaths, particularly among pedestrians and other vulnerable road users. Interventions to prevent collisions and reduce injuries might address over half of the RTI deaths. Improved prehospital transport and hospital trauma care might address just over a third of the RTI deaths.
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              Effect of Italy's motorcycle helmet law on traumatic brain injuries.

              To evaluate the impact of a revised Italian motorcycle-moped-scooter helmet law on crash brain injuries. A pre-post law evaluation of helmet use and traumatic brain injury (TBI) occurrence from 1999 to 2001. Romagna region, northeastern Italy, with a 2000 resident population of 983 534 persons. Motorcycle-moped rider survey for helmet use compliance and all residents in the region admitted to the Division of Neurosurgery of the Maurizio Bufalini Hospital in Cesena, Italy for TBI. Helmet use compliance and change in TBI admissions and type(s) of brain lesions. Helmet use increased from an average of less than 20% to over 96%. A comparison of TBI incidence in the Romagna region shows that there was no significant variation before and after introduction of the revised helmet law, except for TBI admissions for motorcycle-moped crashes where a 66% decrease was observed. In the same area TBI admissions by age group showed that motorcycle mopeds riders aged 14-60 years sustained significantly fewer TBIs. The rate of TBI admissions to neurosurgery decreased by over 31% and epidural hematomas almost completely disappeared in crash injured moped riders. The revised Italian mandatory helmet law, with police enforcement, is an effective measure for TBI prevention at all ages.
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                Author and article information

                Journal
                Natl J Maxillofac Surg
                Natl J Maxillofac Surg
                NJMS
                National Journal of Maxillofacial Surgery
                Wolters Kluwer - Medknow (India )
                0975-5950
                2229-3418
                Jan-Apr 2021
                16 March 2021
                : 12
                : 1
                : 56-61
                Affiliations
                [1]Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
                [1 ]Department of Dentistry, SN Medical College, Agra, Uttar Pradesh, India
                [2 ]Department of Head and Neck Surgery, Homi Bhabha Cancer Hospital, Varanasi, Uttar Pradesh, India
                Author notes
                Address for correspondence: Prof. R. K. Singh, Department of Oral and Maxillofacial Surgery, King George's Medical University, Lucknow - 226 003, Uttar Pradesh, India. E-mail: rksingh@ 123456kgmcindia.edu
                Article
                NJMS-12-56
                10.4103/njms.NJMS_150_20
                8191562
                34188401
                d745975c-d649-45e2-b0a3-0f1b15fc5070
                Copyright: © 2021 National Journal of Maxillofacial Surgery

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 16 July 2020
                : 24 August 2020
                : 01 October 2020
                Categories
                Original Article

                Surgery
                fracture mandible,helmeted riders,road traffic accidents
                Surgery
                fracture mandible, helmeted riders, road traffic accidents

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