exudates and Facial-Injuries

Topics: Accidents, Traffic; Adult; Cross-Sectional Studies; Facial Injuries; Head Protective Devices; Humans; Malaysia; Male; Motorcycles; Prospective Studies; Young Adult

The association between facial injury characteristics and mild traumatic brain injury (mTBI) is unclear. The aim of this study was to determine the association between facial injury characteristics and mTBI.. A retrospective review utilizing patients' medical records at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia, was performed. Records of subjects with a history of facial trauma from 1 April 2012 to 31 December 2012 were selected. Various levels and surgical speciality records were reviewed to ascertain the diagnoses of facial injuries and mTBI.. A total of 348 medical records with the diagnosis of facial injuries were included. The prevalence of mTBI among these patients was 41.4% (95% CI 36.2-46.6). The majority of the patients with mTBI were in the age group of 18-25 years old. Patients with or without facial lacerations that were located on the lower face had a significant association with mTBI, P=.001, compared to other types of soft tissue injury. In addition, a statistically significant association was observed between facial fractures occurring to the middle face and mTBI, P=.018. Pearson chi-square test also showed statistically significant association between the severity of facial injuries and mTBI, P=.018.. Mild traumatic brain injury should be suspected in patients with facial injuries and particularly those with lower face lacerations, midface fractures, moderate to severe facial injury and presence of multiple injuries.

Topics: Adolescent; Adult; Brain Concussion; Facial Injuries; Female; Humans; Incidence; Malaysia; Male; Middle Aged; Prevalence; Retrospective Studies

In Malaysia, motorcyclists continue to outnumber other road users in injuries and deaths. The objective of this study was to determine the association between helmet fixation and helmet type with head injury and severity of head injury among Malaysian motorcyclists.. The study design was a prospective cross-sectional study. The participants involved injured motorcyclists who were admitted in five selected hospitals in Klang Valley, Malaysia. Participants who sustained head injury were selected as the cases while those with injury below the neck (IBN) were selected as the controls. Questionnaire comprising motorcyclist, vehicle, helmet and crash factors was examined. Diagnoses of injuries were obtained from the participants' medical records.. The total subjects with head injuries were 404 while those with IBN were 235. Majority of the cases (76.2%) and controls (80.4%) wore the half-head and open-face helmets, followed by the tropical helmets (5.4% and 6.0% of the cases and controls, respectively). Full-face helmets were used by 1.2% of the cases and 4.7% of the controls. 5.7% of the cases and 6.0% of the controls did not wear a helmet. 32.7% of the cases and 77.4% of the controls had their helmets fixed. Motorcyclists with ejected helmets were five times as likely to sustain head injury [adjusted odds ratio, AOR 5.73 (95% CI 3.38-9.73)] and four times as likely to sustain severe head injury [AOR of 4.83 (95% CI 2.76-8.45)]. The half head and open face helmets had AOR of 0.24 (95% CI 0.10-0.56) for severe head injury when compared to motorcyclists who did not wear a helmet.. Helmet fixation is more effective than helmet type in providing protection to the motorcyclists.

Topics: Accidents, Traffic; Adolescent; Adult; Craniocerebral Trauma; Cross-Sectional Studies; Facial Injuries; Female; Head Protective Devices; Health Knowledge, Attitudes, Practice; Humans; Malaysia; Male; Middle Aged; Motorcycles; Odds Ratio; Prospective Studies; Risk Factors; Surveys and Questionnaires; Young Adult

The effectiveness of helmets in reducing the risk of severe head injury in motorcyclists who were involved in a crash is well established. There is limited evidence however, regarding the extent to which helmets protect riders from facial injuries. The objective of this study was to determine the effect of helmet type, components and fixation status on the risk of facial injuries among Malaysian motorcyclists.. 755 injured motorcyclists were recruited over a 12-month period in 2010-2011 in southern Klang Valley, Malaysia in this case control study. Of the 755 injured motorcyclists, 391 participants (51.8%) sustained facial injuries (cases) while 364 (48.2%) participants were without facial injury (control). The outcomes of interest were facial injury and location of facial injury (i.e. upper, middle and lower face injuries). A binary logistic regression was conducted to examine the association between helmet characteristics and the outcomes, taking into account potential confounders such as age, riding position, alcohol and illicit substance use, type of colliding vehicle and type of collision. Helmet fixation was defined as the position of the helmet during the crash whether it was still secured on the head or had been dislodged.. Helmet fixation was shown to have a greater effect on facial injury outcome than helmet type. Increased odds of adverse outcome was observed for the non-fixed helmet compared to the fixed helmet with adjusted odds ratio (AOR) = 2.10 (95% CI 1.41- 3.13) for facial injury; AOR = 6.64 (95% CI 3.71-11.91) for upper face injury; AOR = 5.36 (95% CI 3.05-9.44) for middle face injury; and AOR = 2.00 (95% CI 1.22-3.26) for lower face injury. Motorcyclists with visor damage were shown with AOR = 5.48 (95% CI 1.46-20.57) to have facial injuries compared to those with an undamaged visor.. A helmet of any type that is properly worn and remains fixed on the head throughout a crash will provide some form of protection against facial injury. Visor damage is a significant contributing factor for facial injury. These findings are discussed with reference to implications for policy and initiatives addressing helmet use and wearing behaviors.

Topics: Accidents, Traffic; Adolescent; Adult; Aged; Aged, 80 and over; Case-Control Studies; Facial Injuries; Female; Head Protective Devices; Humans; Logistic Models; Malaysia; Male; Middle Aged; Motorcycles; Odds Ratio; Risk Factors; Young Adult

This study aims to describe the presence and severity of extracranial concomitant injuries in traumatic brain injury (TBI) patients and to ascertain their effect on long-term functional outcome.. A retrospective cohort study was performed in a single-center recruiting patients with first episode of TBI. The types and severity of extracranial concomitant injuries were documented for patients who fulfilled the inclusion criteria. Injuries with Abbreviated Injury Scale (AIS) grade 3-6 were considered to be high grade. A cross-sectional functional assessment was conducted at 18 months post-injury using Glasgow Outcome Scale.. A total of 100 patients were included in the analysis. Extracranial concomitant injuries were seen in 78% of the patients. Three commonest injuries were facial (44%), lower extremity (20%) and upper extremity (12%) injuries. Among the AIS grade ≥ 3, injury involving the chest was most common (41%). Presence of extracranial concomitant injuries AIS grade ≥ 3 was significantly associated with disability in TBI patients at 18 months (OR 12.74, 95% CI 2.39-67.95, p = 0.003).. Presence of extracranial concomitant injuries was high. In TBI survivors, extracranial concomitant injuries AIS grade ≥ 3 influenced the long-term functional outcome at 18 months, causing moderate and severe disabilities.. Concomitant injuries should be suspected in patients with traumatic brain injury, especially in a high-speed trauma mechanisms as the incidence can be as high as 78% as in this study and may interfere with the long term rehabilitation and outcome. This study shows that severe extra cranial concomitant injuries are associated with a poor long term functional outcome even in the mild traumatic brain injury patients and therefore need to be addressed early in the rehabilitation of this group of patients. Early diagnosis and management of severe concomitant injuries is warranted and may improve the functional gains in the long term after traumatic brain injury.

Topics: Abbreviated Injury Scale; Adolescent; Adult; Arm Injuries; Brain Injuries; Cross-Sectional Studies; Facial Injuries; Female; Glasgow Outcome Scale; Humans; Leg Injuries; Logistic Models; Malaysia; Male; Middle Aged; Multiple Trauma; Prevalence; Recovery of Function; Retrospective Studies; Time Factors; Treatment Outcome; Young Adult

Maxillofacial injuries are among the commonest forms of body injuries. There are three divisions, namely, facial bone fractures, soft tissue injuries, and dentoalveolar injuries. Etiologies include motor vehicle accidents, assaults, falls, and sporting injuries. The aim of this study was to determine the profiles including the causes of maxillofacial injuries seen in an urban government hospital in the mainland of Penang State, Malaysia.. This was a cross-sectional study that recruited cases reported within a period of 1 year. The source population was maxillofacial injury patients presenting to the Oral and Maxillofacial Surgery Department of an urban hospital in the Penang Mainland, North Malaysia between May 2007 and May 2008. Cases of patients involved in accidents that occurred outside the reference vicinity were excluded. A case report form was developed and completed by the attending clinicians. Data were analyzed using spss version 12.0.. A total of 194 cases were studied, with the mean patient age being 27.8 (SD 15.20) years. The majority of patients were Malay men between 20 and 29 years of age. The main cause of injury was motorcycle accident (53.6%). The commonest injury (in isolation/combination with other injuries) involved the soft tissues (87.2%), dentoalveolar region (33.4%), and facial bones (23.9%). Laceration was the commonest soft tissue injury, and crown fracture was the most frequent dentoalveolar injury. The facial bone that was most highly involved in the injury was the zygoma. Subjects involved in motorcycle accidents had a significantly higher incidence of sustaining facial bone fractures.. Motorcycle accidents were the commonest cause of maxillofacial injuries in the Penang Mainland, Malaysia. Most patients were young men. Hence, it is prudent to reinforce appropriate road safety and awareness interventions particularly focusing young male motorcyclists so as to reduce the risk of accidents.

Topics: Accidents, Traffic; Adolescent; Adult; Aged; Child; Child, Preschool; Cross-Sectional Studies; Facial Bones; Facial Injuries; Female; Humans; Infant; Malaysia; Male; Maxillofacial Injuries; Middle Aged; Motorcycles; Periodontium; Soft Tissue Injuries; Tooth Injuries; Young Adult

Road traffic accidents are the main cause of trauma in Malaysia. It has been shown that there was an increase in admissions for trauma patients older than 60 years in the last decade. The purpose of this study was to determine the pattern of maxillofacial injuries in the geriatric patients referred to Seremban Hospital, Malaysia.. Records of patients aged 60 years or older who sustained oral and maxillofacial injuries between 1998 and 2002 were reviewed. Data related to age, sex, race, etiology, types of injuries and treatment modalities were obtained.. A total of 134 geriatric patients with maxillofacial and dental injuries were seen in Seremban Hospital between January 1998 and December 2002. There were 101 (75.4%) men and 33 (24.6%) women. The age ranged 60-92 years with the mean age of 68.3 years (standard deviation, 7.48). Chinese made up the majority of the patients (51.8%), followed by Malays (37.2%), Indian (20.4%) and other ethnic groups (1.5%). The most common cause of injury was due to road traffic accidents (64.2%) However, falls were more common in those aged 76 years and above. The most common bone fracture documented was the mandible (35.7%) followed by fracture of the zygomatic complex (34.0%). The majority of treatment was conservative or closed reduction.. All the elderly patients with facial trauma were managed conservatively or as closed reduction in this hospital. This was largely because of their comorbid state and financial constraints.

Topics: Accidental Falls; Accidents, Traffic; Aged; Aged, 80 and over; Facial Injuries; Female; Hospitals, University; Humans; Malaysia; Male; Middle Aged; Retrospective Studies

Soft-tissue injuries with or without facial bone involvement are the most common presentation following maxillofacial trauma. The objective of this study was to look at the distribution, pattern and type of soft-tissue injury in relation to aetiology. Records of patients over a period of 5 years (1998-2002), who sustained maxillofacial injuries and were treated at Kajang Hospital, a secondary referral hospital, were reviewed. Out of 313 patients with maxillofacial injuries, 295 patients sustained soft-tissue injuries. Males (79%) between 21 and 30 years old (34%) were the majority of patients. Road-traffic accident was the main cause of soft-tissue injuries (75%) with motorcycle accident being the most frequent (40%). The upper lips (23%) and the lower lips (18%) were the most common extraoral site involved, while the labial mucosa and sulcular areas, both accounting for 21%, were the most common intraoral sites. Stringent road-traffic regulations should be practiced in developing countries, as morbidity arising from road-traffic accidents poses a national economic and social problem.

Topics: Accidents, Traffic; Adolescent; Adult; Age Distribution; Aged; Child; Child, Preschool; Comorbidity; Facial Injuries; Female; Humans; Infant; Malaysia; Male; Maxillofacial Injuries; Middle Aged; Motor Vehicles; Mouth; Soft Tissue Injuries; Statistics, Nonparametric