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Maxillofacial injuries in severely injured patients after road traffic accidents—a retrospective evaluation of the TraumaRegister DGU® 1993–2014

  • Sebastian Pietzka
  • Peer W. Kämmerer
  • Silke Pietzka
  • Alexander Schramm
  • Lorenz Lampl
  • Rolf Lefering
  • Dan Bieler
  • Martin KullaEmail author
Original Article

Abstract

Objectives

It was the aim of the study to analyse the prevalence of maxillofacial trauma (MFT) in severely injured patients after road traffic accidence (RTA) and to investigate associated factors.

Materials and methods

In a retrospective study, data from patients after RTA by the TraumaRegister DGU® from 1993 to 2014 were evaluated for demographical and injury characteristics. The predictor variable was mechanism of injury and the outcome variables were type of injury, severity and hospital resources utilization.

Results

During the investigation period, n = 62,196 patients were enclosed with a prevalence of maxillofacial injuries of 20.3% (MFT positive). The injury severity score of MFT-positive patients was higher than in the MTF-negative subgroup (27 ± 12.8 vs. 23.0 ± 12.7). If MFT positive, 39.8% show minor, 37.1% moderate, 21.5% serious and 1.6% severe maxillofacial injuries. Injuries of the midface occurred in 60.3% of MTF-positive patients. A relevant blood loss (> 20% of total blood volume) occurred in 1.9%. MFT-positive patients had a higher coincidence with cervical spine fractures (11.3% vs. 7.8%) and traumatic brain injuries (62.6% vs. 34.8%) than MFT-negative patients. There was a noticeable decrease in the incidence of facial injuries in car/truck drivers during the study period.

Conclusions

Every 5th patient after RTA shows a MFT and the whole trauma team must be aware that this indicates a high prevalence of traumatic brain and cervical spine injuries.

Clinical relevance

Even if sole injuries of the face are seldom life threatening, maxillofacial expertise in interdisciplinary trauma centres is strongly recommended.

Keywords

Maxillofacial injury Trauma Epidemiology Road traffic accident 

Notes

Acknowledgements

The authors state that parts of this article are based on a doctoral dissertation that will be submitted to the Medical School of the University of Ulm by Silke Pietzka.

Compliance with ethical standards

Conflict of interest

Sebastian Pietzka declares that he has no conflict of interest. Peer W. Kämmerer declares that he has no conflict of interest. Silke Pietzka declares that she has no conflict of interest. Alexander Schramm declares that he has no conflict of interest. Lorenz Lampl declares that he has no conflict of interest. Rolf Lefering declares that he has no conflict of interest. Dan Bieler declares that he has no conflict of interest. Martin Kulla declares that he has no conflict of interest.

Ethical approval

The present study has been approved by the Ethic Committee of the Medical School of the University of Ulm (positive Vote 17th December 2017). All procedures were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Cranio-Maxillo-Facial-SurgeryGerman Armed Forces Hospital UlmUlmGermany
  2. 2.Department of Cranio-Maxillo-Facial-SurgeryUniversity Medical Centre MainzMainzGermany
  3. 3.Department of Dental Care and Centre for Dental SpecialtiesGerman Armed Forces Hospital UlmUlmGermany
  4. 4.Department of Cranio-Maxillo-Facial-SurgeryUniversity Hospital UlmUlmGermany
  5. 5.Department of Anaesthesiology and Intensive Care MedicineGerman Armed Forces Hospital of UlmUlmGermany
  6. 6.Institute for Research in Operative Medicine (IFOM)Witten/Herdecke UniversityWittenGermany
  7. 7.Department of Trauma Surgery and Orthopaedics, Reconstructive Surgery, Hand Surgery and Burn MedicineGerman Armed Forces Central Hospital KoblenzKoblenzGermany
  8. 8.Department of Anaesthesiology and Intensive Care Medicine, Emergency Medicine Section, HEMS Christoph 22German Armed Forces Hospital of UlmUlmGermany

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