Researchers point to safer vehicles as reason for fewer fractures
MONDAY, May 18 (HealthDay News) -- People injured in motor vehicle accidents these days are less likely to suffer facial fractures than they were in the past, thanks largely to better and safer automobile designs, researchers say.
Some 50 percent to 60 percent of the group studied were wearing seat belts, said the authors of a report appearing in the May/June issue of the Archives of Facial Plastic Surgery.
But the "news" is not new to many plastic surgeons, who have been seeing a decline in this type of injury for years.
"The American Society of Plastic Surgeons has seen the trend nationwide," said Dr. Malcolm Z. Roth, director of plastic surgery at Maimonides Medical Center in New York City and vice president of health policy and advocacy at the society.
"It points to a trend, and the trend is good," added Dr. Richard M. Winters, vice chairman of the department of plastic surgery at Hackensack University Medical Center in New Jersey.
"There's always been some good evidence that actual design improvements in cars, the way pillars are placed, crumple zones, result in fewer injuries," explained study co-author Dr. John S. Rhee, an associate professor in the division of facial plastic surgery and the department of otolaryngology at the Medical College of Wisconsin.
"But there's still not much data on exactly which design features are beneficial," he added. "The evidence we do have still points to seat belts as "the biggest predictor of facial factors."
According to the study, facial trauma is the most frequent injury resulting from motor vehicle collisions. And maxillofacial fractures can also include damage to the eye or intracranial damage.
The investigators looked at records of drivers and front-seat passengers who had suffered facial fractures after motor vehicle accidents occurring from 1993 to 2005.
During that time period, 167,391 victims sustained one or more facial fractures, 55,150 had skull base or frontal sinus fractures and 196,855 had nasal fractures, the study indicates.
Overall, the number of facial fractures declined each year between 1993 and 2005, as new and safer car models were introduced, the study authors note.
People using seat belts and front air bags had a 14 percent reduced chance of a facial fracture, although air bags on their own were not connected with any reduction, according to the report.
"It all starts with the seat belt," said Roth, who remembers strapping on his seat belt in a driver's education driving class, right before the student driver hit a tree.
"Fortunately or unfortunately, I was a beneficiary of seat belts," he said. "No matter how many air bags you have, you still need a seat belt."
According to the authors, seat belts have been the most important factor in preventing skull base and nose breaks.
Facial fractures were more likely in side impacts or when vehicles of different sizes collided. The greatest risk for fractures was when a vehicle collided with trees, telephone poles and other stationary objects.
And occupants in larger vans or sports utility vehicles were not less likely to be hurt when colliding with regular passenger cars (although those in the smaller vehicle were more likely to sustain facial and skull base injuries). Moreover, when these larger vehicles hit other large vehicles, the risk of facial and skull base injuries was actually higher, the study authors report.
Taller people were more likely to have both nasal and facial breaks, although the difference was slight.
"You can't minimize the risk to zero but if you're wearing a seat belt and are in a car with airbags, not drinking alcohol or doing drugs and not driving 60 miles above the speed limit, chances are you will be spared," Roth said.
The U.S. Centers for Disease Control and Prevention has more on injuries related to motor vehicle accidents.
SOURCES: John S. Rhee, associate professor, division of facial plastic surgery and department of otolaryngology, Medical College of Wisconsin, Milwaukee; Richard M. Winters, M.D., vice chairman, department of plastic surgery, and chairman, medical board, Hackensack University Medical Center, N.J.; Malcolm Z. Roth, M.D., director, plastic surgery, Maimonides Medical Center, New York City, and vice president, health policy and advocacy, American Society of Plastic Surgeons; May/June 2009 Archives of Facial Plastic Surgery
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