Maxillofacial Fractures in Electric and Conventional Bicycle-Related Accidents

Pieter Date van der Zaag; Romke Rozema; Hiëronymus P A M Poos; Jurrijn Y J Kleinbergen; Baucke van Minnen; Inge H F Reininga; REDUCTION study group members

doi:10.1016/j.joms.2022.03.020

Maxillofacial Fractures in Electric and Conventional Bicycle-Related Accidents

J Oral Maxillofac Surg. 2022 Aug;80(8):1361-1370. doi: 10.1016/j.joms.2022.03.020. Epub 2022 Apr 6.

Authors

Pieter Date van der Zaag¹, Romke Rozema², Hiëronymus P A M Poos³, Jurrijn Y J Kleinbergen⁴, Baucke van Minnen⁵, Inge H F Reininga⁶; REDUCTION study group members

Collaborators

REDUCTION study group members:
Michiel H J Doff⁷, Gysbert T de Vries⁸, Mostafa El Moumni⁹, René Verbeek¹⁰, Bas W J Bens¹¹, Frederik K L Spijkervet¹²

Affiliations

¹ MD, PhD Student, Research Physician, Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: p.d.van.der.zaag@umcg.nl.
² MD, PhD Student, Research Physician, Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
³ Research Physician, Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Consultant Trauma Surgeon, Department of Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands.
⁴ Consultant Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Isala hospital, Zwolle, The Netherlands.
⁵ Chef de Clinique Consultant Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
⁶ Senior scientist, Principal investigator, Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Senior scientist, Emergency Care Network Northern Netherlands (AZNN), Northern Netherlands Trauma Registry, The Netherlands.
⁷ Research Physician, Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Consultant Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, Nij Smellinghe Hospital, Drachten, The Netherlands.
⁸ Consultant Emergency Physician, Research Physician, Department of Emergency Medicine, Isala Hospital, Zwolle, The Netherlands.
⁹ Consultant Trauma Surgeon, Department of Trauma Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
¹⁰ Consultant Emergency Physician, Research Physician, Department of Emergency Medicine, Nij Smellinghe Hospital, Drachten, The Netherlands.
¹¹ Consultant Emergency Physician, Research Physician, Department of Emergency Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
¹² Professor, Department Head Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.

PMID: 35533718
DOI: 10.1016/j.joms.2022.03.020

Abstract

Purpose: With the increased use of both e-bike and conventional bicycle, the number of bicycle-related accidents has increased accordingly. To determine whether there are differences in maxillofacial injuries between these 2 types of bicycle accidents, e-bike and conventional bicycle accidents were compared.

Material and methods: A retrospective cohort study was conducted for all the consecutive patients with maxillofacial injury due to e-bike and conventional bicycle accidents attending the emergency department of 4 hospitals in the Netherlands between May 2018 and October 2019. Primary outcomes are maxillofacial fractures present or absent and the severity of maxillofacial injury using the Maximum Abbreviated Injury Scale and Facial Injury Severity Scale (FISS) after e-bike and conventional bicycle accidents. A binary logistic regression analysis was used to assess differences in risk between an e-bike and conventional bicycle accident, where age, alcohol use, and comorbidities were added as covariates, for maxillofacial fractures, dental injury, and severe maxillofacial fractures.

Results: In total, 311 patients were included (73 e-bikers and 238 conventional cyclists). Sex distribution was equal in both groups (45% male vs 55% female). The e-bike group was older (66 vs 53 median age in years, P < .001) and had more comorbidities (0 vs 1, P < .001), while alcohol use was higher in the conventional bicycle group (32% vs 16%, P = .008). e-Bikers sustained midfacial fractures more frequently (47% vs 34%, P = .04), whereas conventional cyclists more often had mandibular fractures (1% vs 11%, P = .01). Although median Maximum Abbreviated Injury Scale and FISS scores did not differ between e-bike and conventional bicycle accidents, severe maxillofacial fractures (FISS score ≥ 2) were observed more often in the conventional cyclists (45% vs 25%, P = .04). No significant differences in risk of midfacial, mandibular, and severe maxillofacial fractures were found between e-bikers and conventional cyclists irrespective of their age, alcohol use, and comorbidities.

Conclusion: Both the distribution and the severe maxillofacial fractures differed between the e-bike and conventional bicycle accident patients. Patient-specific characteristics, such as age, alcohol use, and comorbidities, may have a greater influence on sustaining maxillofacial fractures than the type of bicycle ridden.

MeSH terms

Accidents, Traffic
Bicycling / injuries
Female
Fractures, Bone*
Humans
Injury Severity Score
Male
Maxillofacial Injuries* / epidemiology
Maxillofacial Injuries* / etiology
Retrospective Studies