Maxillofacial trauma patterns and risk factors in 2-wheeler riders: A non-urban South Indian epidemiological study.

Abstract

Objective: The prevalent reliance on 2-wheelers as a preferred mode of private transportation in rural and semi-urban regions and the various associated social and material factors put riders at significant risk for road traffic accidents causing maxillofacial trauma. This epidemiological study aims to investigate these factors and their influence on patterns of maxillofacial injuries among 2-wheeler riders in semi-urban and rural areas of South India.

Methods: Data from all cases with maxillofacial injuries over 6 years were collected retrospectively, including demographic characteristics, accident specifics, helmet use, injury patterns, and management. Statistical analyses were done using chi-square analysis and logistic regression modeling.

Results: The cohort of 424 participants was predominantly young males (86.8%) aged 20 to 29 years (45.3%), with low helmet use rates (27.2%). Higher speeds showed a significant correlation with increased hard tissue injuries (P = .003), with all cases over 80 kph invariably resulting in fractures. Collisions were associated with a markedly higher rate of both soft and hard tissue injuries (80.6%) compared to skids (63.7%; P = .005) and a greater prevalence of complex midface fracture patterns. Non-helmet users had significantly elevated rates of lacerations (33.3%), combined abrasion and laceration injuries (33.9%), and severe tissue loss (2.4%). Half-helmet users predominantly suffered mandibular fractures (62.5%). Logistic regression analysis revealed helmet nonuse as a major risk factor, significantly increasing the likelihood of any fracture (Exp(B) = 0.015, P < .001). Higher speeds raised the risk of hard tissue injuries across all speed brackets (P < .001). Collisions were more likely to result in midface fractures (Exp(B) = 818,915.984, P < .001), whereas skidding accidents often led to mandibular fractures. Not wearing a helmet markedly increased the risk of severe fractures across all facial areas, with statistically significant Exp(B) values. Collisions necessitated considerably more surgical interventions (Exp(B) = 0.312, P < .001).

Conclusions: The findings highlight the vulnerability of young riders and underscore the role of helmet use, speed, and road infrastructure in road traffic accidents causing maxillofacial injuries. They also indicate the need to focus preventive measures and interventions on these factors.