Oral and maxillofacial surgery
Maxillofacial fractures sustained during sports played with a ball

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Abstract

Objective

The aim of this study was to investigate the incidence and type of maxillofacial fractures caused by various sports played with a ball to better understand the nature of these fractures.

Study design

Retrospective study was carried out using records from 100 patients treated between 1986-2002. Age and sex, etiology, and site of the fracture, yearly and monthly distribution of the fractures, and treatment modality were analyzed.

Results

The fractures mostly resulted from baseball (44%), followed by rugby (28%) and soccer (18%). The highest incidence was in the 10- to 19-year age-group with male propensity. The most common cause of the fractures was impact against another player (43%). The majority of the patients suffered from mandibular fractures (56%), followed by midface (31%) and alveolar fractures (12%). Mandibular angle, zygoma, and zygomatic arch fractures were prominent for rugby fractures. A yearly comparison of the fracture incidence showed a gradual decrease over the 16-year period. Fractures had a peak incidence in autumn. 55% of the patients were treated surgically. Surgical intervention was mostly needed for patients sustaining fractures during soccer (72.2%).

Conclusions

Among ball-related sports, baseball is responsible for most of the maxillofacial fractures, but, although the incidence is not that high, soccer-related fractures may be more severe due to the nature of this sport.

Introduction

People are more prone to sports-related injuries parallel to increased popularity of sports and growing participation in various sports activities.1, 2, 3 It has been reported that 3-18% of all maxillofacial fractures are caused by sports and games.1 Contact sports are more dangerous due to their nature, causing extensive and multiple injuries. Many sports and games played with a ball are popular throughout the world, as most of them can be performed both indoor and outdoor, and in all seasons. Research on etiology and extent of maxillofacial injury sustained during sports would be useful to focus on protective measures and to plan changes in legislation. A special field of sports medicine has been established, and sports dentistry has been defined that focuses upon preventive and therapeutic interventions for sports-related oral and maxillofacial injuries. There is a great need for understanding the nature of sports-related traumatic injuries. Sharing the clinical and epidemiological data will permit identification of causative factors for these injuries and development of effective preventive and therapeutic methods for the benefit of patients.

The aim of this study was to analyze maxillofacial fractures due to ball-related sports to evaluate the causes and to better understand the nature of these fractures.

Section snippets

Patients and methods

During the period between 1986 and 2002, 1428 patients with maxillofacial fractures were treated in the First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University. One-hundred-twenty-six patients sustained fractures during sports activities, 100 of which were related to sports played with a ball. A retrospective analysis of patients' files was carried out considering age and gender, cause and site of the fracture, the month and year the injury occurred,

Results

One-thousand-four-hundred-twenty-eight patients were treated with maxillofacial fractures. One-hundred-twenty-six patients (8.8%) had fractures due to sports activities. One-hundred of them (7% of all maxillofacial fractures and 79.3% of sports-related fractures) were due to ball-related sports. The fractures mostly resulted from baseball (44%), followed by rugby (28%), soccer (% 18), and other ball-related sports such as basketball, golf, tennis, and handball (10%).

Yearly and monthly distribution of the fractures

A yearly comparison of the fracture incidence due to ball-related sports showed a gradual decrease over the 16-year period (Fig 4). The highest incidence was seen in 1986 (94.1% of sports related fractures and 14.4% of all maxillofacial fractures), and the lowest incidence was in 2001 (no case). There was a yearly gradual decrease in baseball-related fractures as well. Fractures sustained during soccer and rugby tended to decrease in the last 2 years (no case). The incidence of ball-related

Treatment

Fifty-five of the 100 patients were treated by surgical intervention, including mini-plate and wire fixation. In 45 patients, non-surgical treatment was performed (ie, maxillomandibular fixation that continued for 4 to 6 weeks). Surgical intervention was used to treat 58.9% of the mandibular fractures and 67.7% of midface fractures. Of the patients treated surgically, 45.4%, 64.2% and 72.2% respectively were for baseball, rugby, and soccer-related fractures.

Discussion

The increased interest in sports has focused attention on attempts to prevent sports injuries in recent years. Fractures sustained during sports have lower incidence than those from other causes such as assaults, traffic accidents, and falls.1, 2, 5, 6 The incidence of maxillofacial fractures related to sports was reported to vary from 6-15% in Japan and 2.5-28% in other countries.2 This rate tends to increase in high-contact sports since the facial region is more prone to injury in these

References (18)

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