Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
Oral and maxillofacial surgeryMaxillofacial fractures sustained during sports played with a ball
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.
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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
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