Publikasjoner
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Facial Fractures and Their Relation to Head and Cervical Spine Injuries in Hospitalized Bicyclists
Pål Galteland med flere - Januar / februar 2023 The Journal of Craniofacial Surgery
Abstract
Bicyclists are vulnerable road users. The authors aimed to characterise facial fractures and their association with head and neck injuries in bicyclists admitted to a Scandinavian Level 1 trauma center with a catchment area of ~3 million inhabitants. Data from bicycle-related injuries in the period 2005 to 2016 were extracted from the Oslo University Hospital trauma registry. Variables included were age; sex; date of injury; abbreviated injury scale (AIS) codes for facial skeletal, head and neck injuries; and surgical procedure codes for treatment of facial fractures. Anatomical injury was classified according to AIS98. A total of 1543 patients with bicycle-related injuries were included. The median age was 40 years (quartiles 53, 25), and 1126 (73%) were men. Overall, 652 fractures were registered in 339 patients. Facial fractures were observed in all age groups; however, the proportion rose with increasing age. Bicyclists who suffered from facial fractures more often had a concomitant head injury (AIS head >1) than bicyclists without facial fractures (74% vs. 47%), and the odds ratio for facial fracture(s) in the orbit, maxilla and zygoma were significantly increased in patients with AIS head >1 compared to patients with AIS head=1. In addition, 17% of patients with facial fractures had a concomitant cervical spine injury versus 12% of patients without facial fractures. This results showed that facial fractures were common among injured bicyclists and associated with both head and cervical spine injury. Thus, a neurological evaluation of these patients are mandatory, and a multidisciplinary team including maxillofacial and neurosurgical competence is required to care for these patients.
Characteristics of Electric Scooter and Bicycle Injuries After Introduction of Electric Scooter Rentals in Oslo, Norway
August Vincent Stray med flere - August 15, 2022 jamanetwork.com
Key Points
Question How do electric scooter (e-scooter) injuries compare with traditional bicycle injuries?
Findings In this cohort study of 3191 patients with e-scooter or bicycle injuries, e-scooter injuries commonly occurred at nighttime and involved young adults who were not helmeted and most often intoxicated. In contrast, most bicycle injuries were sustained during commuting hours and involved riders of a wider age range who were often helmeted and less likely to be riding while intoxicated.
Meaning The rate of intoxication in e-scooter riders injured at nighttime is high, and introduction of preventive measures should be considered.
Orbital fractures
Mads Døving med flere - April 2022 Tidsskrift for den Norske laegeforening
Abstract
Orbital fractures can occur as a result of direct trauma to the eye region or surrounding facial bones. The fractures can lead to significant functional impairment and cosmetic changes. Surgical treatment of orbital fractures aims to reconstruct the bony anatomy and restore the orbit's original volume. This clinical review article looks at the key factors regarding orbital fractures.
Anatomical distribution of mandibular fractures from severe bicycling accidents: A 12-year experience from a Norwegian level 1 trauma center
Mads Døving med flere - April 2022 Dental Traumatology
Abstract
The mandible makes up a substantial part of the lower face, and is susceptible to injury. Even in helmeted cyclists, accidents may lead to fractures of the mandible because conventional helmets provide little protection to the lower part of the face. In addition, some studies indicate that helmets may lead to an increased risk of mandibular fractures. Thus, the aim of this study was to examine the anatomic distribution of mandibular fractures in injured cyclists and to assess if helmet use influenced the fracture locations. Material and Methods: Data from a Norwegian Level 1 trauma center were collected in the Oslo University Hospital Trauma Registry over a 12-year period. Of 1543 injured cyclists, the electronic patient charts of 62 cyclists with fractures of the mandible were retrospectively evaluated in detail. Demographic data, helmet use, and fracture type were assessed. Results: Sixty-two patients (4%) had fractures of the mandible, and women had an increased risk (OR 2.49, 95% CI 1.49–4.16, p< .001). The most common fracture site was the mandibular body, followed by the condyle. Isolated mandibular fractures occurred in 45% of the patients and 55% had other concomitant facial fractures. There were 42% of the patients with fractures in multiple sites of the mandible, and 42% had a concomitant dentoalveolar injury. Half of the cyclists were wearing a helmet at the time of the accident and 39% were not. There was no significant difference in fracture distribution between the helmeted and non-helmeted groups. Conclusions: Fracture of the mandibular body was the most prevalent mandibular fracture type following bicycle accidents. Women had an increased risk of mandibular fractures compared with men, whereas helmet wearing did not affect the anatomical fracture site.
Facial Fractures and Their Relation to Head and Cervical Spine Injuries in Hospitalized Bicyclists
Mads Døving med flere January 2023 The Journal of craniofacial surgery
Abstract
Bicyclists are vulnerable road users. The authors aimed to characterise facial fractures and their association with head and neck injuries in bicyclists admitted to a Scandinavian Level 1 trauma center with a catchment area of ~3 million inhabitants. Data from bicycle-related injuries in the period 2005 to 2016 were extracted from the Oslo University Hospital trauma registry. Variables included were age; sex; date of injury; abbreviated injury scale (AIS) codes for facial skeletal, head and neck injuries; and surgical procedure codes for treatment of facial fractures. Anatomical injury was classified according to AIS98. A total of 1543 patients with bicycle-related injuries were included. The median age was 40 years (quartiles 53, 25), and 1126 (73%) were men. Overall, 652 fractures were registered in 339 patients. Facial fractures were observed in all age groups; however, the proportion rose with increasing age. Bicyclists who suffered from facial fractures more often had a concomitant head injury (AIS head >1) than bicyclists without facial fractures (74% vs. 47%), and the odds ratio for facial fracture(s) in the orbit, maxilla and zygoma were significantly increased in patients with AIS head >1 compared to patients with AIS head=1. In addition, 17% of patients with facial fractures had a concomitant cervical spine injury versus 12% of patients without facial fractures. This results showed that facial fractures were common among injured bicyclists and associated with both head and cervical spine injury. Thus, a neurological evaluation of these patients are mandatory, and a multidisciplinary team including maxillofacial and neurosurgical competence is required to care for these patients.
Bicycle-related cervical spine injuries
April 2022 North American Spine Society Journal (NASSJ
Abstract
BACKGROUND Bicyclists are vulnerable road users. The aim of this paper was to describe all bicycle-related traumatic cervical spine injuries (CSIs) in the South-East region of Norway (2015–2019), and to investigate whether certain types of CSIs are typical for bicyclists. METHODS Retrospective cohort study of prospectively collected registry data of all CSIs in the South-East region of Norway (3.0 million inhabitants), from 2015 to 2019. Patient characteristics, injury types, and treatment were summarized with descriptive statistics. Bayesian multivariable logistic regression was used to identify potential factors associated with occipital condyle fractures (OC-Fx) or odontoid fractures (OFx). RESULTS During the five-year study period, 2,162 patients with CSIs were registered, and 261 (12%) were bicycle-related. The incidence of bicycle-related CSIs was 1.7/100,000 person-years. The median age of the patients with bicycle-related CSIs was 55 (IQR: 22) years, 83% were male, 71% used a helmet, 16% were influenced by ethanol, 12% had a concomitant cervical spinal cord injury (SCI), and 64% sustained multiple traumas. The three most common bicycle-related CSIs were C6/C7 fracture (Fx) (28%), occipital condyle Fx (OC-Fx) (23%) and C5/C6 Fx (19%). Patients with bicycle-related CSIs compared to patients with non-bicycle related CSIs were younger, more often male, had fewer comorbidities, more likely multiple traumas, more often had OC-Fx, and less often sustained an odontoid fracture (OFx). Multivariable logistic regression of potential risk factors for OC-Fx demonstrated a significantly increased risk of OC-Fx for bicyclists compared to non-bicyclists (OR=2.8).The primary treatment for bicycle-related CSIs was external immobilization in 187/261 (71.6%) cases, open surgical fixation in 44/261 (16.8%), and no treatment in 30/261 (11.5%). CONCLUSION : Bicycle crashes are a frequent cause of CSIs in the Norwegian population and should be of concern to the public society. The three most common bicycle-related CSIs were C6/C7 fracture, occipital condyle fracture and C5/C6 fracture.
Bakterielle odontogene infeksjoner
Mats Døving - April 2020 Tidsskrift for den Norske laegeforening
Abstract
Odontogene infeksjoner er infeksjoner som oppstår i tennene og/eller i deres støttevev. Infeksjonene forekommer hyppig, og en stor andel av infeksjoner i hode-og halsregionen har odontogen opprinnelse. De fleste odontogene infeksjoner gir milde symptomer og funn, men kan utvikle seg til alvorlige tilstander. Denne artikkelen gir en oversikt over de vanligste patogene mikrobene i munnhulen, de hyppigst forekommende odontogene infeksjoner samt behandling og mulige komplikasjoner. Artikkelen er basert på et ikke-systematisk søk i PubMed, kliniske erfaringer og eget litteraturarkiv.
A case of primary osteomyelitis of themandible preceding Takayasu arteritis
Mats Døving - September 2019.
Abstract
Primary chronic osteomyelitis (PCO) is a rare condition that usually affects the mandible. Although most often occurring isolated, it can be part of various systemic and cutaneous syn-dromes. Takayasu arteritis (TAK) is an autoimmune disease that can co-exist with osteomyelitis, but has only been reported once in conjunction with PCO of the mandible. We present a case of a 27-year old female with PCO of the mandible which was found to have co-existing TAK. Doctors treating patients with PCO should be aware of the associated diseases and actively seek out their signs and symptoms.
