Manfred Giese

Background: The coronavirus disease 2019 (COVID-19) pandemic altered nasal fracture epidemiology, with fewer outdoor injuries and more domestic accidents. This study compared intra-pandemic and post-pandemic nasal fracture patterns and their prevention implications. Materials and Methods: This retrospective study included patients treated for nasal fractures during February 2020–January 2021 (intra-pandemic) and February 2023–January 2024 (post-pandemic). The post-pandemic cohort was identified using the same eligibility criteria, variable definitions, coding framework, and electronic-record retrieval procedure as the previously published intra-pandemic cohort. The predefined objective was a direct comparison of these two matched periods; no pre-pandemic control group was included. Results: A total of 290 patients were analyzed (184 post-pandemic and 106 intra-pandemic). In exploratory unadjusted comparisons, sports accidents occurred in 29/184 (15.8%) post-pandemic versus 7/106 (6.6%) intra-pandemic cases (p = 0.023), road traffic incidents in 31/184 (16.8%) versus 7/106 (6.6%) (p = 0.041), interpersonal violence in 60/184 (32.6%) versus 20/106 (18.9%) (p = 0.009), and alcohol-related events in 37/184 (20.1%) versus 7/106 (6.6%) (p = 0.009). Falls, virus- or flu-associated syncope, and accidents at home were more frequent intra-pandemic. Because multiple comparisons were performed, findings with p-values near 0.05 should be regarded as nominal and hypothesis-generating. The unadjusted mean hospital stay was shorter post-pandemic; however, the study period was not independently associated with length of stay after adjustment. The post-pandemic period showed a borderline, non-significant association with violence-related fractures (odds ratio 1.76, 95% confidence interval 0.99–3.12; p = 0.051). Conclusion: The observed changes are compatible with a return of social, recreational, and traffic-related trauma patterns, although the absence of a pre-pandemic control group and the exploratory nature of subgroup analyses limit causal interpretation. Differences in hospital stay appear to be more closely related to patient-level characteristics than to the study period itself.

Background: Facial fractures are common in emergency and trauma care, with age and sex known to influence fracture patterns, injury mechanisms, and treatment approaches. However, detailed comparative data analyzing these demographic variables separately remain limited. Methods: In this retrospective single-center study, we analyzed 561 patients with radiologically confirmed facial fractures who were treated between January 2021 and December 2022. Patients were stratified by sex and age (p < 0.001). Although most fracture types did not differ significantly by sex, female patients underwent surgical treatment significantly less often than males (OR = 0.45, 95% CI: 0.32–0.64, p < 0.001). Patients over 50 years were significantly less likely to suffer mandibular fractures (OR = 0.59, 95% CI: 0.40–0.88, p = 0.009), while frontal sinus fractures were more common in older individuals (OR = 4.77, 95% CI: 1.02–22.27, p = 0.029). Younger patients more often experienced interpersonal violence, alcohol-related incidents, and received operative care, whereas falls and conservative treatment were more frequent among older individuals. Conclusions: Age and sex significantly influence the epidemiology and management of facial fractures. Understanding these demographic differences can guide targeted prevention strategies and assist clinical decision-making in facial trauma care.

Objectives: The increasing popularity of electric scooters (E-scooters) has led to a rise in trauma-related injuries, particularly in the craniofacial region. This study aims to compare dentoalveolar trauma (DT) patterns between E-scooter and bicycle accidents in a German urban area to identify differences in injury characteristics, risk factors, and treatment approaches. Materials and Methods: This retrospective study analyzed 178 patients treated for DT following E-scooter (n = 56) or bicycle (n = 122) accidents between January 2022 and December 2022 at a single oral and maxillofacial surgery department in a German urban area. Demographic, clinical, temporal, and therapeutic data were collected and statistically compared. Results: E-scooter patients were significantly younger (mean age: 33.6 vs. 47.0 years, p < 0.001) and predominantly female (85.7% vs. 26.2%, p < 0.001) compared to bicycle patients. E-scooter accidents more frequently occurred at night (69.6%) and on weekends (62.5%) and were significantly associated with alcohol consumption (55.4%) and low helmet use (8.9%). Clinically, E-scooter accidents resulted in more complex dental injuries, including a higher incidence of root fractures (14.3% vs. 0%, p < 0.001), complicated crown fractures (25.0% vs. 9.0%, p = 0.004), and crown-root fractures (32.1% vs. 9.8%, p < 0.001). Mandibular injuries were more prevalent in the E-scooter group, and concomitant facial fractures (excluding alveolar) were also more common (28.6% vs. 19.7%, p = 0.018). Conclusion: E-scooter accidents are associated with a distinct DT pattern involving younger, often alcohol-intoxicated, and helmetless patients, typically presenting with more severe and complex DT-injuries. These findings highlight the urgent need for targeted prevention strategies, legislative measures on helmet use, and clinician awareness of specific trauma profiles linked to E-scooter use.

Background: The purpose of this study was to examine how the COVID-19 pandemic influenced the patterns, distribution, and circumstances of dental trauma (DT) cases at a German cranio-maxillofacial trauma center. Materials and Methods: This retrospective analysis compared DT cases from the PreCovid (PC) period (February 2019–January 2020) with those from the IntraCovid (IC) period (February 2020–January 2021). It included an examination of baseline characteristics, types of DT, circumstances leading to DT, and the treatment approaches applied. Results: In the IC period, there was an increase in the number of DT, a significant increase in uncomplicated crown fractures, crown–root fractures, subluxations, avulsions, alveolar fractures, combined tooth fractures and dislocations, and concomitant soft tissue injuries. There were no differences regarding the location of DT. During the IC period there was a significant reduction in sports accidents, road traffic accidents, interpersonal violence, and alcohol-related DT. Simultaneously, there was a marked increase in falls, syncopal episodes, home accidents, and DT incidents occurring on weekdays. Furthermore, during the IC period, the number of cases of DT increased in the morning and decreased at nighttime. Conclusions: The COVID-19 pandemic significantly affected the types of DT, the treatment approaches, and the circumstances under which DT occurred. Investigating these impacts can help to predict the effects of a future pandemic on DT and/or maxillofacial trauma and possibly reduce these effects through establishing appropriate preventive measures.

Background: The aim of this study was to analyze the impact of the COVID-19 pandemic on midfacial fracture patterns/distributions and circumstances in a German craniomaxillofacial trauma center. Methods: This retrospective study compared the midface fracture patterns (excluding nasal fractures) of patients in the pre-COVID (PC) era (February 2019–January 2020) with patients in the intra-COVID (IC) era (February 2020–January 2021). In addition to baseline characteristics, the type of midface fractures, the circumstances leading to midface fractures, and hospital admissions/treatments were analyzed. Results: During the COVID-19 pandemic, a reduction in the total number of midface fractures was observed (PC = 88 vs. IC = 57). No significant differences were found regarding the midfacial fracture localization between both periods. During the pandemic, there was a significant increase in falls, accidents at home, and virus/flu-associated syncopes. At the same time, a significant decrease in sports accidents, interpersonal violence, and alcohol-related accidents leading to midface fractures was recorded. Furthermore, there was a significant increase in accidents during the morning time with a simultaneous reduction in accidents during the nighttime. In addition to that, a significant delay in days from trauma leading to midface fracture until hospital admission and surgical treatment (ORIF) was revealed. Conclusions: Despite the limitations of a monocentric retrospective study, the current findings lead to the conclusion that the COVID-19 pandemic had a significant impact on the patterns and circumstances leading to midface fractures. Analyzing the specific characteristics of patients suffering from midfacial fractures under the influence of the COVID-19 period can represent added value in order to treat facial fractures in future pandemics.