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JOMS study: Skull fractures a concern with emergency department skateboarding injuries

September 9, 2020

ROSEMONT, Ill. – Skull fractures are the most common type of head and facial fracture among skateboarding injuries in the emergency department, and a new study warns of the effects of these fractures, particularly in children.

Increased helmet use and injury prevention programs could help lower hospitalization related to skateboarding, according to the study published in the September issue of the Journal of Oral and Maxillofacial Surgery, the official journal of the American Association of Oral and Maxillofacial Surgeons (AAOMS).

Researchers examined the National Electronic Injury Surveillance System database for head and facial fractures, contusions, abrasions and lacerations related to skateboarding from 2009 to 2018. Of the 2,519 head and facial injuries, most were lacerations (60.2 percent) followed by contusions and/or abrasions (25.7 percent) and fractures (14.1 percent). Researchers estimated 100,201 injuries nationwide.

On average, patients who experienced a head or facial injury were 16 years old. Most patients were male (85.9 percent). The most common fracture types occurred to the skull (31 percent), nose (29 percent) and lower jaw (18 percent). Head and facial fractures that required going to the emergency department were mostly due to falling off the skateboard while riding (76.9 percent). Collisions with motor vehicles accounted for 7.3 percent of head and facial fractures.

Although the majority of fractures did not require hospitalization, the researchers caution of the effects of head and facial injuries. Particularly among children, skull and facial fractures are associated with traumatic brain injury, which can lead to chronic depression, headaches, paralysis, post-traumatic epilepsy, higher risk of dementia and increased suicide rate, the study notes.

For safer skateboarding, the study supports wearing helmets, avoiding riding in or near traffic, riding in skateboarding parks and deterring children younger than 5 from skateboarding (following the American Academy of Pediatrics policy statement). New local and state safety legislation may have led to a large decrease in head and facial injuries in 2018 from the previous year, according to the study.

“Because skateboarding is a popular recreational activity and sport, it is important to realize that riders place themselves at risk of substantial head trauma every time they ride,” researchers said. “It is known that protective gear, such as helmets, provide protection during skateboarding.”

Participation in skateboarding and emergency department visits may increase after skateboarding becomes an official sport at the 2021 Olympic Games, the study notes. The risk of head and facial injuries also may rise, especially among first-time skateboarders, with limited helmet use and children riding, researchers added.

Of the injuries, 21.5 percent occurred in children younger than 10 and 6.4 percent in those under 5.

“These findings suggest that educational efforts and patient counseling should focus on these high-risk populations,” researchers said.

In addition, injuries were most often on a street or highway (20.6 percent) or at home (16.1 percent).

“Riding in skateboarding parks should be encouraged as recreational skateboarding gains popularity, and riders should be discouraged from using home-constructed ramps, given the risk of injury at home,”

researchers said.

The authors of “Injuries to the Head and Face From Skateboarding: A 10-Year Analysis From National Electronic Injury Surveillance System Hospitals” are Benjamin Partiali, MS; Sandra Oska; and Antonio Barbat; from Oakland University William Beaumont School of Medicine in Rochester, Mich.; Joseph Sneij, MD, from Associates In Family Practice in Sterling Heights, Mich.; and Adam Folbe, MD, from the Department of Otolaryngology at William Beaumont Hospital in Royal Oak, Mich.

The full article can be accessed at JOMS.org/article/S0278-2391(20)30445-6/fulltext.

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The Journal of Oral and Maxillofacial Surgery is published by the American Association of Oral and Maxillofacial Surgeons to present to the dental and medical communities comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery. Practice-applicable articles help develop the methods used to handle dentoalveolar surgery, facial injuries and deformities, TMJ disorders, oral and head and neck cancer, jaw reconstruction, anesthesia and analgesia. The journal also includes specifics on new instruments and diagnostic equipment, and modern therapeutic drugs and devices.