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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2018

01-04-2018 | Sports Medicine

Injury mechanism of midfacial fractures in football causes in over 40% typical neurological symptoms of minor brain injuries

Authors: Volker Krutsch, Markus Gesslein, Oliver Loose, Johannes Weber, Michael Nerlich, Axel Gaensslen, Viktor Bonkowsky, Werner Krutsch

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 4/2018

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Abstract

Purpose

The injury mechanisms of midfacial fractures may be typical causes of concussion, but hardly any scientific data on midfacial injuries sustained in football are available. Head and brain trauma represent frequent injuries in athletes of different sports that require appropriate treatment by sports and trauma physicians. This study investigated the management of midfacial fractures in football and the association of such fractures with concomitant brain injury.

Methods

In a prospective cohort study lasting 24 months (2012 to 2013), midfacial injuries of football players were analysed with regard to the injury mechanisms, first aid procedures on the field, treatment and return-to-play. To analyse concomitant and potentially overlooked minor brain injuries due to the trauma, we retrospectively investigated the neurological symptoms of the study population.

Results

The study included 132 football players (37 semi-professionals and 95 amateurs) with midfacial fractures. The main injury mechanisms were head-to-head and head-to-elbow trauma. The mean period of return-to-play after trauma was 33.5 days, which was significantly shortened if a protective face mask was worn (mean 10.4 days earlier, p = 0.0006). Semi-professional football players returned to play earlier (p = 0.009) and more often used protective face masks (p = 0.001). 55 players (41.6%) had neurological symptoms immediately after trauma as a possible sign of concomitant minor brain injury. 5 of 132 players with concussion had been hospitalised for 24 h, but no persistent neurological symptoms were detected.

Conclusion

In football, midfacial fractures represent moderate-to-severe injuries with time away from sports of more than 4 weeks. Over 40% of athletes with a midfacial fracture showed concomitant neurological symptoms as a sign of minor brain injury. Therefore, sports physicians and other staff supervising athletes in daily practice should be aware of the presence of neurological symptoms.

Level of evidence

Level III.
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Metadata
Title
Injury mechanism of midfacial fractures in football causes in over 40% typical neurological symptoms of minor brain injuries
Authors
Volker Krutsch
Markus Gesslein
Oliver Loose
Johannes Weber
Michael Nerlich
Axel Gaensslen
Viktor Bonkowsky
Werner Krutsch
Publication date
01-04-2018
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 4/2018
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-017-4431-z

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