• Facial Trauma Caused by Electric Scooter Accidents

    By Lynda Seminara
    Selected By: Stephen D. McLeod, MD

    Journal Highlights

    Ophthalmology, July 2020

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    As electric scooters have become pop­ular, injuries associated with their use have risen concurrently. However, little is known about ophthalmic trauma re­lated to scooter use. Yarmohammadi et al. reported on patients who sustained facial injury after riding an electric scooter in the standing position. They noted many complex fractures involv­ing multiple anatomic subunits—and the injuries tended to be severe and difficult to repair, likely due to the combination of speed impact, lack of restraint, diffuse impact, and coup/contrecoup forces.

    For this study, the authors reviewed one-year data from two academic emergency departments. They gathered information on demographics, helmet use, drug/alcohol use at presentation, mechanism of trauma, type of facial injury, associated comorbidities, and need for hospitalization or surgical intervention.

    Thirty-four patients presented with scooter-associated facial injury during the study period. Twenty-five (74%) were male; the patients’ mean age was 36.7 years. None had been wearing a helmet. Nearly three-fourths were in­toxicated/impaired from drugs or alco­hol according to self-reports, physician observation, or toxicology results. The mean blood alcohol level of the tested intoxicated patients was 203.4 mg/dL. Nearly all patients (94%) had at least one facial fracture, and most (79%) involved anatomic subunits. Lateral orbital rim and orbital floor fractures were the most common, each occurring in at least half of the study population. Orbital roof and medial orbital wall fractures were each present in about 25%. An ophthalmic examination was performed in 26 patients, including all who had an orbital fracture.

    Five patients had eyelid lacerations, and one had an intraretinal hemorrhage that did not impair vision. All but one patient had normal visual acuity. The exception was a patient with light per­ception and elevated intraocular pres­sure (>50 mm Hg) secondary to retro­bulbar hemorrhage; lateral canthotomy and cantholysis were performed to decrease pressure and restore vision. No patient had extraocular muscle entrap­ment or globe rupture. Most patients (76%) were hospitalized; eight required surgery. About 20% had associated intracranial hemorrhage, and 12% had impaired neurologic status that required intubation. Most patients with hemorrhage had close monitoring but did not require neurosurgical interven­tion. A patient with cerebral contusion and extensive intracranial hemorrhage underwent craniotomy, had prolonged hospitalization, and required cognitive rehab in a skilled nursing facility.

    The original article can be found here.