Patterns of maxillofacial injuries in powered watercraft collisions

Because of the widespread popularity of water sports, plastic and reconstru ctive surgeons can expect to manage an increasing number of injuries associ ated with these activities, particularly those related to powered watercraf t vehicles. Although seat belts for motorists and helmets for motorcyclists may be efficacious, such devices currently do not serve a similar role in powered watercraft sports. In this study, a retrospective chart review of 1 94 consecutive patients who presented to the University of Miami/Jackson Me morial Hospital (Level I trauma center) as a result of powered watercraft c ollisions is presented. The purpose of this investigation was to assess the incidence, cause, demographics, and available management options for head and neck injuries secondary to powered watercraft. Identified were 194 pati ents who presented because of watersports-related injuries during the perio d January 1, 1991, through December 31, 1996. From this group, 81 patients (41.8 percent) sustained injuries directly attributable to powered watercra ft collisions, including 41 personal watercraft collisions (50.6 percent), 39 boat collisions (48.1 percent), and 1 airboat collision (1.2 percent). T he patient population, as expected, tended to be young and male with an ave rage age of 29 years (range, 8 to 64 years old). Interestingly, 41 of the p atients (50.6 percent) who presented to this trauma center as a result of p owered watercraft collisions also sustained associated head and neck trauma . Of 74 injuries 24 were facial fractures (32.4 percent), 18 were facial la cerations (24.3 percent), 14 were closed head injuries (18.9 percent), 8 we re skull fractures (10.8 percent), 4 were scalp lacerations (5.4 percent), 4 were C-spine fractures (5.4 percent), 1 was an ear laceration (1.4 percen t), and 1 was a fatality (1.4 percent). Le Fort fractures were the most com monly identified facial fracture in this series. The number of these injuri es seen in hospital emergency rooms will most likely increase in the future as the popularity of water-related recreational activities becomes even mo re widespread. Based on these findings, it is strongly recommended that fut ure efforts be directed toward the prevention of these injuries through pat ient education and the eventual development of efficacious and safe protect ive equipment.