The influence of airbag and restraining devices on the patterns of facial trauma in motor vehicle collisions

According to the National Highway Traffic Safety Administration (1990), the re were more than 3 million motor vehicle collisions severe enough to lead to significant injury or fatality. Airbags may prevent brain and facial inj ury caused by these accidents. To date, however, no study has focused prima rily on the correlation between facial injuries and the use of airbags and restraining devices. A retrospective analysis was performed on motor vehicle collision data subm itted to the Pennsylvania Trauma Outcome Study database from 1990 through 1 995. Criteria for submission to the database included admission to the inte nsive care unit, death during hospitalization, hospitalization for >72 hour s, or transfer to or from the receiving hospital. There were 15,450 patient s who sustained facial trauma (identified by ICD-9 codes) and were analyzed for patterns of injury and the presence or absence of protective devices. Protective devices were categorized into four groups: airbag alone, airbag with seatbelt, seatbelt or car seat without airbag, and no restraining devi ces. Statistical analysis was performed using chi-squared test of associati on. For contingency tables with small expected frequencies, Fisher's exact test was used. There were 9408 male and 6042 female subjects,with a mean age of 38 years ( range, 3 to 98 years). There were 11,672 drivers and 3778 passengers. Airba gs were deployed in 429 instances. In 216 of these cases, additional restra int was provided with a seatbelt. Airbags were not deployed in 4800 cases w hen a seatbelt or a car seat was used. In 10,155 cases, no restraining devi ce was employed. There was significantly more facial trauma in patients without protective d evices (p < 0.001). Drivers sustained significantly fewer facial fractures when airbags were used, either alone or in combination with a seatbelt (p < 0.001); however, there was no difference in the number of facial laceratio ns. Among passengers, airbags provided protection from lacerations (p < 0.0 01) but had no impact on the incidence of facial fractures. In collisions i n which airbags were deployed, the use of a seatbelt provided no additional protection from facial fractures or lacerations. In summary, the use of any protective device decreased the incidence of fac ial fractures and lacerations sustained in motor vehicle collisions (p < 0. 001). Airbags provided the best protection of all currently available devic es.