Motorcycle riders have a special vulnerability on the road. They have no exterior protection around them should they crash into a stationary object, a moving object or just lose control. For this reason, they have a higher incidence of closed head trauma, facial fractures and skull fractures after a collision. Motorcyclists who ride without a helmet have an increased risk of these types of injuries. Often they are thrown over the handlebars by the forces of the accident and “lead with their head”. The head is then more likely to be traumatized.
In one study, the researchers looked at the associations among facial fractures, skull fractures, traumatic brain injury and the use of the helmet. They looked at a group of riders numbering 5,790 that got into a motorcycle accident in 1991-1993 and who were seen by an emergency room or hospital staff and were found to have an injury. The research was done in 28 hospitals in 11 counties in California using the abbreviated injury scale from 1990 (see explanation below).
Facial injuries accounted for 24 percent of all injured motorcycle riders. A total of 411 riders were diagnosed with at least one facial fracture. The odds of getting a traumatic brain injury were 3 ½ times greater if the rider already had a facial injury than if they didn’t have a facial injury. Facial fractures give the rider a 6.5 times greater chance of getting a traumatic brain injury. The highest rate of traumatic brain injury occurs with people who have fractures of the upper face although any type of facial fracture increases the rate of traumatic brain injury.
Helmet use decreased the rate of facial fractures and skull fractures. If a rider had a skull fracture and a facial fracture at the same time, the risk of traumatic brain injury went up dramatically. Helmeted drivers reduced that risk. The researchers felt that if a person had a facial fracture and was in a motorcycle accident, they should be screened for traumatic brain injury, regardless of their helmet status.
The abbreviated injury scale was invented in 1971 and was revised 6 times by 1990 and has been revised since then. This research study used the 1990 version which was designed for motor vehicle accidents. The score goes from one to six.
1=minor injuries
2=moderate injuries
3=serious injuries
4 =severe injuries
5=critical injuries
6= unsurvivable injuries
The numbers given in the scale are often used in research to identify which patients are more severely injured than others but without identifying the specific injury. The score looks at nine body regions, including the head region, the facial region the neck, the thorax, the abdomen, the spine, the upper extremity, the lower extremity and the external part of the body or any other part of the body not named in the specific areas.
By looking at the various areas and their injuries, doctors and researchers can identify which patients are more serious than others.