title: Choice of motorcycle helmet makes a difference: a prospective observational study.
abstract: BACKGROUND
  Although many states mandate that motorcyclists wear helmets, their laws do not indicate which type of helmet should be used. In addition, there are no prospective studies in the literature evaluating patterns of injuries as they relate to helmet type. The hypothesis in this study was that full-face helmets (FFHs) reduce craniofacial injuries associated with motorcycle collisions when compared with other helmet types.
  
  
  METHODS
  A prospective observational study was conducted at a Level I trauma center to evaluate the efficacy of helmet types relative to craniofacial injuries. Data included patient demographics, helmet types, injuries, and outcomes. The incidences of facial fractures, skull fractures, and traumatic brain injuries (TBIs) were compared in patients wearing FFHs versus other helmet types (OH) during motorcycle crashes.
  
  
  RESULTS
  From 2011 to 2012, 151 patients of motorcycle crashes (135 males, 16 female; mean age, 38.4 years; range, 19-74 years) whose helmet types were identified by health care providers were entered into the study. The distribution of helmets was 84 FFH and 67 OH (39 half and 28 modular). Facial fractures were present in 7% of the patients wearing FFH (95% confidence interval, 0.015-0.125) versus 27% (95% confidence interval, 0.164-0.376) of those wearing OH (p = 0.004). In addition skull fractures were present in 1% of the patients wearing FFH versus 8% in those wearing OH (p < 0.05). While there was a trend for patients wearing FFH to have a lower incidence of TBI (13% vs. 25% in those wearing OH), this was not statistically significant (p = 0.053). There were no differences in Injury Severity Score (ISS), length of stay, or mortality between the two groups.
  
  
  CONCLUSIONS
  Victims of motorcycle crashes who are wearing FFH have a significant reduction in facial and skull fractures when compared with those wearing OH. Further studies will be needed to assess whether FFH will significantly decrease the incidence of TBI.
  
  
  METHODS
  Prognostic/epidemiologic study, level III.
authors.affiliation: Department of Surgery, Sinai Hospital, Baltimore, Maryland, USA. bbrewer@lifebridgehealth.org
authors.forename: Brian L
authors.initials: BL
authors.lastname: Brewer
authors.forename: Albert H
authors.initials: AH
authors.lastname: Diehl
authors.forename: Laura S
authors.initials: LS
authors.lastname: Johnson
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Salomone
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Wilson
authors.forename: Hany Y
authors.initials: HY
authors.lastname: Atallah
authors.forename: David V
authors.initials: DV
authors.lastname: Feliciano
authors.forename: Grace S
authors.initials: GS
authors.lastname: Rozycki
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002755:Choice Behavior; D015331:Cohort Studies; D016001:Confidence Intervals; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000517:prevention & control*; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D006260:Head Protective Devices / Q000592:standards* / Q000639:trends; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009049:Motorcycles; D016017:Odds Ratio; D011446:Prospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D016019:Survival Analysis; D014193:Trauma Centers; D014505:Urban Population; D055815:Young Adult