title: How safe is your motorcycle helmet?
abstract: OBJECTIVE
  Motorcycle crash helmets do not totally prevent head and facial trauma. The aim of this study was to investigate if protection offered by helmets differs according to helmet type.
  
  
  METHODS
  In this retrospective cohort study, outpatient records of motorcyclists were analyzed for the Facial Injury Severity Scale (FISS), traumatic brain injury (TBI), facial fractures, and helmet use. Statistical analysis was conducted using the Fisher and Bonferroni tests, bivariate regression analysis, and 1-way analysis of variance.
  
  
  RESULTS
  There were 253 motorcyclists who sustained craniomaxillofacial injuries and were referred for outpatient treatment (men, 88.9%; mean age, 29.64 ± 11.6 yr); 60.1% had up to 9 years of formal education; 156 patients reported not using crash helmets, 51 were using open-face helmets, and 46 were using full-face helmets. The mean FISS score was significantly higher for unhelmeted riders compared with full-face helmet riders (P = .047), with no difference between unhelmeted riders and open-face helmet users (P = 1.00). Results for TBI were statistically greater for those wearing open-face helmets compared with full-face helmets (P = .035).
  
  
  CONCLUSIONS
  In this study, a large percentage of motorcyclists had facial fractures and TBI, and crash helmets did not always offer adequate protection against craniomaxillofacial injury, especially open-face helmets. Thus, further investigation into helmet types and quality of protection offered is recommended.
authors: Oral and Maxillofacial Surgeon, Department of Craniomaxillofacial Surgery, Santa Casa de Misericórdia de Sobral Hospital, Sobral, Brazil. Electronic address: petergilmara2@gmail.com.
authors: Carlos Eduardo
authors: CE
authors: Lopes Albuquerque
authors: Professor, Department of Research and Development, Federal University of Ceará, Sobral, Brazil.
authors: Francisco Plácido
authors: FP
authors: Nogueira Arcanjo
authors: Neurologist-in-Chief, Department of Neurology, Santa Casa de Misericórdia de Sobral Hospital, Sobral, Brazil.
authors: Gerardo
authors: G
authors: Cristino-Filho
authors: Oral and Maxillofacial Surgeon, Department of Craniomaxillofacial Surgery, Santa Casa de Misericórdia de Sobral Hospital, Sobral, Brazil.
authors: Antônio
authors: A
authors: Mont'alverne Lopes-Filho
authors: Professor, Department of Public Health, State University of Ceará, Brazil.
authors: Paulo
authors: P
authors: Cesar de Almeida
authors: Professor, Department of Dental Medicine, Universidade do Grande Rio, Brazil.
authors: Roberto
authors: R
authors: Prado
authors: Professor, Department of Dental Medicine, State University of Londrina, Brazil.
authors: Cecília Luiz
authors: CL
authors: Pereira-Stabile
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D000704:Analysis of Variance; D001930:Brain Injuries / Q000517:prevention & control*; D001938:Brazil; D015331:Cohort Studies; D004867:Equipment Design; D005151:Facial Injuries / Q000517:prevention & control*; D005260:Female; D006260:Head Protective Devices; D006801:Humans; D008297:Male; D009049:Motorcycles; D012044:Regression Analysis; D012189:Retrospective Studies; D012449:Safety; D012887:Skull Fractures / Q000517:prevention & control*; D015599:Trauma Severity Indices; D055815:Young Adult