Bicycle helmet use and facial injuries

Data sources PubMed/Medline, Google Scholar and Cochrane Library databases Study selection Two reviewers independently selected studies. Observational studies involving patients >16 years comparing facial injuries in those wearing and not wearing cycle helmets were included. Studies were excluded if they examined the effects of helmet legislation, reported facial injuries with other injuries, compared different types of helmet or were wholly paediatric studies. Data extraction and synthesis Selection, reporting, attrition and detection bias of studies were assessed. Data were extracted on the incidence of all facial injuries reported in helmet users and non-helmet users by two reviewers independently. Odds ratios (OR) were extracted for facial injuries and facial fractures and meta-analysis conducted. Results This review suggests that bicycle helmets may offer a protective benefit against facial fractures. However, it is noted that previous analyses have shown that this protection is not uniform across the face and that the upper and middle face may be protected. Conclusions This review suggests that bicycle helmets may offer a protective benefit against facial fractures. However, it is noted that previous analyses have shown that this protection is not uniform across the face and that the upper and middle face may be protected.