Introduction:
Soccer is the popular global sport and infact the most commonly played sport in the world as per world sports statistics. The popularity of this game is high because of its youth centric players and usually 16-to-18-year male players engage in playing soccer. Also, in comparison with other sports, any soccer player or goalkeeper is definitely at a relative risk of sustaining traumatic facial injuries. According to current medical research in oral and maxillofacial injuries, surgical intervention would be definitely needed for almost 72.2 percent of players who sustain maxillofacial fractures when they participate in soccer games.
Why Do Oral and Maxillofacial Trauma Turn Serious in Soccer Injuries?
The term ‘maxillofacial’, refers to the region involving the head, neck, jaws as well as the face. This also comprises dental injuries that can be the most painful consequences of facial trauma in these athletes.
It is important to know that head and facial injuries during sports are often underestimated because the overall incidence of traumatic facial injuries in sports players is much lower in comparison to the injuries that occur in the lower extremities of the body. However, fitness coaches or the players themselves need to be made aware of the importance of preventing head and face injuries. This is because achieving adequate hemostasis is the most essential step in sports injuries, especially in case of injuries that occur in the head, face and the jaws. This is because these are the areas where failure to achieve hemostasis can result in potentially life-threatening complications such as hemorrhage, airway obstruction and even hypovolemic shock.
What Are the Global Statistics of Maxillofacial Soccer Injuries?
This global issue has been focused upon by many experts from the field of oral and maxillofacial surgery throughout the world that has led to awareness in the last decade in many sports institutes and amongst field players.
The appropriate management of maxillofacial trauma cannot be underestimated on a global scale as well, because timely management of oral and maxillofacial injuries can reduce immediate as well as long-term morbidity and mortality associated with soccer injuries.
In an international study involving young male players in the age group of 16 to18 years, the incidence of soccer related facial, or head injuries were not so surprisingly, as high as a whooping 42.5 percent (per 1000 hours of match play). Though the lower extremities are the easy target for soccer injuries, nearly every alternate injury to a soccer player or rather an estimated 22 percent of these injuries commonly involve the face, the head or the jaws.
According to a report by Sullivan et al, there was an overall higher incidence of soccer related facial or head injuries in goalkeepers specifically. Some preliminary research studies also reportedly suggest that almost 75 percent of the fractures caused due to maxillofacial injuries in sports players involve athletes participating in soccer who are in the age group of 10 to 19 years.
What Is the Diagnosis and On-Site Management of Oral and Maxillofacial Soccer Injuries?
It is essential that the oral and maxillofacial surgeon addresses the concerns of the players on field by establishing a correct diagnosis. It will be wise if the oral and maxillofacial surgeon differentially diagnoses various types of common injuries that occur in soccer games. These are as follows:
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Cervical spine injuries.
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Cerebrospinal or cerebrovascular injuries.
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Lacerated superior labial artery.
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Lacerated upper lip.
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Dental fractures.
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Maxillofacial fractures (Lefort 1, 2 or 3 fractures).
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Orbital or blowout fractures.
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Closed head injuries.
For fractures that involve the tooth enamel, dentin, and pulp or the avulsion of tooth or the displacement of a tooth, the players can be immediately referred to a dentist. It is acceptable for most players to still participate in the soccer game as long as the fracture or dental injury is superficial or the tooth is avulsed, however, care should be taken to immediately follow the dental care and instructions given by a professional dentist or a oral and maxillofacial surgeon within 48 to 72 hours. The same does not apply for players who sustain serious maxillofacial or head injuries that can potentially cause hemorrhage. Also, if there is no medical help immediately available or if no maxillofacial surgeon is available on site, it can certainly complicate the initial on-field management of any injured athlete. This can also pose challenges during the standard airway assessment.
The on-spot management Includes:
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ABC: Emergency Management- Maxillofacial trauma that can be usually complicated by heavy facial bleeding will usually result in an airway compromise if hemostasis is not achieved effectively and in time. Many professional coaches or athletic trainers may not be equipped with the necessary oral surgical knowledge or clinical skills to address the needs of the injured player and there would be a high risk of on-site maxillofacial trauma leading to severe consequences. Hence, basic medical emergencies can be addressed by athletic trainers too, if a surgeon is not available on the field.
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Assessing the ABCs: ABC stands for patient's airway (A), breathing (B), and circulation (C) and a basic application of the ABCs can definitely prevent the deaths or mortality risks associated with young soccer players who sustain severe facial trauma. It is advisable for goalkeepers in particular that they must wear protective mouthguards so as to prevent laceration injuries of the lip or oral cavity. Educating the players about sports injuries and timely on-site management by athletic trainers or coaches can definitely prevent risks associated with soccer injuries.
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Need for Awareness- In spite of advances in current professional sports activities, it is surprising that because of the nature of the soccer sport, many individuals refrain from or refuse to wear protective headgear. Professional soccer players who play without any protective head gear or mouth guards are at a high risk of sustaining severe maxillofacial trauma. Facial injuries not only complicate the routine management that one encounters on-field in the form of medical emergencies, but also it can complicate the handling of these injuries by certified soccer coaches or athletic trainers.
Conclusion:
Just like maxillofacial or dental injuries are common during soccer participation, it is also not surprising that ocular (eye) injuries are as well easily encountered in this sport. It is hence imperative that the soccer coaches and team players mutually discuss and realize the importance of protective head gear and protective mouthguards in reducing the high risk involved in traumatic maxillofacial and dental injuries during player participation. Players should be motivated on field to follow basic protective measures and must be asked not to underestimate the risks associated with moderate to severe maxillofacial trauma as these can even lead an individual to high morality risk if not addressed or managed on time by a maxillofacial surgeon or dentist. Timely management on field by a maxillofacial surgeon can definitely prevent life threatening consequences in professional players or athletes who play games such as soccer.
