This is a meta-analysis completed by a maxillofacial unit on the South Coast of England. Nine studies from an initial literature review of 102 were included in the analysis. Cycling has been reported as the cause of 3-20% of facial injuries presenting to hospital whilst the use of helmets is observed in 14-50% of cyclists. They postulate a reduction of upper and mid facial injuries is due to the anterior projection of the helmet making contact with the impacting object first and helps to reduce trauma to the adjacent midface. They note that there have been some reports of an increased incidence of a mandibular fractures although these findings were not significant. The authors acknowledge that this study has a high degree of heterogeneity, the numbers small, a higher level of credible data is unlikely to be forthcoming.