Burn injuries related to motorcycle exhaust pipes: a study in Greece

PURPOSE: To identify measures that should reduce the incidence of burn injuries resulting from motorcycle exhaust pipes through epidemiological analysis of such injuries. BASIC PROCEDURES: During a 5-year period, 251 persons who suffered burn injuries related to motorcycle exhaust pipes have contacted four major hospitals belonging to the Emergency Department Injury Surveillance System (EDISS) operating since 1996 in Greece. These burn injuries were studied in relation to person, environment and vehicle characteristics. MAIN FINDINGS: The estimated countrywide incidence of burns from motorcycle exhaust pipes was 17 per 100,000 person-years (208 per 100,000 motorcycle-years). The incidence was two times higher for children than for older persons and among the latter it was 60% higher among females than among males. Most of burn injuries (70.5%) concerned motorcycle passengers, mainly when getting on or off motorcycle, with peak incidence during summer. The most frequent location of burn wounds was below the knee and particularly the right leg. It was estimated that the risk of motorcycle exhaust pipe burns when wearing shorts could be reduced by 46% through wearing long pants. Among the victims 65.3% experienced second degree burns. PRINCIPAL CONCLUSIONS: Motorcycle exhaust burns could be substantially reduced by systematically wearing long pants, by incorporating in the design of motorcycles external thermo resistant shields with adequate distance to the exhaust pipe, and by avoiding riding with children on motorcycles.     

Motorcycle passenger's burn of the right foot: prevention of a peculiar type of accident

The right feet of two children, passengers on small motorcycles, were caught between the rear wheels and the exhaust boxes, leading to deep burns. This type of accident is on the increase in Japan. Treatment and prevention of such burns are discussed. We suggest that an improvement in the motorcycle will be a solution.     

Accidents with bicycles and motorcycles. The injury pattern, costs, and possibilities for prevention]

This review comprises all 641 patients subjected to inpatient treatment in 1976, 1980 and 1984 at the Basel district hospital after accidents involving bicycles or motorcycles. A study of the case histories--supplemented by phone conversations--yielded the following results: Accidents involving bicycles or motor-driven bicycles were seen in all age groups, but motorcycle accidents occurred exclusively among the younger generation. Whereas motorcycle accidents mostly happened during joyrides, accidents with bicycles or mobikes mainly occurred on the way to work. The incidence rate was highest during summertime and in the rush hours at noon or in the evening. Motorcycle accidents resulted in more severe injuries, longer hospitalisation, longer periods of disability and higher costs than bicycle or mobike accidents the latter being mainly characterised by mostly slight head injuries and the former by injuries of the legs and arms.     

Motorcycle accidents in China

Objective： To analyze the characteristics and causes of motorcycle accidents in China from 2000 to 2005.
Methods： We collected data on possession of motor- cycles and automobiles, number of traffic crashes, casualty and economic loss from 2000-2005 Statistic Annual Report of Traffic Management Bureau, Ministry of Public Security of China. The data was processed statistically by SPSS 11.0 software package.
Results： During 6 years, the number of motorcycle accidents were up to 122 300 in 2003, which was the highest, and then gradually decreased. However, the casualty had the tendency of consistent increase, for example, the motorcycle accidents resulted in 26 200 deaths and 157 500 injuries in 2005. The mortality per 10 000 motorcycles and the ratio of deaths to injuries were lower than those of automobiles, but the mortality per 100 motorcycle accidents was significantly higher than that of automobiles （P〈0.01）.
Conclusions： China has attached great importance to the management of traffic safety, which is beneficial to con- trol and reduce traffic accidents in recent years. However, the casualty keeps increasing annually. Therefore, it is urgent to strengthen the management of motorcycles, promote the education of motorcyclists, take effective traffic measures and improve the first-aid system of traffic injuries.     

Burn injuries associated with the water tank of motorfarming tricycles in China

Burns caused by hot coolant from the reservoir of motorfarming tricycles have not been reported previously. We performed retrospective studies of such cases in 126 patients with complete records in rural areas of China. The majority of victims were unmarried (59.5%), young (<40 years, >20, 55.6%), and male (male to female ratio 9:1). The burn accident occurred mostly during the busy seasons of spring and summer (66.7%). The mechanism of injury was usually the same. The drivers were trapped under the farming tricycle in a traffic accident and then hot coolant leaked from the mouth of the coolant, resulting in long contact with the hot fluid. The burn wounds were located mostly on the areas of the buttocks and lower extremities (especially on the thigh) (64.3%). The generally burned patients had moderate burn areas, about 20–50% total burn surface area (TBSA) of deep partial thickness or full thickness burn wound. For the purpose of decreasing the number of burns presenting, or at least making them less severe, the suggestions include: (1) the design of motorfarming tricycle should be changed; obviously separation of the coolant tank from the seat is the most important factor in reducing such burns. (2) Road conditions should be improved to reduce traffic accidents and loading regulations introduced. (3) Traffic control should be enhanced, especially in rural areas.     

Epidemiologic study of traffic crash mortality among motorcycle users in Iran(2011e2017)

Purpose: Motorcycle accident is a major cause of road traffic injuries and the motorcyclists are considered as vulnerable road users. The present study aimed to determine the epidemiological characteristics of fatal motorcycle crashes in Iran. Methods: In this cross-sectional study, a total of 28,356 motorcycle traffic fatalities registered in the Legal Medicine Organization of Iran were analyzed during the period between March 2011 and March 2017. The examined variables included demographic characteristics, helmet use, crash mechanisms, crash location, position state, type of counterpart vehicle, cause of death and place of death. In the study, road traffic mortalities involving drivers and/or passenger of motorcycles were included. Cases or events registered without these conditions were excluded from the study. To analyse the data, SPSS statistics 25 and GraphPad Prism 8 softwares were used. Results: Of the 122,682 fatal traffic injury cases, 28,356 (23.1%) were motorcycle users, of whom 95.3% were male and 4.7% were female. Most of the motorcycle fatalities belonged to the age group of 18-24 years (29.1%). Head trauma was the major cause of death (59.0%). Also, the overall proportion of safety helmet use among motorcycle crash victims was estimated at 37.4%. Most of the road traffic crash cases (46.8%) happened out of city and half of people (49.9%) died in hospital. About 77.4% of the victims were motorcycle riders and 21.1% were pillion passengers. The highest rate of mortality belonged to the selfemployed (38.4%) and then workers (21.8%) and students (10.2%). In addition, most fatalities occurred in people with low education (77.5%) and the least occurred in university graduates (5.5%). Among 31 provinces of Iran, Fars had the highest (9.3%) occurrence rate and Kohgiluyeh and Buyer-Ahmad had the lowest (0.5%). Most of the crash mechanisms were due to motorcycle-vehicle crashes (80.2%), followed by rollover (9.8%). Conclusion: Comprehensive public education and special rules are needed to reduce the rate of deaths in motorcycle crashes.     

Motorcycle injuries at a tertiary referral hospital in Kenya: injury patterns and outcome

Background

The rise in the use of motorcycles in Kenya in the last 10 years has been associated with increased injury rates. Between 2004 and 2009, motorcycle injuries increased at a rate of 29 % and, in some hospitals, motorcycle users have become the predominant road user category injured. Although most road traffic injuries occur in Nairobi, there has been no previous account of motorcycle injury and associated outcomes at its main hospital.

Objective

To describe the injury patterns and outcomes following motorcycle trauma at the Kenyatta National Hospital.

Methods

All motorcycle trauma admissions during one calendar year were analyzed. The data captured included demographics, injury patterns and outcomes, lengths of hospital stay, hospitalization cost, and early hospital mortality. Factors associated with outcomes were analyzed by univariate and multivariate means. The probability of survival was estimated using the Trauma and Injury Severity Score (TRISS) methodology for each patient.

Results

Two hundred and five patients were reviewed. Motorcycle trauma admissions formed 22.3 % of all road traffic injury admissions. Male riders predominated. The average age and modal age group was 30.78 and 21–30 years, respectively. Half of riders and 20 % of passengers used protective helmets. Injuries were mostly to the extremities (60.7 %) and head/neck (32.07 %), and the average Injury Severity Score (ISS) was 7.57 + 4.0 (median 9.0). At 2 weeks, 9.0 % of patients had died. The estimated probability of survival ranged from 0.86 to 0.97. Surgical interventions were needed for 51.7 % of patients. The mean length of stay in the hospital was 24.3 days, while the cost of treatment was 31,783 Kenya Shillings (Kshs). Injury severity (P < 0.001), admission to the intensive care unit (ICU) (P < 0.001), non-surgical treatment (P = 0.003), blood transfusion (P = 0.029), head injury (P < 0.001), and low Glasgow Coma Scale (GCS) score at admission were significantly associated with mortality.

Conclusion

Injuries to the lower limbs and the head predominate in motorcycle trauma. The high mortality rate, need for surgery in the majority of patients, and prolonged admission days call for motorcycle control and expedited care. Significant head injury mortality calls for efforts to embrace helmet laws for riders and passengers.     

The effect of state motorcycle licensing laws on motorcycle driver mortality rates

OBJECTIVE: The purpose of this study was to evaluate the association between motorcycle licensing and operation regulations and motorcycle mortality rates in the United States during 1997 through 1999. METHODS: A population-based ecologic study was used. RESULTS: Lower mortality rates were observed in states with the following motorcycling requirements: skill test for a motorcycle permit (rate ratio [RR], 0.76; 95% confidence interval [CI], 0.69-0.84), driver training (RR, 0.80; 95% CI, 0.74-0.86), longer duration of learner's permits (95-190 days [RR, 0.86; 95% CI, 0.79-0.95] and >190 days [RR, 0.87; 95% CI, 0.81-0.93], three or more learner's permit restrictions (RR, 0.78; 95% CI, 0.73-0.84), and a full helmet law (RR, 0.76; 95% CI, 0.71-0.81). CONCLUSION: Specific motorcycle licensure policies appear to be associated with lower mortality rates.     

First aid is associated with improved outcomes in large body surface area burns

BackgroundAnimal studies indicate treating burn injuries with running water (first aid) for 20 min up to 3 h after burn reduces healing time and scarring. We have previously demonstrated the benefits of first aid in minor burn injuries with respect to a reduction in wound depth, faster healing, and decreased skin grafting utilisation. The purpose of this cohort study was to assess the effect of first aid on clinical outcomes in large body surface area burn injuries (≥20%).MethodsData was prospectively collected for patients with ≥20% TBSA burns from 2004– 2018. Multivariate regression analysis was used to determine the association of adequate first aid with 8 outcomes – mortality, total length of stay, total body surface area (TBSA), percentage/proportion of TBSA that was full thickness [PFTI], TBSA grafted, number of re-grafting sessions, intensive care admission, and intensive care length of stay. Adequate first aid was defined as the application of 20 min of cool, running tap water up to 3 h following the burn injury.Findings390 patients were identified. Adequate first aid was received in 35.6% (139) of patients. There was a trend towards a reduction in mortality (OR 0.37; 95% CI 0.12–1.13; P = 0.08). Patients who received adequate first aid had a statistically significant 9.8% reduction in TBSA (95% CI −13.6% to −6.1%; P < 0.0001) as well as a 12% lower PTFI compared to patients who received inadequate first aid (95% CI −19% to −4%; P < 0.01). Whilst there was no significant effect of adequate first aid on the TBSA grafted (P = 0.37), adequate first aid was associated with a significantly less number of re-grafting sessions (95% CI −-0.29 to −0.08; P < 0.001).InterpretationAdequate first aid with 20 min of running water is associated with improved outcomes in large burn injuries. Significant benefits are seen in a reduction in TBSA, proportion of the burn wound that is full thickness, as well as decreased re-grafting. This has significant patient and health system benefits and adds to the body of evidence supporting 20 min of cooling in burns care.     

Management of the burned trauma patient: balancing conflicting priorities

PURPOSE: Approximately 5% of multiple trauma patients sustain concomitant burns. Complicated management issues arise in these patients as burn and trauma care often conflict. This study reviews 53 consecutive burned multiple trauma patients in order to examine common management conflicts and recommend appropriate compromises in caring for these difficult patients. PROCEDURE: A retrospective review of 53 consecutive burn patients with coincident trauma admitted to The Massachusetts General Hospital (MGH) from 1993-2001 was performed. FINDINGS: In the study period, 53 patients were admitted to the Massachusetts General Hospital with concomitant burns and trauma. Of this group, 42 (79%) were male. Average age was 31.5 +/- 15.0. Mechanisms included 11 motor vehicle collisions (MVC), 10 explosions, 10 electrocutions with subsequent falls, nine house fires, four motorcycle collisions (MCC), three pedestrian versus car accidents, two falls into fires, two plane crashes, and one each of a lawnmower accident and a patient drawn into a machine. Average burn size was 25.4% +/- 22.4. The most common traumatic injury was fracture (52). Management of fractures in burn patients and resuscitation in head injured burn patient represented the most common conflicts in patient care. There were five deaths (9.4%) in this series. CONCLUSIONS: Burns are a rare but significant complication in the trauma patient. Outcomes are dependent on rapid trauma evaluation as well as effective resuscitation and wound management. Given the complexities of their problems, these patients necessitate a balanced multidisciplinary approach to maximize their potential for full recovery. Thoughtful compromise between trauma and burn priorities is frequently necessary.     

A prospective, randomized, blind comparison between saline, calcium gluconate and diphoterine for washing skin acid injuries in rats: effects on substance P and beta-endorphin release

BACKGROUND AND OBJECTIVE: A randomized, blind study to evaluate the effects on beta-endorphin and substance P release after washing acid burns with 0.9% saline, calcium gluconate or diphoterine in a model of chemical burn in rats. METHODS: Twenty Sprague-Dawley rats (approximate weight 250 g) were anaesthetized with ketamine (30 mg kg(-1) intramuscularly) and then given an acid injury on the back skin with 0.5 mL of hydrochloric acid 52%. The rats were then randomly allocated to receive no washing (control group, n = 5), washing with normal saline (0.9% NaCl) (n = 5), 10% calcium gluconate (n = 5) or diphoterine (n = 5). Blood concentrations of substance P and beta-endorphin were measured 6 h, 48 h and 7 days after the chemical burn. An independent blinded observer evaluated wound healing at the 7th day. RESULTS: Seven days after burn wound healing was almost complete only in rats treated with diphoterine. Plasma concentrations of substance P were lower in rats receiving skin flushing with diphoterine compared to the other groups at 6 and 48 h after acid burn (P < 0.05 and P < 0.05, respectively); this was also associated with higher concentrations of beta-endorphin at day 7 (P < 0.05). CONCLUSIONS: Skin flushing with diphoterine reduced substance P release during the first 48 h after burn, and was associated with better wound healing and higher concentrations of beta-endorphin 7 days later when compared with normal saline or 10% calcium gluconate.     

Significant reductions in mortality for children with burn injuries through the use of prompt eschar excision.

During the past 19 years, mortality due to burn injuries has markedly declined for children at the Boston Unit of the Shriners Burns Institute (SBI), dropping from an average of 9% of SBI admissions during 1968-1970 to an average of 1% during 1981-1986. Detailed statistical analysis using logistic regression was necessary for determining whether this decline in mortality was explained by changes in patient characteristics, such as age or burn size, which are known to strongly influence the outcome of burn injuries. This dramatic decline in mortality during the past 19 years was not the result of change in the age of the patients or their burn sizes; rather, it may be attributed to improvements in burn care. Results of this statistical analysis indicated that, for burn injury patients whose ages ranged from 11 days to 19 years, age had no demonstrable effect on survival from a burn injury. Children survived burn injuries at least as well if not better than the young adult (20-29 years of age). Also, infants (less than 1 year old) survived as well as other children (2-19 years old). Dramatic improvement in survival occurred in patients with burns covering more than 50% of the body surface area. Since 1979, mortality has been essentially eliminated for patients with burn sizes less than 70% of the total body surface area (of 296 patients with burns covering 15-69% of the total body surface area, only two patients died). During the period 1979-1986, 29 of 37 patients (78%) survived an 80% or greater total body surface area thermal injury.     

Association of age and severe injury in young motorcycle riders: A cross-sectional study from Karachi,Pakistan

IntroductionThe burden imposed by motorcyclist deaths and injuries is high in low- and middle-income countries. Many injured motorcycle riders in these settings are underage. The aim of this study was to assess the association between age and severe injury in young motorcycle riders.MethodsWe analysed road traffic injury surveillance data from the emergency rooms of five hospitals in Karachi from 2007 to 2015. We used logistic regression to assess the association of motorcycle riders’ age, categorised as underage (13-17 years), early licensing age (18-19 years) and late licensing age (20-24 years), with severe injury, defined as an Injury Severity Score (ISS) ≥ 16.ResultsThe study sample included 45,366 motorcycle riders. There were 10115 (22.3%) motorcycle riders aged 13-17 years, 9899 (21.8%) aged 18-19 years and 25352 (55.9%) aged 20-24 years. Almost all were male (99%). Being aged 13-17 years (adjusted odds ratio 1.25; 95% CI 1.11, 1.42) and 18-19 years (adjusted odds ratio 1.26; 95% CI 1.10, 1.43) were associated with higher odds of severe injury compared with being aged 20-24 years.ConclusionMotorcycle riders who presented to the hospital with injuries after road traffic crashes and were aged 13-17 years and 18-19 years had significantly higher odds of severe injury than those aged 20-24 years.     

Mechanism of injury influences the pattern of injuries sustained by patients involved in vehicular trauma

The authors examined the patterns of injury and death rates of patients involved in vehicle-related accidents who were admitted to the Regional Trauma Unit of Sunnybrook Health Science Centre in Toronto. Information was collected prospectively over a 36-month period. The subjects were placed in one of three mechanism-of-injury categories: four-wheel passenger vehicles, motorcycles and pedestrians. The patterns of injury were classified as primarily to the craniofacial and neck area, the torso, the extremities or to multiple regions. There were 815 patients who were involved in vehicle-related crashes and who suffered moderate to severe injuries (at least one region scoring more than 3 on the abbreviated injury scale). The death rate was 13% overall but was 21% in the group receiving multiple injuries. By mechanism of injury the death rates were: pedestrian group 20%, motorcycle group 18% and passenger-vehicle group 11% (p less than 0.01, chi 2 analysis). There was no difference in the mean injury severity score among the mechanism of injury groups. A higher proportion of the passenger-vehicle group sustained isolated craniofacial and torso injuries, and the pedestrian and motorcycle groups sustained more extremity injuries (p less than 0.001, chi 2 analysis). The results reveal a clear association between mechanism of injury and the patterns of injury observed.     

Hypertonic lactated saline resuscitation reduces the risk of abdominal compartment syndrome in severely burned patients

BACKGROUND: Secondary abdominal compartment syndrome is a lethal complication after resuscitation from burn shock. Hypertonic lactated saline (HLS) infusion reduces early fluid requirements in burn shock, but the effects of HLS on intraabdominal pressure have not been clarified. METHODS: Patients admitted to our burn unit between 2002 and 2004 with burns > or =40% of the total body surface area without severe inhalation injury were entered into a fluid resuscitation protocol using HLS (n = 14) or lactated Ringer's solution (n = 22). Urine output was monitored hourly with a goal of 0.5 to 1.0 mL/kg per hour. Hemodynamic parameters, blood gas analysis, intrabladder pressure as an indicator of intraabdominal pressure (IAP), and the peak inspiratory pressure were recorded. Pulmonary compliance and the abdominal perfusion pressure were also calculated. RESULTS: In the HLS group, the amount of intravenous fluid volume needed to maintain adequate urine output was less at 3.1 +/- 0.9 versus 5.2 +/- 1.2 mL/24 h per kg per percentage of total body surface area, and the peak IAP and peak inspiratory pressure at 24 hours after injury were significantly lower than those in the lactated Ringer's group. Two of 14 patients (14%) in the HLS group and 11 of 22 patients (50%) developed IAH within 20.8 +/- 7.2 hours after injury. CONCLUSION: In patients with severe burn injury, a large intravenous fluid volume decreases abdominal perfusion during the resuscitative period because of increased IAP. Our data suggest that HLS resuscitation could reduce the risk of secondary abdominal compartment syndrome with lower fluid load in burn shock patients.     

Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration: a randomized, prospective study

HYPOTHESIS: High-dose ascorbic acid (vitamin C) therapy (66 mg/kg per hour) attenuates postburn lipid peroxidation, resuscitation fluid volume requirements, and edema generation in severely burned patients. STUDY DESIGN AND SETTING: A prospective, randomized study at a university trauma and critical care center in Japan. SUBJECTS AND METHODS: Thirty-seven patients with burns over more than 30% of their total body surface area (TBSA) hospitalized within 2 hours after injury were randomly divided into ascorbic acid and control groups. Fluid resuscitation was performed using Ringer lactate solution to maintain stable hemodynamic measurements and adequate urine output (0.5-1.0 ml/kg per hour). In the ascorbic acid group (n = 19; mean burn size, 63% +/- 26% TBSA; mean burn index, 57 +/- 26; inhalation injury, 15/ 19), ascorbic acid was infused during the initial 24-hour study period. In the control group (n = 18; mean burn size, 53% +/- 17% TBSA; mean burn index, 47 +/- 13; inhalation injury, 12/18), no ascorbic acid was infused. We compared hemodynamic and respiratory measurements, lipid peroxidation, and fluid balance for 96 hours after injury. Two-way analysis of variance and Tukey test were used to analyze the data. RESULTS: Heart rate, mean arterial pressure, central venous pressure, arterial pH, base deficit, and urine outputs were equivalent in both groups. The 24-hour total fluid infusion volumes in the control and ascorbic acid groups were 5.5 +/- 3.1 and 3.0 +/- 1.7 mL/kg per percentage of burn area, respectively (P<.01). In the first 24 hours, the ascorbic acid group gained 9.2% +/- 8.2% of pretreatment weight; controls, 17.8% +/- 6.9%. Burned tissue water content was 6.1 +/- 1.8 vs 2.6 +/- 1.7 mL/g of dry weight in the control and ascorbic acid groups, respectively (P<.01). Fluid retention in the second 24 hours was also significantly reduced in the ascorbic acid group. In the control group, the ratio of PaO2 to fraction of inspired oxygen at 18, 24, 36, 48, and 72 hours after injury was less than that of the ascorbic acid group (P<.01). The length of mechanical ventilation in the control and ascorbic acid groups was 21.3 +/- 15.6 and 12.1 +/- 8.8 days, respectively (P<.05). Serum malondialdehyde levels were lower in the ascorbic acid group at 18, 24, and 36 hours after injury (P<.05). CONCLUSIONS: Adjuvant administration of high-dose ascorbic acid during the first 24 hours after thermal injury significantly reduces resuscitation fluid volume requirements, body weight gain, and wound edema. A reduction in the severity of respiratory dysfunction was also apparent in these patients.     

Frequency of burn-trauma patients in an urban setting

BACKGROUND: Burn-trauma patient encounters constitute 5% of the emergency department population. HYPOTHESIS: A large urban hospital will treat twice as many (ie, 10%) burn-trauma patients. DESIGN: Retrospective 44-month study. SETTING: Metropolitan county hospital. PATIENTS: Population-based sample of burn-only (n = 1102), burn-trauma (n = 120), and assault burn-trauma (n = 43) patients. MAIN OUTCOME MEASURES: Frequency and demographics. RESULTS: Just under 10% (n = 120) of the burn population had burn-trauma injuries. The mean +/- SD Injury Severity Score was 12 +/- 12 in these burn-trauma patients: 4 +/- 2 in outpatients and 14 +/- 13 in inpatients. The burn-only and burn-trauma groups had similar age ranges, ethnic distribution, frequency of inhalation injury, substance abuse, malnutrition, sepsis, pneumonia, diabetes mellitus, percentage total burn surface area, number of procedures, grafted areas, and mortality. Forty-three burn-trauma patients (35.8%) sustained injuries due to assault, compared with 123 (11.2%) in the burn-only group (P<.001). Burn-trauma patients who were assaulted had a mean +/- SD Injury Severity Score of 11 +/- 10. There was a significantly increased male-female ratio among the assault burn-trauma patients (6:1) compared with the burn-trauma (3:1) and burn-only (2.3:1) groups (P<.04). Most of these injuries were caused by an unknown assailant, in connection with an automobile, a motorcycle, a bicycle, or pedestrians intentionally struck by moving vehicles, or by child abuse. The main mechanism of injury was contact in 57 burn-trauma patients (47.5%), compared with 127 (11.5%) in the burn-only group (P<.001). CONCLUSIONS: A large urban population will have an increased frequency (2-fold in our center) of burn-trauma injuries. Assault and child abuse are significant contributory factors to burn-trauma injuries in this population.     

239. Zweiradboom -ein heißes Eisen

Zusammenfassung 287 stationär behandelte Zweiradunfälle, 1968–1971. Nach einem Gipfel 1968 kontinuierlich ansteigende Unfallzahlen. Mopedunfälle nehmen prozentual von 840f0 (1968) auf 57,5% (1971) ab. Die Zahl der Motorrad-unfälle steigt von 10,3% auf 31,5%. Durchschnittsalter der Verletzten 17 Jahre. Häufigste Unfallursache Kollision mit Pkw. 1971 ist ein Anstieg der schweren Verletzungen um 10% zu beobachten. Der Anteil der Kopfverletzungen steigt nach einem Gipfel 1968 von 65% kontinuierlich an und erreicht 1971 44%. Nach 1968 sprunghaftes Ansteigen der schweren knöchernen Verletzungen von 48% (1968) auf 66% (1969–1971). Die abdominellen Verletzungen schwanken zwischen 4,5 und 10,5%. Thoraaverletzungen treten mit einer Häufigkeit zwischen 7 und 13,5% auf. Der Anteil der verstorbenen Patienten liegt von 1968–1970 durchschnittlich bei 7,5%, steigt aber 1971 auf 15% an.

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Motorcycle accidents-an increasing threat

Summary Between 1968 and 1971, the victims of 287 motorcycle accidents were treated. Since 1969 the number has increased steadily. The proportion of light motorcycles involved decreased from 84% (1968) to 57.5% (1971). The number of injuries due to accidents with heavy motorcycles increased from 10.3% to 31.5%. The mean age was 17 years. The frequency of severe injuries increased by 10%, and head injuries by 44% (1971). The frequency of severe peripheral fractures jumped from 480% (1968) to 660f0 (1971). Spine injuries varied from 4.5 to 10.5%. Pelvic and vascular lesions were between 1.5–3%. Abdominal and thoracic trauma varied between 7 and 13.5%. Deaths increased from 7.5% in 1968-1970 to 150% in 1971.

     

Spinal injuries in motorcycle crashes: patterns and outcomes

BACKGROUND: The purpose of this study was to determine patterns of spinal injury and clinical outcomes resulting from motorcycle crashes. METHODS: We analyzed data collected on 1,121 motorcyclists involved in road traffic accidents (from 1993-2000) and identified those who had sustained a spinal injury. RESULTS: Spinal injury occurred in 126 (11.2%) riders (112 male riders [88.9%] and 14 female riders [11.1%]), with a mean age of 30.2 years (range, 16-61 years) and Injury Severity Score of 18.8 (range, 4-66). Isolated injuries to the spine occurred in 30 (23.8%) riders. The thoracic spine was injured in 69 (54.8%), the lumbar spine in 37 (29.4%), and the cervical spine in 34 (27.0%) cases. Multiple vertebral levels were affected in 54 (42.9%). Neurologic injury occurred in 25 riders (19.8%), with complete distal neurologic injury in 14 (4 cervical, 9 thoracic, and 1 lumbar). Eleven (8.7%) patients required spinal surgery. There were 13 (10.3%) deaths. CONCLUSION: The thoracic spine is the most commonly injured spinal region in motorcycle crashes. Multiple level injuries are common. Protocols concentrating on the radiographic clearance of the cervical region may miss a significant number of spinal injuries. Vigilance is required in assessing these patients, who often have multiple injuries.     

Road traffic injuries as seen in a Nigerian teaching hospital

Trauma is a major problem in both developing and developed countries. World wide road-traffic injuries (RTIs) represent 25% of all trauma deaths. Injuries cause 12% of the global disease burden and are the third commonest cause of death globally. In our own environment, trauma is also important, with RTIs being a leading cause of morbidity and mortality. There is limited data on RTIs in West African countries, and this necessitated our study. We aimed to find common causative factors and proffer solutions. This was a one year prospective study examining all cases of trauma from RTIs seen at the Accident and Emergency Department of the Ebonyi State University Teaching Hospital (EBSUTH), Abakaliki, Nigeria. Three hundred and sixty-three patients were studied. There was a male/female ratio of 3.4:1, with the modal age being 25 years. Most injuries involved motorcycles (54%). Passengers from cars and buses were also commonly affected (34.2%). Most of accidents occurred from head-on collisions (38.8%). Soft-tissue injuries and fractures accounted for 83.5% of injuries. The head and neck region was the commonest injury site (41.1%), and the most commonly fractured bones were the tibia and fibula (5.8%). Death occurred in 17 patients (4.7%), and 46 (12.7%) patients discharged themselves against medical advice. Improvements in road safety awareness, proper driver education—especially motorcycle drivers—and proper hospital care are needed in our subregion.