Characteristics of bodily injuries of the pelvic girdle and lower extremities in car trauma

Authors

DOI:

https://doi.org/10.26641/1997-9665.2020.4.72-78

Keywords:

road traffic injury, pelvic fractures, fractures of the lower extremities, forensic medical examination

Abstract

Background. Fractures of the pelvic girdle and lower extremities as a result of a road traffic accident are the most frequent localization of injuries in victims, however, the structure of pedestrian and intra-salon injuries has not been sufficiently studied. Objective - to study the nature of injuries in victims of a car injury to the pelvic girdle and lower extremities. Methods. Research material - 170 acts of primary forensic medical examinations of victims with fractures of the pelvic bones and long bones of the lower extremities, received as a result of a non-lethal automobile injury. An expert assessment of the nature of bodily injuries was carried out at the Kharkiv Regional Bureau of Forensic Medicine (KRBSFM) within a period of no more than 1 month after injury. Acts of primary forensic medical examinations were selected at random for the period February - June 2018. Research methods - retrospective analysis, descriptive statistics. Results. Among the injured as a result of a car injury - 129 (75.9%) pedestrians, 23 (13.5%) drivers, 14 (8.2%) front seat passengers and 4 (2.4%) rear seat passengers. Thus, pedestrians and car drivers are the most vulnerable to road traffic injuries; the most protected rear seat passengers. Men predominated among the drivers; in the remaining groups of victims, the gender distribution was generally even. Among the participants in the accident were mainly people of working age. Injuries to the chest (26.5%), head (25.9%), abdomen (16.5%) prevailed among the associated injuries. Conclusion. A distinctive feature of injuries sustained as a result of a collision of a pedestrian or a car with another car with a relatively low speed of movement was an isolated injury to the bones of the pelvic girdle or lower extremities, both during pedestrian and intra-salon trauma. All the victims had injuries of the integumentary system of various localization in the form of subcutaneous hematomas and abrasions (158; 92.9%), bruised lacerations (96; 56.5%), stamp injuries (62; 36.5%). The main mechanism of pedestrian injury is the direct impact of the traumatic force with the formation of primary injuries in the form of bumper fractures of the shin bones (35.9%), hip (22.4%) and pelvis (10%).

References

  1. Freitas CD, Garotti JER, Nieto J, Guimarfes RP, Ono NK, Honda E, Polesello GC. There have been changes in the incidence and epidemiology of pelvic ring fractures in recent
  2. decades? Review Article. Rev Brasil Ortop. 2013;48(6):475-81. https://doi.org/10.1016/j.rboe.2013.12.013
  3. Agarwal-Harding KJ, Meara JG, Greenberg SLM, Hagander L, Zurakowski D, Dyer G. Estimating the Global Incidence of Femoral Fracture from Road Traffic Collisions: A Literature Review. J Bone Joint Surg 2015;97(6):e31 DOI: 10.2106/JBJS.N.00314 PMID: 25788312
  4. Larsen P, Elsoe R, Hansen SH, Graven-Nielsen T, Laessoe U, Rasmussen S. Incidence and epidemiology of tibial shaft fractures. Injury. 2015;46(4):746-50. doi: 10.1016/j.injury.2014.12.027. PMID: 25636535.
  5. Pley C, Purohit K, Krkovic M, Abdulkarim A. A health economic analysis of the management of open lower limb fractures in the elderly. Europ J Orthop Surg Traumat. 2020;30:1383–91. https://doi.org/10.1007/s00590-020-02713-3.
  6. Pan R-H, Chang N-T, Chu D, Hsu K-F, Hsu Y-N, Hsu J-C, Tseng L-Y et al. Epidemiology of Orthopedic Fractures and Other Injuries among Inpatients Admitted due to Traffic Accidents: A 10-Year Nationwide Survey in Taiwan. Scie World J 2014; ID 637872: 7 p. https://doi.org/10.1155/2014/637872
  7. Global status report on road safety 2018. Geneva: World Health Organization; 2018. Licence: CC BY- NC-SA 3.0 IGO. 403 р.
  8. Stinner DJ, Edwards D. Surgical 76 Management of Musculoskeletal Trauma. Surg Clin N Am. 2017;97:1119–31
  9. http://dx.doi.org/10.1016/j.suc.2017.06.005
  10. Azami-Aghdash S, Aghaei MH, Sadeghi-Bazarghani H. Epidemiology of Road Traffic Injuries among Elderly People; A Systematic Review and Meta-Analysis. Bull Emerg Trauma. 2018;6(4):279-91.
  11. doi: 10.29252/beat-060403. PMID: 30402515
  12. Eid HO, Barss P, Adam SH, Torab FC, Lunsjo K, Grivna M, Abu-Zidan FM. Factors affecting anatomical region of injury, severity, and mortality for road trauma in a high-income
  13. developing country: lessons for prevention. Injury. 2009;40(7):703-7. doi: 10.1016/j.injury.2008.07.012. PMID: 19117565.
  14. Glinsky S.V. [Forensic medical assessment of a car collision in cases of non-fatal injury]. The
  15. court-medical expert was elected. Khabarovsk. 2019;18:61-3. Russian.
  16. Barkanov VB, Ermilov VV, Civic VV, Vlasova EV, Kinash AA, Podchaynov PV. [Specific injuries of a pedestrian with auto-trauma (bumper-fracture)]. Vestnik VolgGMU. 2018;1(65):53-5.
  17. Russian. DOI 10.19163/1994-9480-2018-1(65)-53-55
  18. Leonov SV, Pinchuk PV. [The forensic-medical characteristic of the injuries inflicted to a pedestrian in a road traffic accident by the vehicle in the side and front impact position]. Forensic-med exam. 2016;4:21-4. Russian. doi: 10.17116/sudmed201659421-24
  19. Carson JT, Shah SG, Ortega G, Thamyongkit S, Hasenboehler EA, Shafiq B. Complications of pelvic and acetabular fractures in 1331 morbidly obese patients (BMI ≥ 40): a
  20. retrospective observational study from the National Trauma Data Bank. Patient Saf Surg. 2018;12:26. doi: 10.1186/s13037-018-0172-2 PMID: 30181776
  21. Siada SS, Davis JW, Kaups KL, Dirks RC, Grannis KA. Current outcomes of blunt open pelvic fractures: how modern advances in trauma care may decrease mortality. Trauma Surg Acute Care Open. 2017;2(1):e000136. doi: 10.1136/tsaco-2017-000136. eCollection 2017.
  22. Sinha AP: Study of Orthopedic Injuries Pattern by Road Traffic Accident Victims. Int J Life
  23. Sci Scienti Res.2017;3(2):961-3. DOI:10.21276/ijlssr.2017.3.2.14 PMID: 29766121
  24. Guryev SO, Evdoshenko VP, Satsyk SP. [Clinical and nosological structure of injuries of long
  25. bones in the victims of road accidents]. Trauma. 2015;16(1):60-3. Ukrainian.
  26. Ravikanth R, Varghese PS. Pattern and Distribution of Long Bone Fractures in Victims of
  27. Road Traffic Accidents in Bangalore City. Indian J Forensic Med & Toxicology. 2017;11(1):229-32. DOI: 10.5958/0973-9130.2017.00047.0
  28. Parkinson F, Kent S, Aldous C, Oosthuizen G, Clarke DL. Patterns of injury seen in road crash
  29. victims in a South African trauma centre. S Afr J Surg 2013;51(4):131-4. DOI:10.7196/SAJS.1627 PMID: 24209697
  30. Nesterov AV. [The state of the issue of injury inside the car in an accident]. Selected issues
  31. of forensic medical examination. Khabarovsk. 2007;82:10-22. Russian.
  32. Mayakova MV, Tenkov AA, Kochkarov VI. [Forensic medical assessment of injuries sustained in the passenger compartment by living persons]. Scientific statements. Series Medicine, Pharmacy. 2010;22(93):86-94. Russian.

Downloads

Published

2021-09-25

How to Cite

Sokol, V. K. (2021). Characteristics of bodily injuries of the pelvic girdle and lower extremities in car trauma. Морфологія / Morphologia / Morfologìâ, 14(4), 72–78. https://doi.org/10.26641/1997-9665.2020.4.72-78

Issue

Vol. 14 No. 4 (2020)

Section

Статті

License

Copyright (c) 2021 Morphologia

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

 The authors reserve the right to authorship of their work and transfer to the Journal the right to the first publication of this work under the terms of a license Creative commons Attribution 4.0 International (CC BY 4.0), which allows other people to freely distribute the published work with a mandatory reference to the authors of the original work and the first publication of the work in this journal.
        By submitting a manuscript to the editorial office of the Journal ‘Morphologia’ authors agree to transfer the rights to protect and use the manuscript (all supplemental materials, particularly protected objects such as photos, drawings, diagrams, tables, etc.), including the reproduction in the press and distribution via the Internet; translation of the manuscript into any language; export and import of journal copies with the Authors’ article in order to make it available for public. Authors convey the rights mentioned above to the editorial office without any temporal or territorial limitation all over the world. 
        The Authors guarantee that they have the exclusive rights to use the material transferred to editorial office. Editors are not responsible to third parties for contraventions of warranty given by the Authors. The considered rights are transferred to the editorial office since the moment when the current issue is signed for publishing. Reproduction of materials published in the Journal by other individuals and legal entities is possible only with the consent of Editorial office, with the obligatory indication of the full bibliographic reference of the primary publication. The Authors reserve the right to use the published material, its fragments and parts for teaching materials, oral presentations, dissertation thesis prepararion with obligatory bibliographic citation of the original paper. Electron copy of the published article, downloaded from official journal web-site in .pdf format may be put by authors on the official web-site of their institutions, any other official resources with open access.