Lower limb and associated injuries in frontal-impact road traffic collisions.

Mohannad B Ammori,Fikri M Abu-Zidan,Hani O Eid

doi:10.4314/ahs.v16i1.40

Mohannad B Ammori, Fikri M Abu-Zidan + Show 1 more

Open Access

https://doi.org/10.4314/ahs.v16i1.40

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Abstract

To study the relationship between severity of injury of the lower limb and severity of injury of the head, thoracic, and abdominal regions in frontal-impact road traffic collisions. Consecutive hospitalised trauma patients who were involved in a frontal road traffic collision were prospectively studied over 18 months. Patients with at least one Abbreviated Injury Scale (AIS) ≥3 or AIS 2 injuries within two AIS body regions were included. Patients were divided into two groups depending on the severity of injury to the head, chest or abdomen. Low severity group had an AIS < 2 and high severity group had an AIS ≥ 2. Backward likelihood logistic regression models were used to define significant factors affecting the severity of head, chest or abdominal injuries. Eighty-five patients were studied. The backward likelihood logistic regression model defining independent factors affecting severity of head injuries was highly significant (p =0.01, nagelkerke r square = 0.1) severity of lower limb injuries was the only significant factor (p=0.013) having a negative correlation with head injury (Odds ratio of 0.64 (95% CI: 0.45-0.91). Occupants who sustain a greater severity of injury to the lower limb in a frontal-impact collision are likely to be spared from a greater severity of head injury.

Highlights

An analysis of the biomechanics of a road traffic collision can provide clues to establish the diagnosis of occult injuries[1,2]
Lee et al reported that restrained occupants who sustained an injury to the knee, thigh or hip were four times less likely to suffer from a serious intra-abdominal injury in a frontal-impact road traffic collision[6]
We aimed to study the relationship between the severity of injury to the lower limb and the severity of injury to the head, thoracic, and abdominal regions in frontal-impact road traffic collisions

Summary

Introduction

An analysis of the biomechanics of a road traffic collision can provide clues to establish the diagnosis of occult injuries[1,2]. An appreciation of the mechanisms of injury and the relationship between the injuries sustained is imperative to guiding the clinical suspicion of the physician towards certain injuries when conducting the primary and secondary survey. An example of this is the raised probability of a solid organ injury in the presence of a concomitant fracture to the rib and the pelvis[3]. Lee et al reported that restrained occupants who sustained an injury to the knee, thigh or hip were four times less likely to suffer from a serious intra-abdominal injury in a frontal-impact road traffic collision[6]. The advantages of the safety belt are well-established[7,8], the relationship between lower limb injuries and other body regions is less well understood

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