Upper Extremity Injuries in Road Traffic Accidents

Abstract

Objectives The mechanisms of upper limb injuries in road traffic accidents have not been widely investigated or understood. The present study was designed to obtain more specific information on upper limb injuries sustained by front seat occupants involved in front- and side-impact collision car accidents. Its purpose was to identify injuries that are a priority for prevention and further research. Methods Hospital records, radiographs and, where appropriate, crash data were reviewed. Data were analyzed to identify the frequency and severity of upper limb injuries, the mechanism of injury and the impairment sustained, in accordance with the American Medical Association guide. The total financial costs for NHS management, as well as that relating to the upper limb injury, were calculated. Results Sixty-two cases were reviewed (34 males), with a mean (range) age of 44 years (18 years to 83 years). There were 20 clavicle fractures of which 18 were right sided, and often attributed to a ‘seat-belt effect’. There were also 17 wrist and 13 forearm fractures. The median (range) upper limb Abbreviated Injury Score was 2 (2 to 4) and the overall Injury Severity Score was in the range 1 to 50 (median 6). In terms of impairment, the upper extremity sensory deficit was in the range 0% to 9% and motor deficit 0% to 22.5%, giving up to 5% sensory and 13.5% motor ‘whole person impairment’. The mean treatment cost for upper limb management was £2200 compared to a mean total injury treatment cost of £11,000 per person. Discussion The present study has served to identify the range and subsequent costs (impairment and financial) of upper limb injuries in road traffic accidents. These data will be used by researchers to advance the design of current and future car crash dummies in the upper limb and to allow accurate finite element remodelling. These data may be used in support of legislative changes in the future.