Fracture patterns and complications related to pedestrian-vehicle collision victims in a public Level-1 Trauma Centre ICU population

Abstract

Introduction: Death and injury associated with road traffic collisions are global phenomena that require urgent attention. Approximately 1.2 million people worldwide are killed each year. Pedestrian collisions remain one of the single largest causes of injury, disability, and death in the developing world and contribute significantly to trauma centre activity, especially in urban areas. Materials and methods: The study aim was to describe the fracture patterns in pedestrians, and to highlight the epidemiology, spectrum, and outcomes of orthopaedic injuries identified in pedestrian vehicle collision (PVC) victims admitted to a major trauma intensive care unit (TICU). This retrospective analysis of 405 PVC victims, retrieved from an Ethics Approved Trauma Registry (BE360/13 and BE207/09) admitted to the TICU at Inkosi Albert Luthuli Central Hospital, Durban, South Africa, spans a six-year period from 2007 to 2012. Results: Four hundred and five pedestrian-vehicle collision patients were admitted over the six-year study period. Missing data were found in two patients. The mean age was 25.8 ± 17.49 years, with 135 (33.3%) female patients and 270 (66.7%) males. One hundred and eleven patients were referred directly from the scene; the others were inter-hospital transfers. Two hundred and eighty-five patients had fractures and from this group, 63 (22%) patients died in ICU. The most common fracture site was femur (122), followed by tibia (112) and pelvis (95). The mortality was related mainly to the age of the victims; none of the fractures were found to be associated directly with increased mortality. Conclusion: Diverse fracture patterns are seen in PVC patients. The leading cause of death is head injury, followed by chest injury. Increased age of the patients was associated with increased mortality. The predominance of specific fractures, in specific sex and age groups, were noted, and some fractures were found to be associated with more complications; however, none of the fractures were linked directly to mortality.