Motorcyclists and pillion passengers with open lower-limb fractures: a study using TARN data 2007–2014

Abstract

Introduction We aimed to identify population demographics of motorcyclists and pillion passengers with isolated open lower-limb fractures, to ascertain the impact of the revised 2009 British Orthopaedic Association/British Association of Plastic Reconstructive and Aesthetic Surgeons joint standards for the management of open fractures of the lower limb (BOAST 4), in terms of time to skeletal stabilisation and soft-tissue coverage, and to observe any impact on patient movement. Methods Retrospective cohort data was collected by the Trauma Audit and Research Network (TARN). A longitudinal analysis was performed between two timeframes in England (pre-and post-BOAST 4 revision): 2007-2009 and 2010-2014. Results A total of 1564 motorcyclists and 64 pillion passengers were identified. Of these, 93% (1521/1628) were male. The median age for males was 30.5 years and 36.7 years for females. There was a statistically significant difference in the number of patients who underwent skeletal stabilisation (49% vs 65%, P < 0.0001), the time from injury to skeletal stabilisation (7.33 hours vs 14.3 hours, P < 0.0001) and the proportion receiving soft-tissue coverage (26% vs 43%, P < 0.0001). There was no difference in the time from injury to soft-tissue coverage (62.3 hours vs 63.7 hours, P = 0.726). The number of patients taken directly to a major trauma centre (or its equivalent) increased between the two timeframes (12.5% vs, 41%, P < 0.001). Conclusions Since the 2009 BOAST 4 revision, there has been no difference in the time taken from injury to soft-tissue coverage but the time from injury to skeletal stabilisation is longer. There has also been an increase in patient movement to centres offering joint orthopaedic and plastic care.

The Value of an Orthoplastic Approach to Management of Lower Extremity Trauma: Systematic Review and Meta-analysis

“…Mean times ranged from 0.56 to 9.1 days in orthoplastic cohorts compared to 0.77 to 29.9 days in nonorthoplastic cohorts. 14 , 16 , 18 Three studies suggest orthoplastic management likely decreases the time to bone fixation compared to nonorthoplastic management (SMD: −0.35, 95% CI: −0.46 to −0.25, P < 0.0001; participants = 1777; studies = 3; I 2 = 0%; moderate certainty evidence).…”

“…1; Tables 2 and 3). [12][13][14][15][16][17][18][19][20] Nine studies included were published from 2013 through 2019. A total of 1663 orthoplastic managed patients and 692 nonorthoplastic managed patients with traumatic lower extremity injuries were managed at an MTC.…”

“…14 Eight before-and-after studies compared orthoplastic management at the same MTC. 12,[14][15][16][17][18][19][20] Six studies were performed solely in the United Kingdom, 12,[14][15][16]18,20 1 in the United Kingdom, Pakistan, and Italy, 13 1 in Sweden, 17 and 1 in Italy. 19…”

Acolhimento de enfermagem à pessoa vítima de acidente de motocicleta e ao familiar acompanhante

“…The characteristics of the individuals who were motorcycle accident victims are similar to the ones identified in national [18][19][20] and international 21,22 research studies, and the majority are young adult males with injuries on the lower limbs. Because the driver absorbs the energy generated, the vulnerability of the rider at the time of the accident can produce traumatic injuries, such as fractures of the limbs, which can prolong the period of hospital stay and cause complications.…”

Open lower limb fractures in the UK trauma system: A multicentre prospective audit of current practice

“…A further longitudinal study on motorcyclists with open fractures using TARN data has looked at adherence to some key BOAST open fracture standards with large patient numbers. [22] The TARN database does not report on all of the BOAST standards included in this study or the breadth of data such as frailty score, tetanus toxoid, types of procedure performed, soft tissue cover and reasons for returning to theatre.…”