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The incidence and treatment of sternal fractures among traffic accidents are of increasing importance to ensure best possible outcomes. Analysis of technical indicators of the collision, preclinical and clinical data of patients with sterna fractures from 1985-2004 among 42,055 injured patients were assessed by an Accident Research Unit. Two time groups were categorized: 1985-1994 (A) vs. 1995-2004 (B). 267/42,055 patients (0.64%) suffered a sterna fracture. Regarding the vehicle type, the majority occurred after car accidents in 0.81% (251/31,183 pts), followed by 0.19% (5/2,633pts) driving motorbike, and 0.11% (4/3,258pts) driving a truck. 91% wore a safety belt. Only 13% of all passengers suffering a sternal fracture had an airbag on board (33/255 car/trucks), with an airbag malfunction in 18%. The steering column was deformed in 39%, the steering wheel in 36%. Cars in the recent years were significantly older (7.67-±5 years (B) vs. 5.88-±5 years (A), p=0.003). Cervical spine injuries are frequent (23% vs. 22%), followed by multiple rib fractures (14% vs. 12%) and lung injuries (12% vs. 11%). We found 9/146 (6%) and 3/121 patients (3%) with heart contusion among the 267 sternal fractures. MAIS was 2.56-±1.3 vs. 2.62-±1.3 (A vs. B, p=0.349). 18% of patients were polytraumatized, with 11.2% dying at the scene, 2.3% in the hospital. Sternal fractures occur most often in old cars to seat-belted drivers often without any airbag. Severe multiple rib fractures and lung contusion are concomitant injuries in more than 10% each indicating the severity of the crash. Over a twentyyear period, the injury severity encountered was not different with 18% polytrauma patients suffering sternal fractures.
The number of injuries sustained by car occupants involving the head, thorax, spine, pelvis and the upper limbs have been reduced significantly during recent years. This is probably due to better safety features in the cars, especially the availability and usage of safety belts, airbags etc. Therefore one can notice clinically a relative increase in survivors of severe frontal crashes, but many of them have injuries to the lower extremities. To verify this, we analyzed the foot and ankle injuries of front seat passengers.
The primary goal of this investigation was to determine the relative risk of traffic accidents in students. In a two year period, a survey amongst 2,325 students was carried out, and 3,645 injuries sustained by students treated at our hospital were analyzed. Moped-riding in adolescents were associated with a 23.75-fold increased risk for injury as compared to biking. Children who ride bicycles have a 2.2-fold increased risk for an injury sustained by traffic accidents compared to pedestrians. None of 50 injured bicycle riders with helmet had an AIS for head injuries of more than 2. 24 of 233 injured bicycle drivers without helmet had an AIS for head injuries of more than 2. The use of a protective helmet significantly reduced the severity of head injuries. The level of awareness towards danger and a history of previous accidents correlate with the likelihood of future accidents. Due to the severity of traffic accidents, more adequate prevention measures (wearing of bicycle helmets and better education for moped riders) are urgently needed.