Sonstige
Ruptures and dissections of the thoracic and abdominal aortic vessel caused by traffic accidents are rare but potentially life-threatening injuries. They can occur by blunt trauma via seat belt or dashboard injury. The study aimed at evaluating the overall mortality, morbidity, neurological disorders, and differences in operative procedures of open repair and stenting. It shows that, with a change and improvement in diagnostic tools and surgical approach, mortality and morbidity of blunt aortic injuries were significantly reduced. Still an immediate life-threatening injury early diagnosis via multiple-slice and scans and surgical repair with minimally invasive stents showed excellent short-time results for selected patients.
Introduction: Spine injuries pose a considerable risk to life and quality of life. The total number of road deaths in developed countries has markedly decreased, e.g. in Germany from over 20000 in 1970 to less than 4000 in 2010, but little is known how this is reflected in the burden of spine fractures of motor vehicle users. In this study, we aimed to show the actual incidence of spine injuries among drivers and front passengers and elucidate possible dependencies between crash mechanisms and types of injuries.
Bicyclists are minimally or unprotected road users. Their vulnerability results in a high injury risk despite their relatively low own speed. However, the actual injury situation of bicyclists has not been investigated very well so far. The purpose of this study was to analyze the actual injury situation of bicyclists in Germany to create a basis for effective preventive measures. Technical and medical data were prospectively collected shortly after the accident at the accident scenes and medical institutions providing care for the injured. Data of injured bicyclists from 1985 to 2003 were analyzed for the following parameters: collision opponent, collision type, collision speed (km/h), Abbreviated Injury Scale (AIS), Maximum AIS (MAIS), incidence of polytrauma (Injury Severity Score >16), incidence of death (death before end of first hospital stay). 4,264 injured bicyclists were included. 55% were male and 45% female. The age was grouped to preschool age in 0.9%, 6 to 12 years in 10.8%, 13 to 17 years in 10.4%, 18 to 64 years in 64.7%, and over 64 years in 13.2%. The MAIS was 1 in 78.8%, 2 in 17.0%, 3 in 3.0%, 4 in 0.6%, 5 in 0.4%, and 6 in 0.2%. The incidence of polytrauma was 0.9%, and the incidence of death was 0.5%. The incidence of injuries to different body regions was as follows: head, 47.8%; neck, 5.2%, thorax, 21%; upper extremities, 46.3%; abdomen, 5.8%; pelvis, 11.5%, lower extremities, 62.1%. The accident location was urban in 95.2%, and rural in 4.8%. The accidents happened during daylight in 82.4%, during night in 12.2%, and during dawn/dusk in 5.3%. The road situation was as follows: straight, 27.3%; bend, 3.0%; junction, 32.0%; crossing, 26.4%; gate, 5.9%; others, 5.4%. The collision opponents were cars in 65.8%, trucks in 7.2%, bicycles in 7.4%, standing objects in 8.8%, multiple objects in 4.3%, and others in 6.5%. The collision speed was grouped <31 in 77.9%, 31-50 in 4.9%, 51-70 in 3.7%, and >70 in 1.5%. The helmet use rate was 1.5%. 68% of the registered head injuries were located in the effective helmet protection area. In bicyclists, head and extremities are at high risk for injuries. The helmet use rate is unsatisfactorily low. Remarkably, two thirds of the head injuries could have been prevented by helmets. Accidents are concentrated to crossings, junctions and gates. A significant lower mean injury severity was observed in victims using separate bicycle lanes. These results do strongly support the extension or addition of bicycle lanes and their consequent use. However, the lanes are frequently interrupted at crossings and junctions. This emphasizes also the important endangering of bicyclists coming from crossings, junctions and gates, i.e. all situations in which contact of bicyclists to motorized vehicles is possible. Redesigning junctions and bicycle traffic lanes to minimize the possibility of this dangerous contact would be preventive measures. A more consequent helmet use and use and an extension of bicycle paths for a better separation of bicyclists and motorized vehicle would be simple but very effective preventive measures.