Study On Characteristics And Mechanisms Of Fractures In Road Traffic Accidents And Traffic Manners

OBJECTIVE: To investigate the epidemiology and characteristics of bone fractures from road traffic accidents and analyze their injury mechanisms so as to provide the bases data for the research and medical care of traffic trauma and preventing and reducing the road traffic accident and appraisement of forensic. The significance is to explore the relationship between bone fractures and traffic manners for forensic medicine. METHODS: The restropective statistical annlysis was carried out in 518 cases with clinical forensic medicine and 199 cases with forensic pathology medicine in the Center of Judicial Expertise of Kunming Medicine College in 2004. RESULTS: The quantity of road traffic accidents, the death and the injury, the loss of direct property, the mortality of road traffic accidents per ten thousand vehicles and the mortality of per one hundred thousand populations had obviously decreased more from 2005 to 2006 than the last four years in China . The condition in Yunnan province was similar, but the mortality of road traffic accidents per ten thousand vehicles was higher than the average level in China. The age distribution of bone fractures from road traffic accidents in Kunming was partial to the normal school distribution, from 15 to 45 years old accounted for 61. 2 percent of the total casualties. It is the highest percent of peasant in occupation distribution. There were three peak time (from 7 to 9 am, from 17 to 19 pm and from 20 to 24 pm) in time distribution. The vehicles that caused the bone fracture accounted for 97. 2 percent of the total. Pedestrian and the bicycle riders were constituted 46.1 percent of the total casualties. It was the highest by crashing the flank of pedestrian, which accounted for 61.7 percent. The road traffic accidents often happened at the crossroad. The most common location of fractures was the lower extremities, followed by skull and maxillofacial region, the ribs and the upper extremities. A total of 64. 6% of the casualties suffered from multiple fractures. The fractures of the patella, femur and pelvis and the fractures of the olecranon, humerus and shoulder often happened simultaneously. The fractures of skull and maxillofacial with intracalvarium injuries were often found, which accounted for 60. 6%. Cerebral contusion was the highest of intracalvarium injuries. The rib fractures were often fonud at 2-10 ribs, which were suffered from multiple fractures. Lumbar vertebra was the most location of fractures of vertebra, majority of vertebra burst of compression, majority of multi-segment fractures and spinal cord injury. Fracture of pubis was the most of pelvic fracture, and pelvic fracture was malunion by healing. The sternum and rib fractures in driver of motor vehicle were higher than those in front and rear occupant, scapula, clavicle and spinal fractures in front occupant were the highest in all crowds, pelvic fractures in rear occupant were the highest. Skull fractures by car were the lowest in all vehicles, the sternum and rib fractures by small bus were highest in all vehicles, pelvic fractures by truck were higher than those by motorcycle, spinal fractures by car were higher those by bus and truck, the inferior fractures of the lower extremities by small motor vehicle were higher than those by big motor vehicle. The run-over fractures often happened by bus and truck, the impacting fractures in driver of motor vehicle were the most, the crushing and temping fractures were found in the occupants of the car. CONCLUSIONS: The quantity of road traffic accidents had obviously decreased from 2005 to 2006 in China and Yunnan province. The fractures from traffic accidents have the following characteristics: centrifugal distribution of the injuries, multiple fractures, the most common location of fractures was the lower extremities, force transmission and ipsilateral occurrence. The impacting fractures were the most common fracture, followed the tumbling fracture. The injury mechanisms can be classified into four types: impacting, tumbling, incoordinate movement, stretch injury and crush and extrusion. The measures were drawn off to prevent and reduce road traffic accident.