Abstract
Introduction: Upper limb injuries in road traffic accidents (RTAs) have been sparsely investigated and poorly understood. The purpose of this study was to obtain more specific information on upper limb injuries sustained by front seat occupants in car accidents with a view to identifying injuries that are a priority for prevention and further research.
Methods: With ethical approval and after obtaining identification of cases from the Transport and Research Laboratory the appropriate hospital records and radiographs were reviewed. Data were analysed to identify the frequency and severity of upper limb injuries, the mechanism of injury and the impairment sustained in accordance with the American Medical Association guide. The costs of management of the upper limb injury and that for the patient in total were calculated.
Results: Sixty cases were reviewed (29 male), aged 18–83 years (mean 45 years). There were 19 clavicle fractures of which 17 were right sided, two requiring operative intervention. These injuries were attributed to a “seat-belt” effect. The mean upper limb Abbreviated Injury Score was 1.9 and the overall Injury Severity Score ranged from 1 to 50 (median 12.3). Upper extremity sensory deficit ranged from 0 to 9% and motor deficit 0 to 22.5% giving up to 5% sensory and 13.5% motor “whole person impairment”. The wrist generally suffered a poorer functional outcome compared with the elbow. The mean estimated treatment cost for upper limb management was £2,200 compared with a total injury treatment cost of £11,000 per person.
Conclusions: The study demonstrates the significance of upper limb injuries in road traffic accidents and the data has been used in conjunction with crash dynamics data to formulate recommendations for future car safety and further research.
The abstracts were prepared by Cormac Kelly. Correspondence should be addressed to The Secretary, British Elbow and Shoulder Society, Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE
