Train versus pedestrian accidents.

Railroad-related trauma has been associated with injuries causing considerable morbidity. This is a retrospective study of 15 consecutive patients who were run over by trains. The initial injury produced a traumatic amputation of 10 extremities in eight patients. Limb salvage in two other patients with severe fractures failed, and subsequent lower extremity amputation was required. Despite efforts to salvage the most distal tissue possible, 8 of 12 extremities amputated in the acute traumatic period required revision to a more proximal level. Alcohol ingestion was involved in 13 of the 15 incidents in the study. No patient received posthospitalization alcohol rehabilitation. In addition, despite the young age of the patients in this series, only one patient was rehabilitated to a prosthetic ambulator.