Landy David C, Norton Robert A, Barkin Jodie A, Henriques Stephen, Owens Patrick, Miki Roberto A
University of Miami Miller School of Medicine, Miami, FL, USA.
Iowa Orthop J. 2010;30:99-102.
Though pedestrian versus motor vehicle (PVMV) accidents are a common cause of trauma admission and subsequent orthopaedic consult, the prevalence of upper extremity fracture (UEF) in such events and its association with lower extremity injury (LEI) is unknown. We sought to describe UEF in PVMV accident patients at the time of orthopaedic consult.
A retrospective chart review was conducted for all pedestrian hit by motor vehicle cases for which an orthopaedic consult was performed at Jackson Memorial Hospital between July 2006 and January 2008. Fractures were recorded by location along with relevant clinical information. Logistic regression was used to calculate odds ratios (O.R.) and 95% confidence intervals (C.I.) for variables associated with UEF.
336 cases were identified and reviewed. LEI was the most frequent injury type (67% of cases). UEF was also common, found in 25% of cases (humerus 11%, ulna 7%, radius 6%, hand 4%, and wrist 2%). Tibia or fibula fracture, femur fracture, and spine fracture were negatively associated with UEF in univariate analyses and after controlling for other associated factors.
In PVMV accident populations, UEF is a frequent injury often seen in the absence of any LEI. These findings emphasize the importance of carefully screening all PVMV accident patients for UEF and may call into question the usefulness of currently discussed injury pattern.
尽管行人与机动车碰撞（PVMV）事故是创伤入院及后续骨科会诊的常见原因，但此类事故中上肢骨折（UEF）的发生率及其与下肢损伤（LEI）的关联尚不清楚。我们试图描述在骨科会诊时PVMV事故患者中的UEF情况。
对2006年7月至2008年1月期间在杰克逊纪念医院进行骨科会诊的所有机动车撞击行人病例进行回顾性图表审查。记录骨折的部位以及相关临床信息。使用逻辑回归计算与UEF相关变量的比值比（O.R.）和95%置信区间（C.I.）。
共识别并审查了336例病例。LEI是最常见的损伤类型（67%的病例）。UEF也很常见，在25%的病例中发现（肱骨11%、尺骨7%、桡骨6%、手部4%、腕部2%）。在单因素分析以及控制其他相关因素后，胫骨或腓骨骨折、股骨骨折和脊柱骨折与UEF呈负相关。
在PVMV事故人群中，UEF是一种常见损伤，常出现在无任何LEI的情况下。这些发现强调了对所有PVMV事故患者仔细筛查UEF的重要性，并可能对目前讨论的损伤模式的实用性提出质疑。
