Winkler Dennis, Goudie Stuart T, Court-Brown Charles M
University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Trauma and Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom.
Injury. 2018 Feb;49(2):208-212. doi: 10.1016/j.injury.2017.11.009. Epub 2017 Nov 14.
To investigate the changing epidemiology of open fractures in vehicle occupants, pedestrians, motorcyclists and cyclists.
Data on all non-spinal open fractures admitted to the Royal Infirmary of Edinburgh after a road traffic accident between 1988 and 2010 were collected and analysed to provide information about the changing epidemiology in different patient groups. Demographic information was collected on all patients with the severity of injury being analysed with the Injury Severity Score (ISS), Musculoskeletal Index (MSI) and the number of open fractures. The severity of the open fractures was analysed using the Gustilo classification. The 23-year study period was divided into four shorter periods and the results were compared.
There were 696 patients treated in 23 years. Analysis showed that the incidence of RTA open fractures initially fell in both males and females and continued to fall in females during the 23 years. In males it levelled off about 2000. The age of the female patients also fell during the study period but it did not change in males. The only patient group to show an increased incidence of open fractures were cyclists. In vehicle occupants the incidence fell throughout the study period but it levelled off in pedestrians and motorcyclists. There was no difference in the severity of injury in any group during the study period. The most severe open fractures were those of the distal femur and femoral diaphysis although open tibial diaphyseal fractures were the most common fracture in all patient groups.
Improved car design and road safety legislation has resulted in a reduction in the incidence of open fractures in vehicle occupants, pedestrians and motorcyclists. The most obvious group to have benefitted from this are older female pedestrians. The only group to show an increase in age during the study period were male motorcyclists.
调查车辆驾乘人员、行人、摩托车骑行者和自行车骑行者开放性骨折的流行病学变化情况。
收集并分析了1988年至2010年间因道路交通事故入住爱丁堡皇家医院的所有非脊柱开放性骨折的数据，以提供不同患者群体流行病学变化的信息。收集了所有患者的人口统计学信息，并使用损伤严重程度评分（ISS）、肌肉骨骼指数（MSI）和开放性骨折数量分析损伤的严重程度。使用 Gustilo 分类法分析开放性骨折的严重程度。将23年的研究期分为四个较短的时期，并对结果进行比较。
23年中共治疗了696例患者。分析表明，道路交通事故开放性骨折的发病率最初在男性和女性中均有所下降，并且在23年期间女性继续下降。男性的发病率在2000年左右趋于平稳。研究期间女性患者的年龄也有所下降，但男性患者的年龄没有变化。唯一开放性骨折发病率增加的患者群体是自行车骑行者。在车辆驾乘人员中，发病率在整个研究期间都在下降，但在行人与摩托车骑行者中趋于平稳。研究期间任何组别的损伤严重程度均无差异。最严重的开放性骨折是股骨远端和股骨干骨折，尽管胫骨干开放性骨折是所有患者群体中最常见的骨折。
汽车设计的改进和道路安全立法导致车辆驾乘人员、行人及摩托车骑行者开放性骨折的发病率降低。受益最明显的群体是老年女性行人。研究期间唯一年龄有所增加的群体是男性摩托车骑行者。
