Pandey Rohit, Rajnish Rajesh Kumar, Srivastava Amit, Bhayana Himanshu, Dhammi Ish Kumar
Department of Orthopaedic, Heritage Institute of Medical Sciences Varanasi, India.
Department of Orthopaedics, All India Institute of Medical Sciences Bilaspur, India.
Int J Burns Trauma. 2021 Oct 15;11(5):350-356. eCollection 2021.
Sideswipe injuries are most commonly described in passengers traveling in a car or bus, but here we report an unusual mode of sideswipe injuries, in passengers traveling in a train sitting on window seats with elbow protruding outside the window.
Four patients reported to our Orthopaedic emergency 2 hours after a railway track accident with more or less similar pattern of injury, an open proximal forearm monteggia fracture-dislocation with bone and soft tissue loss along with closed fracture humerus, and with or without radial nerve palsy and intact distal pulses. We followed a multidisciplinary approach with initial wound lavage followed by wound debridement, stabilization of monteggia and humerus fractures with different justifiable modalities of treatment with an exploration of the radial nerve.
Sideswipe injury is a well-known case entity in literature, classically described mode of trauma is when an elbow protruding out of the window of a vehicle struck by a moving or fixed object. However, in our series patients sitting in a train on window seat with elbow protruding outside sustained sideswipe injury which has not been reported in literature. We also explained the mechanism of impact forces caused bony and soft tissue injury in our series presented in diagrammatic representation. Hence, the purpose of this case series is to spread the awareness regarding such kind of preventable injury which can be easily prevented with awareness, and an appropriate preventive measure can be taken by the local administration.
侧方擦撞伤最常见于乘坐汽车或公交车的乘客,但在此我们报告一种不寻常的侧方擦撞伤方式,发生在乘坐火车靠窗座位且肘部伸出窗外的乘客身上。
4名患者在铁路轨道事故发生2小时后到我们的骨科急诊就诊,损伤模式大致相似,均为开放性近端尺桡骨孟氏骨折脱位,伴有骨与软组织缺损,同时合并闭合性肱骨骨折,伴有或不伴有桡神经麻痹且远端脉搏正常。我们采用多学科方法,首先进行伤口冲洗,然后进行伤口清创,采用不同合理的治疗方式稳定孟氏骨折和肱骨骨折,并探查桡神经。
侧方擦撞伤在文献中是一个广为人知的病例类型,经典描述的创伤模式是当肘部伸出车窗被移动或固定物体撞击时。然而,在我们的病例系列中,坐在火车靠窗座位且肘部伸出窗外的患者遭受了侧方擦撞伤,这在文献中尚未有报道。我们还以示意图的形式解释了我们病例系列中导致骨与软组织损伤的冲击力机制。因此,本病例系列的目的是提高对这类可预防损伤的认识,通过提高意识可以很容易地预防此类损伤,地方行政部门也可以采取适当的预防措施。