Camel collision as a major cause of low cervical spinal cord injury

Patterns of horse and camel- related injuries: A descriptive analysis from a national trauma registry (2007-2021)

BACKGROUND

The large animal-related injuries are emerging major trauma but remain underestimated public health problem worldwide. We aimed to determine the incidence, clinical characteristics, mechanisms and patterns of horse and camel-related injuries (HCRIs) in a Middle Eastern country.

METHODS

A retrospective analysis of all patients who were hospitalized due to HCRIs was conducted. Data included patient's demographics, mechanism of injury, anatomical location and severity of injury, and hospital outcomes.

RESULTS

Between November 2007 and December 2021, there were 273 hospitalized patients with HCRIs representing1.3 % of the total trauma admissions. Of these, 145 (53.1 %) and 128 (46.9 %) were horse (HRI) and camel-related injuries (CRI) respectively. The most common presenting age group of the cohort was 20-29 years and 88 % were males. Patients with HRIs were younger (27.5 ± 11 years) than CRIs (34 ± 13.5 years). Injuries to the extremities were the most common (62 % vs. 40 %), followed by the head injury (25.5 % vs. 31 %) among the HRIs and CRIs, respectively. The most common mechanism of injury was falling off followed by getting kicked by the HCRIs. Major trauma (ISS ≥12) was found in 23 % of HRIs (47.5 %) and CRIs (52.5 %). Only 5 % of patients had shock index >0.90 on admission; two thirds were due to CRIs. There were four fatalities (1.5 %), all attributed to traumatic brain injury, of which three were due to HRIs and one due to CRIs.

CONCLUSION

This study reveals that HCRIs predominantly affect young adult males and may involve serious injuries, exhibit distinct injury patterns, however, it is associated with low mortality. Preventive measures need to be revisited.

The nature and consequences of camel-related injuries: A scoping review with special reference to Arab Middle Eastern countries

Animal-related injuries are a substantial but under-reported, emerging public health problem contributing considerably to worldwide morbidity and death. Understanding the behavior of big animals may help in injury prevention. Camels are large long-neck ungulates of the genus Camelus that have been domesticated for millennia as a mode of transportation, race, and food source. Camel-related injuries are not well studied when compared with other animals' injuries. Camels can occasionally be very hostile to humans, inflicting serious injuries. These injuries can be caused by camel bites, falls from their backs, kicks, or collisions with motor vehicles. The relative magnitude of each mechanism has never been extensively studied in the literature. Furthermore, the incidence of camel-related injuries is not well reported worldwide. Camels remain a potential cause of serious injuries and a public health problem for some countries in the Middle East. There are gaps in the incidence, risk factors and mechanism, distribution of camel-related injuries. We aimed to summarize the data and draw conclusions pertaining not just to the most common mechanism of injury but to demographics, incidence, severity, and appropriate methods of prevention of camel-related injuries. This scoping review findings will help for better understanding of the nature and consequences of camel-related injuries, and to improve the existing preventive and management strategies.

Head, face and neck camel-related injuries: Biomechanics and severity

INTRODUCTION

Large animal-related human injuries are associated with high morbidity and mortality. There are no studies on biomechanics of the camel-related head, face, and neck (HFN) injuries. We aimed to study the mechanism, anatomical distribution and severity of camel-related HFN injuries.

METHODS

We analyzed our prospectively collected data of patients who were admitted to Al Ain Hospital with camel-related HFN injury during the period of October 2001 to January 2010.

RESULTS

Seventy-three patients were studied; all were males having a median (range) age of 28 (5-89) years. Camel kick was the most common mechanism of injury (45%) followed by falling from a camel (22%). Facial fractures were significantly more common in patients who were kicked by a camel. Severe head injuries were significantly more in patients who fell from a camel or who had a car collision with a camel. Car collision with a camel was significantly associated with lower cervical spine fractures (p = 0.017) and severe cervical spine injuries (p = 0.004). Two patients died (overall mortality 3%) CONCLUSIONS: Our study provides an insight into the complex biomechanics and severity of camel-related HFN injuries. It is essential to adopt protective measures in our community so as to reduce camel-related HFN injuries.

Causes and patterns of spine trauma in children and adolescents in Saudi Arabia: implications for injury prevention

BACKGROUND AND OBJECTIVES

Knowledge regarding traumatic spine injuries (TSIs) is essential for effective prevention strategies, particularly in the developing world, where majority of the population is younger and organized prevention programs are scarce. Therefore, our objective was to describe TSI mechanisms, demographics, patterns, and outcomes in children and adolescents.

DESIGN AND SETTINGS

Retrospective chart review in a major trauma center from May 2001 to May 2009 in Riyadh, Saudi Arabia.

PATIENTS AND METHODS

Detailed chart reviews were done for all consecutive TSI patients ≤18 years old.Cases were identified through the trauma database registry that included admitted patients.

RESULTS

Of the 3796 cases identified, 120 cases (3.2%) sustained 141 TSIs (mean age: 13.5 years; males:83.8%). TSI was most common among children from 16 to 18 years old. Overall, motor vehicle collision (MVC)was the most common injury mechanism (60.8%). However, younger patients (<12 years) sustained more pedestrian injuries (40.6%). Among MVC cases with known seat belt statuses (43.8%), 90.6% were not wearing seat belts. The cervical spine level was the most commonly affected (55.8%) region, especially in children <12 years old (88%). More than 1 affected spinal level was found in 23.3% cases. Spinal cord injuries were found in 19.2% cases. Overall, mortality was 8.3%, and half of these mortalities were secondary to pedestrian injuries. A total of 22.7% of cases were discharged with neurological deficits.

CONCLUSION

The high frequency and severity of MVC and pedestrian injuries observed in the present study raise significant concerns regarding the safety of children on the roads. Spine involvement was age specific;younger patients tended to have more cervical injuries, and older patients exhibited more thoracic spine involvement.

Camel-related injuries: prospective study of 212 patients

BACKGROUND

Camel-related injuries have been less well studied than other animal-related injuries. We aimed to study prospectively the incidence, mechanism, distribution of injury, and outcome of patients admitted to hospital with camel-related injuries in Al-Ain, United Arab Emirates.

METHODS

All patients who were admitted to Al-Ain Hospital with a camel-related injury were prospectively studied during the period of October 2001 to January 2010. Patient's demography, time of injury, mechanism of injury, and distribution and severity of injury were studied.

RESULTS

A total of 212 patients, all male, with a median age of 28 years (5-89 years) were studied. The estimated incidence of hospitalized camel-related injured patients in Al-Ain City was 6.88 per 100,000 population per year. Camel kicks were most common (36.8 %) followed by a fall from a camel (26.4 %) and camel bites (25.0 %). Camel kicks and falling from a camel were more common during the hot month of August, and camel bites were more common during the rutting season (November to February). Patients with a kick-related injury had a significantly higher rate of maxillofacial fractures compared with other mechanisms. Spinal injuries occurred significantly more often in vehicle occupants who collided with camels compared with other mechanisms (3/7 compared with 7/205, p = 0.0022, Fisher's exact test). Twelve patients (5.7 %) were admitted to the intensive care unit. The mean hospital stay was 8.6 days (1-103 days). Two patients died (overall mortality 1 %).

CONCLUSIONS

Understanding the biomechanisms and patterns of injury and correlating them with the behavior of the camel is important for identification and prevention of camel-related injuries.

Road crashes involving animals in Australia

Each year in Australia many thousands of collisions occur between motor vehicles and animals, resulting in considerable vehicle repair costs, injury to persons, and loss of animal life. This paper reviews animal-related road crashes in Australia and presents data from the in-depth Rural and Remote Road Safety Study in North Queensland for serious casualties (n=33) resulting from direct impact with an animal or swerving to avoid an animal on public roads. These crash types accounted for 5.5% of all eligible on-road serious casualties in the study and, hence, are considered to be an important issue that requires particular attention within rural and remote areas. Kangaroos and wallabies were the predominant species involved in these crashes (44.8%). Consistent with international studies, night-time travel was found to be a significant risk factor when comparing animal-related crashes to other serious injury crashes in the study. There were also a significantly higher proportion of motorcyclists (51.7%) than other vehicle occupants involved in animal-related serious crashes compared to all other serious injury crashes. Data matching to official Government records found underreporting of animal-related crashes to be an issue of concern. These findings are discussed in terms of countermeasures suitable for the Australian context and the need for consistent crash reporting across jurisdictions.

Camel racing injuries among children

OBJECTIVE

The aim of this study is to determine the frequency and severity of camel racing injuries among children aged 5 to 15 years during the period 1992 to 2003 in the State of Qatar.

DESIGN

Case series.

SETTING

The study was conducted in the Hamad General Hospital, State of Qatar, from January 1992 to December 2003.

PATIENTS AND METHODS

A total of 275 subjects aged 5 to 15 years with camel racing injuries who were seen at the Accident Emergency Department, Critical Care, and Physiotherapy Departments of the Hamad General Hospital were studied. The sociodemographic information and the details of the injury of the studied subjects were collected. The Abbreviated Injury Scale system was used to determine the severity of injury.

RESULTS

Overall, 275 camel racing injuries were reported among boys aged 5 to 15 years. The majority of patients were Sudanese (91.3%). The most commonly injured locations were upper limb (23.2%), lower limb (21.1%), and head (20.7%), followed by other injury locations. Seventeen patients were disabled as a result of their injury, and another 3 injuries were fatal. This study revealed that 34% of injuries were considered to be minor, 22.1% moderate, 18.1% serious, 11.6% critical, and 6.4% maximum.

CONCLUSIONS

The injury severity caused by the camel racing significantly affected the length of hospital stay. At present, the government is serious about this problem, and there is a draft of proposed legislation intended to prevent the employment of children below the age of 12 as camel jockeys.

Dorsal spine injuries in Saudi Arabia--an unusual cause

BACKGROUND

Motor vehicle accidents are the most common cause of spinal injuries in Saudi Arabia. Camel collisions usually result in cervical spine injuries. Although extremely rare, dorsal spine injuries have also resulted from these accidents.

METHOD

Retrospective analysis of the type of accident of all the patients with dorsal spine injuries was conducted at the supra-regional spinal injuries rehabilitation unit in Riyadh.

RESULTS

Of all the patients' records reviewed, three patients' injuries to the dorsal spine had resulted from car accidents involving a camel. These patients, during further interviews, described in detail the exact mechanism of their injuries. Protective lateral bending to avoid the direct impact of the animal resulted in their injuries.

CONCLUSION

Camel collisions remain a significant cause of mortality and morbidity although they affect the cervical spine most often. Dorsal spine injuries can result from protective lateral bending in unrestrained drivers and passengers.

An unusual cause of depressed skull fracture: case report

BACKGROUND

Camel collision accidents are a common occurrence in Saudi Arabia, with a high rate of mortality and morbidity. Isolated injuries are rare because of the nature of impact sustained by the person.

CASE DESCRIPTION

A 4-year-old child with an isolated depressed skull fracture resulting from a camel collision is described. The other occupants of the car were crushed to death. The child sustained only an impact to his head, causing a compound depressed skull fracture with localized cortical damage.

CONCLUSIONS

Camel collision accidents are a common cause of mortality and morbidity in Saudi Arabia. Isolated skull injuries are rare and result from a localized impact. This is the first report of a compound depressed skull fracture from such an incident. The extent of the problem and efforts toward prevention are described.