Analysis of increased motorcycle accidents during the COVID-19 pandemic: a single-center study from Türkiye

BACKGROUND

The Coronavirus Disease 2019 (COVID-19) pandemic has led to a unique set of circumstances, straining health-care systems and affecting the way of life in societies around the world. Measures such as social isolation, travel restrictions, and workplace closures have led to an increase in motorcycle use. Consequently, motorcycle accidents have become a significant problem during this period. This study presents detailed research conducted to examine motorcycle accidents during the COVID-19 pandemic and to understand the causes and consequences of the increase in these accidents.

METHODS

This research evaluated records from a single health examination and used various models to analyze motorcycle acci-dents within a specified time period. Additionally, retrospective analyses were conducted to examine associations between motorcycle use and crashes in our country before and after the pandemic. The records of 386 patients who were injured in motorcycle accidents and followed up, received treatment, and were recorded at Biruni University Hospital between November 2015 and April 2023 were retrospectively examined. Noted details included the victims' age, gender, injury mechanism, injury site, injury severity, helmet use, presence and location of fractures, time distribution of the accident, and the severity of other important tissue injuries. The relationship between the injury site, fractures, and accident details, and the "Injury Severity Score" (ISS) was also investigated.

RESULTS

Among the 386 injured victims in motorcycle accidents, 333 were male and 53 were female. Of these, 168 (43.5%) were motorcycle drivers, 137 (35.5%) were motorcycle couriers, and 81 (21%) were pedestrians. A total of 186 (48%) injuries occurred before the pandemic (November 2015-March 2020), while 200 (52%) were sustained during the pandemic. The study indicates a noticeable increase in motorcycle injuries, particularly among motor couriers, especially during the pandemic quarantine periods. Post hoc analysis revealed that motor couriers had significantly lower ISS compared to other professions (p=0.009 and p=0.045, respectively). Motorcyclists who wore helmets were found to have significantly lower ISS than those who did not wear helmets (p<0.05). Furthermore, it was found that the ISS was positively correlated with the number of bone fractures, total soft tissue injury, and significant clinical characteristics (r=0.758, r=0.756, and p<0.001, respectively).

CONCLUSION

This clinical study's findings demonstrate that the measures implemented during the pandemic to limit society's mobility have led to an increase in motorcycle accidents. Notably, there has been a significant rise in the number of accidents, particularly involving individual motorcycle use and motorcycle courier services.

Anthropometric measurements of tibial plateau and correlation with the current tibial implants

PURPOSE

The aim of the study was to make an anthropometric analysis at the resected surfaces of the proximal tibia in the Turkish population and to compare the data with the dimensions of tibial components in current use. We hypothesized that tibial components currently available on the market do not fulfil the requirements of this population and a new tibial component design may be required, especially for female patients with small stature.

METHODS

Anthropometric data from the proximal tibia of 226 knees in 226 Turkish subjects were measured using magnetic resonance imaging. We measured the mediolateral, middle anteroposterior, medial and lateral anteroposterior dimensions and the aspect ratio of the resected proximal tibial surface. All morphological data were compared with the dimensions of five contemporary tibial implants, including asymmetric and symmetric design types.

RESULTS

The dimensions of the tibial plateau of Turkish knees demonstrated significant differences according to gender (P < 0.05). Among the different tibial implants reviewed, neither asymmetric nor symmetric designs exhibited a perfect conformity to proximal tibial morphology in size and shape. The vast majority of tibial implants involved in this study tend to overhang anteroposteriorly, and a statistically significant number of women (21 %, P < 0.05) had tibial anteroposterior diameters smaller than the smallest available tibial component.

CONCLUSION

Tibial components designed according to anthropometric measurements of Western populations do not perfectly meet the requirements of Turkish population. These data could provide the basis for designing the optimal and smaller tibial component for this population, especially for women, is required for best fit.

LEVEL OF EVIDENCE

II.

Effect of body mass index on functional outcomes following arthroplasty procedures

AIM: To evaluate the body mass index (BMI) change in arthroplasty patients and its impact on the patients’ functional results.

METHODS: Between October 2010 and May 2013, 606 patients who were operated due to gonarthrosis, coxarthrosis, aseptic loosening of the total knee and hip prosthesis were evaluated prospectively. Patients were operated by three surgeons in three medical centers. Patients who were between 30-90 years of age and who were underwent total knee arthroplasty, total hip arthroplasty, revision knee arthroplasty, or revision hip arthroplasty were included in the study. We excluded the patients who cannot tolerate our standard postoperative rehabilitation program. Additionally, patients who had systemic inflammatory diseases, diabetes mellitus, or endochrinopathies were excluded from the study. The remaining 513 patients comprised our study group. Preoperative functional joint scores, height, weight and BMI of all patients were recorded. We used the Knee Society Score (KSS) for knee and Harris Hip Score (HHS) for hip patients. Postoperative functional scores were measured at 1^st, 6^th and 12^th months and recorded separately at outpatient visits.

RESULTS: The mean age of the patients was 64.7 (range: 30-90) years (207 males/306 females) and the mean follow-up duration was 14.3 (range: 12-26) mo. We found that arthroplasty patients had weight gain and had an increase in BMI at the postoperative 1^st, 6^th and 12^th months. The mean BMI of the patients was 27.7 preoperatively, 27.8 at the postoperative 1^st month, 28.1 at the 6^th month and 28.6 at the 12^th month (P < 0.01). At the last visit, the mean postoperative HHS of the hip arthroplasty patients was 82.2 ± 7.12 (preoperatively, 52.3; 1^st month, 78.2; 6^th month, 81.1; 12^th month, 82.2), and the mean KSS of the knee arthroplasty patients was 79.3 ± 4.31 (preoperatively, 35.8; 1^st month, 75.2; 6^th month, 79.1; 12^th month, 79.3). Worse functional results were noted in the patients who had a BMI increase, however, this correlation was statistically significant only at the postoperative 6^th month (P = 0.03).

CONCLUSION: To prevent the negative functional effects of this weight gain during the postoperative period, arthroplasty patients should be advised for weight control and risky patients should consult with a dietician.