Achilles Tendon Tear Following an Unusual Pattern of Open Pure Ankle Dislocation: A Case Report

We present a rare case of concurrent open Achilles tendon tear and pure subtalar dislocation in a 20-year-old male following a motorcycle accident, highlighting the complexity of managing such unique musculoskeletal injuries. The patient was initially admitted with an open and deformed left ankle, underwent prompt primary debridement, and received immediate medical intervention. Despite unsuccessful attempts to reduce the dislocation through external maneuvers, subsequent radiographic evaluation revealed a subtalar dislocation associated with a 90° rotation of the talus. A direct reduction was achieved in the operating room, uncovering a complete tear of the Achilles tendon and a section of the posterior tibial artery during more intensive debridement. The vascular surgery team repaired the posterior tibial artery, followed by Achilles tendon repair using a Kessler suture technique. Postoperative care involved immobilization and adapted rehabilitation, resulting in the patient regaining full range of motion without complications. To the best of our knowledge, this case represents the first reported open lateral subtalar dislocation associated with an open Achilles tendon tear. The detailed treatment strategies and outcomes offer valuable insights for clinicians facing similar challenges and inspire further research on rare musculoskeletal injuries.

Predicting and factor analysis of rider injury severity in two-wheeled motorcycle and vehicle crash accidents based on an interpretable machine learning framework

OBJECTIVE

As one of the vulnerable road users in accidents, how to improve the two-wheeled motorcyclist's driving safety and reduce accident injury is a public health issue. Accurate identification of the factors influencing the severity of accidents is an important prerequisite for mitigating injury from crashes.

METHODS

Based on a vehicle and a two-wheeled motorcycle crash accident data from the China in-depth accident study database (CIDAS), this study uses the performance evaluation indicators of accuracy, precision, recall, F1-score, AUC, and the ROC curve. The classification and prediction performances of the six machine learning methods on the dataset are compared, and the LightGBM algorithm with the best performance is selected to model the accident injury severity of the motorcyclists. The SHAP method is used to extend the interpretability of the LightGBM model results. Based on the SHAP method, the importance, main effect, and the interaction effect of factors under each accident injury severity are quantitatively analyzed.

RESULTS

The model prediction accuracy is 92.6%, the F1-Score is 92.8%, and the AUC value is 0.986. The importance of factors varies with the accident injury severity of motorcyclists. The kilometers traveled per year by the driver, the throwing distance of the motorcyclist, and the road speed limit are the three most important factors. The motorcyclist is more likely to suffer fatal injuries when the throwing distance is >1,000 cm.

CONCLUSIONS

The prediction model of driver injury severity based on LightGBM algorithm has a good prediction performance. It can be used to analyze the influence factors of injury severity in two-wheeled motorcyclist accident by combining the model with SHAP method. These results could help the traffic management department to take measures to reduce accident injury of motorcyclists.

Motorcycle Accidents are the Strongest Risk Factor for Panfacial Fractures Among Pediatric Patients

Study Design

A retrospective cohort study was conducted using the Kids' Inpatient Database from 2000 to 2014. Subjects were included if they were 18 years and younger and suffered any type of facial fracture.

Objective

The purpose this study was to determine the risk factors for incurring panfacial fractures among the pediatric population.

Methods

The primary predictor variables were a set of heterogenous variables that included patient characteristics, injury characteristics, hospitalization outcomes. The primary outcome variable was panfacial fracture. Logistic regression was used to determine the independent risk factors for panfacial fractures.

Results

Relative to infants and toddlers, teenagers were nearly three times more likely to sustain panfacial fractures (P < .01). Relative to no chronic conditions, patients with one or more chronic conditions were more likely to incur panfacial fractures. Motorcycle accidents were over three times more likely (P < .01) to result in panfacial fractures while car accidents were over two times more likely (P < .01) to result in panfacial fractures. Falls were less likely (OR, .39; P < .01) to result in panfacial fractures.

Conclusions

Motor vehicle accidents was a major risk factor for panfacial fractures. Teenagers are also found to have an increased risk for panfacial fractures relative to infants and toddlers. Each additional chronic condition was a significant risk factor for suffering panfacial fractures relative to not having any chronic condition at all. In contrast, falls independently decreased the risk of incurring a panfacial fractures. Special attention should be given to safety precautions when occupying a motor vehicle.

Testicular Rupture Following Motorcycle Accident

Testicular rupture is a surgical emergency necessitating prompt diagnosis and intervention to prevent irreversible damage. Blunt trauma, including motorcycle collisions, is a common cause of testicular rupture. In the case of multi-trauma, the diagnosis of testicular rupture may be missed in the rush to surgical intervention of more grossly obvious injuries. We present a case of a 24-year-old male who suffered a motorcycle accident and subsequently presented with diffuse abdominal and hip pain. Physical exam and imaging at the emergency department showed multiple pelvic bone fractures, along with a small scrotal injury which was triaged below his pelvic injuries. His pelvic fractures were immediately operated on. Nearly 18 hours after his initial presentation, the patient received a scrotal ultrasound which demonstrated a rupture of the right testicle. Due to this long delay in diagnosis, his urological team opted for non-surgical management and instead employed a more conservative treatment regimen involving pain control, scrotal support, rest, and serial scrotal ultrasounds. This case highlights the importance of timely ultrasound examination for testicular pathology in the setting of multi-trauma and known scrotal injury. Another highlight of this case is the showcase of an uncommon treatment regimen utilizing conservative tactics as opposed to opting for surgical intervention.

Delayed Tension Hemothorax With Nondisplaced Rib Fractures After Blunt Thoracic Trauma

Blunt thoracic trauma often causes rib fractures, hemothorax, and pneumothorax. Although there is no established definition regarding the duration and management of delayed hemothorax, it commonly occurs in a few days and exhibits at least one displaced rib fracture. Moreover, delayed hemothorax rarely develops tension hemothorax. A 58-year-old male who had a motorcycle accident received conservative treatment from his orthopedic doctor. He felt a sudden severe chest pain 19 days after the accident. Contrast-enhanced computed tomography (CT) of the chest revealed multiple left-sided rib fractures without displacement, left pleural effusion, and extravasation near the intercostal space of the seventh rib fracture. After transfer to our hospital and a plain CT scan, which showed a more mediastinal shift toward the right, his condition deteriorated with cardiorespiratory embarrassment, such as restlessness, hypotension, and neck vein distention. We diagnosed him with obstructive shock due to tension hemothorax. Immediate chest drainage ameliorated restlessness and elevated blood pressure. Here, we report an extremely rare and atypical case of delayed tension hemothorax after blunt thoracic trauma without displaced rib fractures.

Match the Metatarsal Heads: A Case of All-Metatarsal Fractures After a Motorcycle Accident

Metatarsal bone fractures are one of the most frequent foot injuries, especially after motor vehicle accidents in children. This case report briefly demonstrated a rare instance of pediatric all-metatarsal fractures of the left foot in an adolescent patient with polytrauma after a motorcycle accident. This case report illustrated the surgical procedure's potential for healing pediatric foot fractures in teenage patients after polytrauma. In the examination of a 16-year-old male patient brought to the emergency department after a motorcycle accident, we detected a right foot third finger proximal phalanx open fracture, right foot fourth finger proximal phalanx fracture, left foot first metatarsal proximal fracture, left foot second, third, fourth, and fifth metatarsal distal fractures, left foot cuboid, and navicular bone fractures. The patient's left foot's metatarsals were all fractured. The posterolateral wall fracture of the patient's right maxilla was also detected. All metatarsals were displaced, the second metatarsal paired with the third, etc., and because of this displacement, the closed reduction was impossible, and even the open reduction was challenging to reach the correct pairs. We performed closed reduction and fixation with Kirschner wire for the left foot's first metatarsal fracture and open reduction and fixation with Kirschner wire for the left foot's second, third, and fourth metatarsal distal fractures. We also performed closed reduction and fixation with Kirschner wire for the right foot third and fourth proximal phalanx fractures. We observed callus formation in the sixth week and removed the patient's K-wires. At eight weeks, the X-ray demonstrated the correct alignment of all metatarsals. The proper alignment of all metatarsals and the full range of motion of all foot and ankle joints were achieved with early surgical intervention, open reduction, and timely rehabilitation. This case also emphasizes the importance of open reduction in such irreducible and heavily displaced cases of multiple fractures as all-metatarsal fractures and contributes to the literature with a specific treatment modality in the case of all-metatarsal fractures lacking in the literature.

Mucormycosis Necrotizing Soft Tissue Infection: A Case Report of Fungal Infection Following a High-Speed Motorcycle Accident

Mucormycosis is a rare fungal infection characterized by rapidly progressing infarction and necrosis of host tissue, frequently resulting in death. It is most well-known for causing a devastating rhinocerebral infection, however, cutaneous mucormycosis has been documented. While this opportunistic infection generally affects immunocompromised individuals or patients with uncontrolled diabetes, mucormycosis can also present following traumatic injuries. Infection following motor vehicle accidents accounts for as little as 3% of traumatic cutaneous mucormycosis cases, however, it can have devastating consequences. In this report, we present a case of a 54-year-old male who acquired cutaneous mucormycosis following a motorcycle accident. The patient was treated for multiple traumatic orthopedic injuries and remained intubated in the ICU for several days due to his critical condition. Shortly after extubation on hospital day five, lower extremity ischemia and necrosis began to develop as a result of poor tissue perfusion. Extensive serial debridements were performed and empiric IV antibiotics were initiated for presumptive bacterial necrotizing soft tissue infection. Necrosis continued to rapidly progress despite intervention, and eventually, care was withdrawn. We provide a discussion of this case to highlight the importance of including rare fungal infections in the differential diagnosis early in the clinical course to mitigate fatal complications.

Traumatic testicular dislocation: A case report and literature review

INTRODUCTION

Traumatic testicular dislocation is an uncommon complication of blunt scrotal injury and is easily overlooked because of the presence of other severe accompanying injuries. In most cases, an operation is needed for the prevention of malignant change or infertility.

PATIENT CONCERNS AND DIAGNOSIS

We report a case of traumatic testicular dislocation with pelvic fracture and internal bleeding in a 27-year-old male with testis rupture after a motorcycle collision.

INTERVENTIONS AND OUTCOMES

He received emergent right radical orchiectomy, and a series of operations for femoral and pelvic fractures were performed after his condition stabilized in the intensive care unit. After 1 month postsurgery, no obvious genitourinary complications were noted.

CONCLUSION

We suggest scrotum examination in all trauma patients, particularly if a pelvic injury is suspected or in case of a high risk of a motorcycle collision, to avoid missing the diagnosis and prevent severe complications.

Prevalence of Motorcycle Accidents and Its Associated Factors Among Road Traffic Accident Patients in Hawassa University Comprehensive Specialized Hospital, 2019

Background

Road traffic damages were amongst the central causes of passing away, hospitalization, disability, and low socioeconomic status. About 1.3 million lethal road traffic damages and 20–50 million nonfatal damages happened consequently of road traffic accidents every year globally. Motorcycles are a small subsection of all motor vehicles significantly over-represented in total motor vehicle accidents and lead to a great rate of deaths and disabilities.

Objective

The study aimed to assess the prevalence of motorcycle accident and associated factors among road traffic accident patients in Hawassa University Comprehensive Specialized Hospital, Hawassa city, Ethiopia in 2019.

Methods and Materials

The health institution/hospital-based retrospective cross-sectional study design was applied and a systematic random sampling technique was implemented to select the sample size of 274 patient’s cards from January 2018 to January 2019. The data were entered and analyzed on SPSS 20.

Results

From 274 patients’ medical records reviewed in the study period, 151 (55.1%) injuries were due to motorcycle accident. In a multiple logistic regression analysis, age, sex, high speed, and types of roads showed significant association with motorcycle accidents.

Conclusion

The prevalence of motorcycle accidents was the main cause of injuries among others, which was 55.1%. Motorcycle accidents occurred mainly in males and in people with the age category of 20–29 years. Age, sex, high speed, and type of road were significantly associated with a motorcycle accident.

Ten-year retrospective study on mandibular fractures in central Taiwan

Objective

To analyse the epidemiology of mandibular fractures and the correlation between combined fractures during a 10-year period in central Taiwan.

Methods

This retrospective study analysed data collected from the medical records of patients that had mandibular fractures between January 2007 and October 2017. Data on age, sex, cause of injury, anatomical site of fracture, treatment and complications were obtained and analysed.

Results

A total of 265 patients who received treatment were included in the study. The mean ± SD age was 30.08 ± 13.47 years (range, 6–70 years) and the 21–30 years age group showed the highest incidence of mandibular fractures. The male-to-female ratio was 1.25:1. Road traffic accidents were the most common cause of fracture (206 of 265; 77.74%). The symphysis and parasymphysis area was the most common fracture site (169 of 420; 39.29%). Single-site fracture represented slightly more than 50% of the total 420 fractures. The most frequent combination of two fractures was an angle fracture combined with a symphysis and parasymphysis fracture (29 of 106 double fracture patients [27.36%]). There was a weak positive association between several combinations of fractures.

Conclusions

A better understanding of the influence of age and sex on the mechanism of injury is of great clinical importance in the assessment and diagnosis of fractures.

An application of the theory of planned behaviour to understand compliance with daytime running headlights law among motorcycle riders

Fatal motorcycle crashes are a persistent problem in Southeast Asia. In many respects, road safety experts have acknowledged conspicuity issue as one of the main causes of such accidents. To mitigate this deficiency, daytime running headlights (DRHs) law has been documented among the widely exercised countermeasures. The present study aimed to explore socio-psychological factors shaping intentions towards use of DRHs among Malaysian motorcyclists, because compliance level with this rule has remained constant since 1996 (80%). For this purpose, a model was constructed through the Theory of Planned Behaviour (TPB) to evaluate factors affecting motorcyclists' intentions towards compliance with DRHs law. A series of statistical analyses were performed to explain the effect of these factors and to predict degree of compliance with this rule. The model applied on a sample of university students (N = 398) demonstrated that the TPB components could significantly predict motorcycle riders' behaviours and degree of compliance with DRHs law. Moreover, it would be of assistance to policy-makers to recognize groups of motorcyclists more likely to cause an increase in traffic accidents. In general, regular educational campaigns were recommended to raise awareness regarding consequences of not using DRHs and also to nurture factors influencing motorcyclists' attitudes towards DRHs.

Impact of Road Traffic Injury to Pediatric Traumatic Brain Injury in Southern Thailand

Background

Motor vehicle is a major transportation in Southern Thailand as the result of road traffic injury and death. Consequently, severe disability and mortality in pediatric traumatic brain injury (TBI) were observed from traffic accident, particularly motorcycle accident. To identify the risk of intracranial injury in children, the association of treatment outcome with various factors including mechanisms of injury, clinical characteristics, and intracranial pathology can be assessed.

Materials and Methods

This was a retrospective study conducted on children, who were younger than 15 years old with TBI and were enrolled from 2004 to 2015. Several clinically relevant issues were reviewed and statistically analyzed.

Results

A total of 948 casualties were enrolled. Compared with falling down, the motorcycle accident was significantly associated with intracranial injury (odds ratio 1.73, 95% confidence interval [CI] 1.08-2.76). Other factors associated with intracranial injury were hemiparesis (odds ratio 5.69, 95% CI 1.44-22.36), positive of basal skull fracture signs (odds ratio 15.66, 95% CI 3.44-71.28), and fixed reaction to light of both pupils (odds ratio 5.74, 95% CI 1.71-19.23). Mortality found in thirty cases (3.2%). Furthermore, the risk of death correlated with motorcycle accident (P = 0.02) and severe head injury (P < 0.001). Neurosurgical intervention was not associated with outcome, but severe head injury, hemorrhagic shock, epidural, and subdural hematoma were impact factors.

Conclusion

The findings demonstrate road traffic injury, especially motorcycle accident leading to brain injury and death. Prevention program is a necessary key to decrease mortality and disability in pediatric TBI.

A Comparison of Patients from Argentina and Germany to Assess Factors Impacting Brachial Plexus and Brain Injury

Background  Traumatic brachial plexus injuries (BPIs) represent a major cause of disability in young patients. The purpose of this study was to compare two populations (from Argentina and Germany) who suffered a traumatic BPI after a motorcycle accident to identify predictors of BPI and brain injury severity.

Methods  Univariate and multivariable intergroup comparisons were conducted, and odds ratios were calculated to assess the associations between the different demographic, morphometric, and trauma-related variables, and the type and severity of patients' injuries. Pearson correlation coefficients were generated to identify statistically significant correlations.

Results  A total of 187 patients were analyzed, 139 from Argentina and 48 from Germany. The two countries differed significantly in age and several morphometric and trauma-related variables. The clinical presentation was also convincingly different in the two countries. The following three variables remained as statistically significant predictors of a complete (vs. partial) BPI: living in Argentina ( p  < 0.001), presenting prior to 2015 ( p  = 0.004), and greater estimated speed at the time of impact ( p  = 0.074). As for BPIs, a disproportionate percentage (85.6%) of more severe brain injuries occurred in Argentinian patients ( p  < 0.001) and among those whose accident involved striking a stationary vertical object.

Conclusions  This study identified several factors that might be considered when planning governmental policies and education initiatives to reduce BPI and brain injuries related to motorcycle use.

Level of evidence  II-2 (evidence obtained from case–control studies).

Derivation and validation of different machine-learning models in mortality prediction of trauma in motorcycle riders: a cross-sectional retrospective study in southern Taiwan

OBJECTIVES

This study aimed to build and test the models of machine learning (ML) to predict the mortality of hospitalised motorcycle riders.

SETTING

The study was conducted in a level-1 trauma centre in southern Taiwan.

PARTICIPANTS

Motorcycle riders who were hospitalised between January 2009 and December 2015 were classified into a training set (n=6306) and test set (n=946). Using the demographic information, injury characteristics and laboratory data of patients, logistic regression (LR), support vector machine (SVM) and decision tree (DT) analyses were performed to determine the mortality of individual motorcycle riders, under different conditions, using all samples or reduced samples, as well as all variables or selected features in the algorithm.

PRIMARY AND SECONDARY OUTCOME MEASURES

The predictive performance of the model was evaluated based on accuracy, sensitivity, specificity and geometric mean, and an analysis of the area under the receiver operating characteristic curves of the two different models was carried out.

RESULTS

In the training set, both LR and SVM had a significantly higher area under the receiver operating characteristic curve (AUC) than DT. No significant difference was observed in the AUC of LR and SVM, regardless of whether all samples or reduced samples and whether all variables or selected features were used. In the test set, the performance of the SVM model for all samples with selected features was better than that of all other models, with an accuracy of 98.73%, sensitivity of 86.96%, specificity of 99.02%, geometric mean of 92.79% and AUC of 0.9517, in mortality prediction.

CONCLUSION

ML can provide a feasible level of accuracy in predicting the mortality of motorcycle riders. Integration of the ML model, particularly the SVM algorithm in the trauma system, may help identify high-risk patients and, therefore, guide appropriate interventions by the clinical staff.

Patterns Associated with Adult Mandibular Fractures in Southern Taiwan-A Cross-Sectional Retrospective Study

Purpose: This study aimed to determine the patterns associated with adult mandibular fractures from a Level-I trauma center in southern Taiwan. Methods: The data of adult trauma patients admitted between 1 January 2009 and 31 December 2014 were retrieved from the Trauma Registry System and retrospectively reviewed. Fracture site and cause of injury were categorized into groups for comparison, and corresponding odds ratios (ORs) and 95% confidence intervals (CIs) were obtained by multivariate logistic regression. Results: Motorcycle accidents were the most common cause of mandibular fractures (76.3%), followed by falls (10.9%), motor vehicle accidents (4.8%), and being struck by/against objects (4.5%). Of the 503 cases of mandibular fractures, the condylar neck and head were the most common sites (32.0%), followed by the parasymphysis (21.7%), symphysis (19.5%), angle and ramus (17.5%), and body (9.3%). The location of mandibular fractures in patients who had motorcycle accidents was similar to that in all patients. Motor vehicle accidents resulted in a significantly higher number of body fractures (OR 3.3, 95% CI 1.24-8.76, p = 0.017) and struck injury in a significantly higher number of angle and ramus fractures (OR 3.9, 95% CI 1.48-10.26, p = 0.006) compared to motorcycle accidents. The helmet-wearing status and body weight were not associated with the location of mandibular fractures in motorcycle accidents. Conclusions: Our study revealed that the anatomic fracture sites of mandible were specifically related to different etiologies. In southern Taiwan, motorcycle accidents accounted for the major cause of mandibular fractures and were associated with the condylar neck and head as the most frequent fracture sites. In contrast, motor vehicle accidents and struck injuries tended to cause more body fracture as well as angle and ramus fracture compared to motorcycle accidents. Furthermore, the status of helmet-wearing and body weight were not associated with the location of mandible fractures caused by motorcycle accidents.

Risky behaviors and helmet use among young adolescent motorcyclists in Southern Thailand

BACKGROUND

In Thailand, road traffic injuries are the leading cause of death for youth ages 15-19 years, with 80% of the injuries and deaths from motorcycle accidents.

OBJECTIVES

To determine the prevalence of child and young adolescent motorcyclists in Hat Yai municipality and their risk behaviors.

METHOD

A cross-sectional study was conducted between June 2011 and March 2012 in which 2,471 students, ages 8 to 18 years, were recruited from 9 primary and secondary schools in Hat Yai municipality. The questionnaire included questions on being a motorcycle rider or passenger, risky behaviors, and helmet use while riding.

RESULTS

Of the total, 1,573 (63.7%) were riders and 898 (36.3%) were pillion passengers. The majority of the riders younger than 15 years rode their motorcycle mainly only in narrow streets for a short trip. Only 30% of the riders wore a helmet every time they rode a motorcycle. About 10% of the participants riding or a passenger on a motorcycle had consumed alcohol at least once before riding their motorcycle. Multiple logistic regression analysis found that motorcycle injuries were significantly associated with speeds greater than 60 km/h, not wearing a helmet while riding, and alcohol consumption before riding (odds ratios 1.63, 1.59, and 3.09, respectively).

CONCLUSION

Nearly two thirds of young adolescents in Hat Yai municipality were motorcycle riders. These young adolescents were at risk of traffic injuries because more than 50% of them had ridden at high speed or not worn a helmet while riding, and some of them had consumed alcohol before riding.

Does law enforcement awareness affect motorcycle helmet use? evidence from urban cities in Thailand

Although helmet use has been compulsory for motorcycle drivers and passengers in Thailand since the enactment of the Helmet Act in 1994, recent surveys show that the prevalence of helmet usage remains low, particularly among passengers. This paper has sought to explore motorcyclists' awareness of helmet law enforcement in Thailand and examine whether it affects their helmet use behaviour. A total of 2,429 drivers and 1,328 passengers in urban cities nationwide were interviewed in 2009, and the data were analysed using a multivariate ordered logit regression technique. About 60% of the drivers and only 28% of the passengers reported that they always wore a motorcycle helmet. Apart from basic demographics (i.e. age and gender) and riding frequency, our analysis reveals that the awareness of helmet law enforcement was among the contributing factors influencing the use of motorcycle helmets in Thailand. Regardless of riding position, the prevalence of helmet use tended to be greater among those frequently observing the police's checkpoints for helmet wearing and those perceiving the high risk of being caught for non-helmet use. However, the use of helmets appeared to be lower among drivers who perceived the checkpoints to take place at the same times and locations, which were likely predicted. For motorcycle passengers, it was found that the low prevalence of helmet use was potentially attributable to the absence of knowledge on the compulsory helmet law for passengers and the perception that the law was not enforced by the police. Thus, if motorcycle helmet use in Thailand is to be increased, considerable efforts need to be given to increasing the perceived risk of apprehension for non-helmet use (e.g. more police presence and random scheduling of enforcement activities), improving the awareness of the existing helmet law for passengers, and ensuring that helmet wearing by passengers is more strictly enforced.

Comparison of standard and nonstandard helmets and variants influencing the choice of helmets: A preliminary report of cross-sectional prospective analysis of 100 cases

Background:

The literature does not offer the rate of protection provided by different types of helmets used, especially as it applies to developing countries. We hypothesize that standard versus nonstandard types of helmets might differ in the rate of complications of head and neck trauma occurring in victims of motorcycle accidents. Here we report the rate of occurrence, the type of injuries and differences thereof in standard and nonstandard helmet bearers, and its relevance to protection from serious injury.

Methods:

The data were gathered from a data set of motorcycle accident victims admitted to the emergency department of Sina Hospital (Teheran/Iran). A cross-sectional study was designed for a 6-month period of time, June to December 2007. Variants analyzed included: demographics, types of helmets used, level of education of the victims (as in: being trained for using helmets and status of holding a valid driving license). The latter variants were evaluated for possibly influencing the outcome of the injured motorcyclists using either kind of helmets.

Results:

Among a total of 576 injured motorcyclists who had head, face, or neck injuries, 432 (75%) were using some kind of helmet. A total of 144 (25%) of the injured patients were admitted to the neurosurgical emergency service. There were 100 patients whose data sheets contained all variables which could be included in the pilot analysis of this cohort.

Discussion:

All 100 subjects were male patients with the age range of 32 ± 11 years. Twenty-five percent were using standard helmets at the time of accident, 43% had no cranio-facio-cervical injury except very mild skin abrasions, and 23% had facial injury, including skin lacerations needing sutures, two nasal bone fractures, and no maxillofacial damage. Among the patients using standard helmets, 44% had head injuries which needed to be taken care of (mostly nonoperatively), while 61% using nonstandard helmets had head trauma (P > 0.05). The other variables did not reach a significant value affecting the use of either standard or nonstandard helmets in prevention of craniofacial damages.

Conclusion:

This pilot analysis (comprising the data from 100 cases of motorcycle accidents) could not demonstrate statistically significant differences in injury patterns of different types of helmets and variants influencing their respective use. However, it can lead the way for further analysis of larger and more comprehensive head trauma databases regarding factors contributing to the issue of head injury.