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Investigation of factors affecting the injury severity of single-vehicle rollover crashes: A random-effects generalized ordered probit model

Anarkooli AJ, Hosseinpour M, Kardar A

Accid Anal Prev, 2017 Sep;106:399-410.
PMID: 28728062 DOI: 10.1016/j.aap.2017.07.008

Rollover crashes are responsible for a notable number of serious injuries and fatalities; hence, they are of great concern to transportation officials and safety researchers. However, only few published studies have analyzed the factors associated with severity outcomes of rollover crashes. This research has two objectives. The first objective is to investigate the effects of various factors, of which some have been rarely reported in the existing studies, on the injury severities of single-vehicle (SV) rollover crashes based on six-year crash data collected on the Malaysian federal roads. A random-effects generalized ordered probit (REGOP) model is employed in this study to analyze injury severity patterns caused by rollover crashes. The second objective is to examine the performance of the proposed approach, REGOP, for modeling rollover injury severity outcomes. To this end, a mixed logit (MXL) model is also fitted in this study because of its popularity in injury severity modeling. Regarding the effects of the explanatory variables on the injury severity of rollover crashes, the results reveal that factors including dark without supplemental lighting, rainy weather condition, light truck vehicles (e.g., sport utility vehicles, vans), heavy vehicles (e.g., bus, truck), improper overtaking, vehicle age, traffic volume and composition, number of travel lanes, speed limit, undulating terrain, presence of central median, and unsafe roadside conditions are positively associated with more severe SV rollover crashes. On the other hand, unpaved shoulder width, area type, driver occupation, and number of access points are found as the significant variables decreasing the probability of being killed or severely injured (i.e., KSI) in rollover crashes. Land use and side friction are significant and positively associated only with slight injury category. These findings provide valuable insights into the causes and factors affecting the injury severity patterns of rollover crashes, and thus can help develop effective countermeasures to reduce the severity of rollover crashes. The model comparison results show that the REGOP model is found to outperform the MXL model in terms of goodness-of-fit measures, and also is significantly superior to other extensions of ordered probit models, including generalized ordered probit and random-effects ordered probit (REOP) models. As a result, this research introduces REGOP as a promising tool for future research focusing on crash injury severity.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data*
Fulltext Fatal motorcycle crashes: a growing public health problem in Cambodia

Roehler DR, Ear C, Parker EM, Sem P, Ballesteros MF

Int J Inj Contr Saf Promot, 2015;22(2):165-71.
PMID: 24499413 DOI: 10.1080/17457300.2013.876050

This study examines the risk characteristics of fatal motorcycle crashes in Cambodia over a 5-year period (2007-2011). Secondary data analyses were conducted using the Cambodia Road Crash and Victim Information System, the only comprehensive and integrated road crash surveillance system in the country. Researchers from the Centers for Disease Control and Prevention and Handicap International found that (1) males are dying in motorcycle crashes roughly seven times more frequently than females; (2) motorcyclist fatalities increased by about 30% from 2007 to 2011; (3) the motorcyclist death rates per 100,000 population increased from 7.4 to 8.7 deaths from 2007 to 2011; and (4) speed-related crashes and not wearing motorcycle helmet were commonly reported for motorcyclist fatalities at approximately 50% and over 80% through the study years, respectively. Additionally, this study highlights that Cambodia has the highest motorcycle death rate in South-East Asia, far surpassing Thailand, Malaysia, and Myanmar. By recognising the patterns of fatal motorcycle crashes in Cambodia, local road-safety champions and stakeholders can design targeted interventions and preventative measures to improve road safety among motorcyclists.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data
Factors related to seatbelt-wearing among rear-seat passengers in Malaysia

Ng CP, Law TH, Wong SV, Kulanthayan S

Accid Anal Prev, 2013 Jan;50:351-60.
PMID: 22633252 DOI: 10.1016/j.aap.2012.05.004

The benefit of wearing a rear seatbelt in reducing the risk of motor vehicle crash-related fatalities and injuries has been well documented in previous studies. Wearing a seatbelt not only reduces the risk of injury to rear-seat passengers, but also reduces the risk of injury to front-seat occupant who could be crushed by unbelted rear-seat passengers in a motor vehicle crash. Despite the benefits of wearing a rear seatbelt, its rate of use in Malaysia is generally low. The objective of this study was to identify factors that are associated with the wearing of a seatbelt among rear-seat passengers in Malaysia. Multinomial logistic regression analysis of the results of a questionnaire survey of 1651 rear-seat passengers revealed that rear-seat passengers who were younger, male, single and less educated and who had a perception of a low level of legislation enforcement, a lower risk-aversion and less driving experience (only for passengers who are also drivers) were less likely to wear a rear seatbelt. There was also a significant positive correlation between driver seatbelt and rear seatbelt-wearing behaviour. This implies that, in regards to seatbelt-wearing behaviour, drivers are more likely to adopt the same seatbelt-wearing behaviour when travelling as rear-seat passengers as they do when driving. These findings are crucial to the development of new interventions to increase the compliance rate of wearing a rear seatbelt.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data*
Prevalence and determinants of non-standard motorcycle safety helmets amongst food delivery workers in Selangor and Kuala Lumpur

Kulanthayan S, See LG, Kaviyarasu Y, Nor Afiah MZ

Injury, 2012 May;43(5):653-9.
PMID: 21764054 DOI: 10.1016/j.injury.2011.06.197

BACKGROUND: Almost half of the global traffic crashes involve vulnerable groups such as pedestrian, cyclists and two-wheeler users. The main objective of this study was to determine the factors that influence standard of the safety helmets used amongst food delivery workers by presence of Standard and Industrial Research Institute of Malaysia (SIRIM) certification label.
METHODS: A cross sectional study was conducted amongst 150 food delivery workers from fast food outlets in the vicinity of Selangor and Kuala Lumpur. During observation, safety helmets were classified as standard safety helmet in the presence of SIRIM label and non-standard in the absence of the label. They were approached for questionnaire participation once consent was obtained and were requested to exchange their safety helmet voluntarily with a new one after the interview. Data analysis was carried out using SPSS. Chi square and logistic regression analysis was applied to determine the significance and odds ratio of the variables studied, respectively (penetration test, age, education level, knowledge, crash history, types of safety helmet, marital status and years of riding experience) against the presence of SIRIM label.
RESULTS: The response rate for this study was 85.2%. The prevalence of non-standard helmets use amongst fast food delivery workers was 55.3%. Safety helmets that failed the penetration test had higher odds of being non-standard helmets compared with safety helmets passing the test. Types of safety helmet indicated half-shell safety helmets had higher odds to be non-standard safety helmets compared to full-shell safety helmets. Riders with more years of riding experience were in high odds of wearing non-standard safety helmets compared to riders with less riding experience.
CONCLUSION: Non-standard (non-SIRIM approved) helmets were more likely to be half-shell helmets, were more likely to fail the standards penetration test, and were more likely to be worn by older, more experienced riders. The implications of these findings are discussed.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data*
Fatigue-related crashes involving express buses in Malaysia: will the proposed policy of banning the early-hour operation reduce fatigue-related crashes and benefit overall road safety?

Mohamed N, Mohd-Yusoff MF, Othman I, Zulkipli ZH, Osman MR, Voon WS

Accid Anal Prev, 2012 Mar;45 Suppl:45-9.
PMID: 22239931 DOI: 10.1016/j.aap.2011.09.025

Fatigue-related crashes have long been the topic of discussion and study worldwide. The relationship between fatigue-related crashes and time of day is well documented. In Malaysia, the possibility of banning express buses from operating during the early-hours of the morning has emerged as an important consideration for passenger safety. This paper highlights the findings of an impact assessment study. The study was conducted to determine all possible impacts prior to the government making any decision on the proposed banning. This study is an example of a simple and inexpensive approach that may influence future policy-making process. The impact assessment comprised two major steps. The first step involved profiling existing operation scenarios, gathering information on crashes involving public express buses and stakeholders' views. The second step involved a qualitative impact assessment analysis using all information gathered during the profiling stage to describe the possible impacts. Based on the assessment, the move to ban early-hour operations could possibly result in further negative impacts on the overall road safety agenda. These negative impacts may occur if the fundamental issues, such as driving and working hours, and the need for rest and sleep facilities for drivers, are not addressed. In addition, a safer and more accessible public transportation system as an alternative for those who choose to travel at night would be required. The proposed banning of early-hour operations is also not a feasible solution for sustainability of express bus operations in Malaysia, especially for those operating long journeys. The paper concludes by highlighting the need to design a more holistic approach for preventing fatigue-related crashes involving express buses in Malaysia.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data
Exploring the economics of motorcycle helmet laws--implications for low and middle-income countries

Hyder AA, Waters H, Phillips T, Rehwinkel J

Asia Pac J Public Health, 2007;19(2):16-22.
PMID: 18050559

This paper reviews economic evaluations of motorcycle helmet interventions in preventing injuries. A comprehensive literature review focusing on the effectiveness of motorcycle helmet use, and on mandatory helmet laws and their enforcement was done. When helmet laws were lifted between 1976-80, 48 states within the U.S.A. experienced a cost of $342,047 per excess fatality of annual net savings. Helmet laws in the USA had a benefit-cost ratio of 1.33 to 5.07. Taiwan witnessed a 14% decline in motorcycle fatalities and a 22% reduction of head injury fatalities with the introduction of a helmet law. In Thailand, where 70-90% of all crashes involve motorcycle, after enforcement of a helmet law, helmet-use increased five-fold, the number of injured motorcyclists decreased by 33.5%, head injuries decreased by 41.4%, and deaths decreased by 20.8%. There is considerable evidence that mandatory helmet laws with enforcement alleviate the burden of traffic injuries greatly. For low and middle-income countries with high rates of motorcycle injuries, enforced, mandatory motorcycle helmet laws are potentially one of the most cost-effective interventions available.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data*
Fulltext Mechanisms of cervical spine injuries for non-fatal motorcycle road crash

Ooi SS, Wong SV, Radin Umar RS, Azhar AA, Yeap JS, Megat Ahmad MMH

Med J Malaysia, 2004 Jun;59(2):146-52.
PMID: 15559162 MyJurnal

Cervical spine injuries such as subluxation and fracture dislocation have long been known to result in severe consequences, as well as the trauma management itself. The injury to the region has been identified as one of the major causes of death in Malaysian motorcyclists involved in road crashes, besides head and chest injuries (Pang, 1999). Despite this, cervical spine injury in motorcyclists is not a well-studied injury, unlike the whiplash injury in motorcar accidents. The present study is a retrospective study on the mechanisms of injury in cervical spine sustained by Malaysian motorcyclists, who were involved in road crash using an established mechanistic classification system. This will serve as an initial step to look at the cervical injuries pattern. The information obtained gives engineer ideas to facilitate design and safety features to reduce injuries. All cervical spine injured motorcyclists admitted to Hospital Kuala Lumpur between January 1, 2000 and December 31, 2001 were included in the present study. Based on the medical notes and radiological investigations (X-rays, CT and MRI scans), the mechanisms of injuries were formulated using the injury mechanics classification. The result shows that flexion of the cervical vertebrae is the most common vertebral kinematics in causing injury to motorcyclists. This indicates that the cervical vertebrae sustained a high-energy loading at flexion movement in road crash, and exceeded its tolerance level. The high frequency of injury at the C5 vertebra, C6 vertebra and C5-C6 intervertebral space are recorded. Classification based on the Abbreviated Injury Scale (AIS) is made to give a view on injury severity, 9.1% of the study samples have been classified as AIS code 1, 51.5% with AIS 2 and 21.2% with AIS 3.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data*
Fulltext The epidemiology of shoulder dislocations in Malaysia

Yeap JS, Lee DJK, Fazir M, Borhan TAM, Kareem BA

Med J Malaysia, 2004 Dec;59 Suppl F:19-23.
PMID: 15941156 MyJurnal

The case notes of 102 patients (117 shoulder dislocations) were reviewed retrospectively to improve the understanding of the epidemiology of this common injury. Eighty-one dislocations were primary and 36 dislocations were second or recurrent dislocations. The age distribution was characterized by a peak in male patients aged between 21-30 years. The mean age for males was 30.5 years and 47.7 years for females. The male:female ratio in first time dislocations was 5:2, while it was 5:1 in recurrent dislocations. Ninety-eight percent were anterior dislocations and 2% were posterior dislocations. Greater tuberosity fractures were found in 17 patients and almost half of these patients were aged between 41-50 years. The most common cause of first time dislocation was a direct blow or fall onto the shoulder, accounting for 42 patients (55%). The majority of these patients were aged 40 years and above. Next common cause was motor vehicle accident which occurred mostly in the younger age group. Dislocations due to sporting injuries accounted for only 5.3% of all first time dislocations. Nearly 97% were successfully reduced without a general anaesthesia. Seventy-seven percent of the patients had their shoulders immobilized after reduction, mostly with body strapping only. Fifteen patients (14.7%) were referred for physiotherapy for stiffness. Few operations were performed for recurrent dislocations but surgery does not appear to be well accepted as yet by our patients.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data
Fulltext The epidemiology of childhood brain injury in the state of Selangor and Federal Territory of Kuala Lumpur, Malaysia

Tay EL, Lee SWH, Jamaluddin SF, Tam CL, Wong CP

BMC Pediatr, 2016 04 27;16:56.
PMID: 27122016 DOI: 10.1186/s12887-016-0590-1

BACKGROUND: There are limited studies describing the epidemiology of childhood brain injury, especially in developing countries. This study analyses data from the Malaysian National Trauma Database (NTrD) registry to estimate the incidence of childhood brain injury among various demographic groups within the state of Selangor and Federal Territory of Kuala Lumpur.
METHODS: This study analysed all traumatic brain injury cases for children ages 0-19 included in the 2010 NTrD report.
RESULTS: A total of 5,836 paediatric patients were admitted to emergency departments (ED) of reporting hospitals for trauma. Of these, 742 patients (12.7 %) suffered from brain injuries. Among those with brain injuries, the mortality rate was 11.9 and 71.2 % were aged between 15 and 19. Traffic accidents were the most common mode of injury (95.4 %). Out of the total for traffic accidents, 80.2 % of brain injuries were incurred in motorcycle accidents. Severity of injury was higher among males and patients who were transferred or referred to the reporting centres from other clinics. Glasgow Coma Scale (GCS) total score and type of admission were found to be statistically significant, χ (2) (5, N = 178) = 66.53, p traffic, specifically motorcycle-related, accidents being the main mode of injury. These findings point to risk factors that could be targeted for future injury prevention programs.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data
Pediatric craniomaxillofacial injuries after road traffic crashes: characteristics of injuries and protective equipment use

Yunus SS, Ngeow WC, Ramli R

Am J Emerg Med, 2015 Sep;33(9):1253-7.
PMID: 26026365 DOI: 10.1016/j.ajem.2015.05.009

A cross-sectional study to determine the pattern of craniomaxillofacial (CMF) injuries among children involved in road traffic crashes was performed. The association of protective equipment use with the CMF injuries was evaluated.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data*
Fulltext A profile of injuries in four villages in the Jasin District of Malacca, Malaysia

Htay Moe

Asia Pac J Public Health, 2002;14(2):118-22.
PMID: 12862417

Injuries are a major public health problem in Malaysia. A cross-sectional study on the profile of injuries was conducted in four villages in the Jasin District of Malacca using a prepared questionnaire among the residents. A sample of 199 households was selected from the total of 385 by using the simple random method and personal interviews were carried out. Injuries were common (56%) among the family members within the period of one year prior to the survey. Home and residential injuries were the most common type (60.2%) followed by road traffic injuries and injuries at work place. Among the home injuries (68 cases), falls were the most common type of injuries encountered with most occurring in the evenings within the house compounds. For all types of injuries (113 cases), the majority (46.9%) preferred to seek treatment at government clinics and hospitals. Among the road injuries (29 cases), most occurred in the evenings and at nights. They were more severe in nature and some required admission to the hospital. The extremities were the most severe injuries among the home and road ones. Preventive strategies should be targeted towards the home and road injuries by environmental and behavioural changes together with community participation on injury prevention and control at district level.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data
Matching of police and hospital road crash casualty records - a data-linkage study in Malaysia

Kamaluddin NA, Abd Rahman MF, Várhelyi A

Int J Inj Contr Saf Promot, 2019 Mar;26(1):52-59.
PMID: 29806792 DOI: 10.1080/17457300.2018.1476385

Underreporting of road crashes hampers the development of appropriate road safety countermeasures in many countries. In this study, police and hospital records from road crash casualties in the Melaka Tengah district in Malaysia from 2014 were collected to determine their matching and reporting rates. Based on authentic personal identifiers from both types of records, Microsoft SQL was used to reveal how the matching rate varies due to multiple factors. The results showed that 311 cases (of 7625 hospital records) could be linked to both databases, yielding a 4.1% matching rate and a 4.7% police reporting rate. Both the reporting and matching rates increased with the level of injury severity. The significant underreporting in the police database showed that complementary data are necessary for enhancing the current official crash data records.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data*
Fulltext Buckling up in Singapore: residency and other risk factors for seatbelt non-compliance - a cross-sectional study based on trauma registry data

Wong TH, Lim GH, Chow KY, Trauma Coordinators and Trauma Service Representatives, Zaw NN, Nguyen HV, et al.

BMC Public Health, 2016 05 14;16:402.
PMID: 27180046 DOI: 10.1186/s12889-016-3080-3

BACKGROUND: Seatbelt non-compliance is a problem in middle income countries, and little is known about seatbelt compliance in populations with a high proportion of non-residents. This study analyses the profile of seatbelt non-compliance in Singapore based on trauma registry data from five of the six public hospitals.
METHODS: This is a cross-sectional study of seatbelt compliance of patients aged over 18 years, attending the emergency departments of five public hospitals in Singapore after road collisions from 2011-2014. Seatbelt data was obtained from paramedic and patient history.
RESULTS: There were 4,576 patients studied. Most were Singapore citizens (83.4 %) or permanent residents (2.4 %), with the largest non-resident groups from Malaysia, India, and China. Overall seatbelt compliance was 82.1 %. On univariate analysis, seatbelt compliance was higher in older patients (OR 1.02, 95 % CI 1.001-1.021, p

Matched MeSH terms: Accidents, Traffic/statistics & numerical data*
Motorcycle-related spinal injury: crash characteristics

Zulkipli ZH, Abdul Rahmat AM, Mohd Faudzi SA, Paiman NF, Wong SV, Hassan A

Accid Anal Prev, 2012 Nov;49:237-44.
PMID: 23036400 DOI: 10.1016/j.aap.2011.12.011

This study presents an analysis of crash characteristics of motorcyclists who sustained spinal injuries in motorcycle crashes. The aim of the study is to identify the salient crash characteristics that would help explain spinal injury risks for motorcyclists. Data were retrospectively collected from police case reports that were archived at MIROS from year 2005 to 2007. The data were categorized into two subcategories; the first group was motorcycle crashes with spinal injury (case) and the second group was motorcycle crashes without spinal injury (control). A total of 363 motorcyclists with spinal injury and 873 motorcyclists without spinal injury were identified and analyzed. Descriptive analysis and multivariate analysis were performed in order to determine the odds of each characteristic in contributing to spinal injury. Single vehicle crash, collision with fixed objects and crash configuration were found to have significant influence on motorcyclists in sustaining spinal injury (p<0.05). Although relatively few than other impact configurations, the rear-end impacted motorcyclist shows the highest risk of spinal injury. Helmets have helped to reduce head injury but they did not seem to offer corresponding protection for the spine in the study. With a growing number of young motorcyclists, further efforts are needed to find effective measures to help reduce the crash incidents and severity of spinal injury. In sum, the study provides some insights on some vital crash characteristics associated with spinal injury that can be further investigated to determine the appropriate counter-measures and prevention strategies to reduce spinal injury.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data*
Motorcycle accident is the main cause of maxillofacial injuries in the Penang Mainland, Malaysia

Hashim H, Iqbal S

Dent Traumatol, 2011 Feb;27(1):19-22.
PMID: 21244625 DOI: 10.1111/j.1600-9657.2010.00958.x

Maxillofacial injuries are among the commonest forms of body injuries. There are three divisions, namely, facial bone fractures, soft tissue injuries, and dentoalveolar injuries. Etiologies include motor vehicle accidents, assaults, falls, and sporting injuries. The aim of this study was to determine the profiles including the causes of maxillofacial injuries seen in an urban government hospital in the mainland of Penang State, Malaysia.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data*
A prospective study on elderly patients with facial fractures in a developing country

Royan SJ, Hamid AL, Kovilpillai FJ, Junid NZ, Mustafa WM

Gerodontology, 2008 Jun;25(2):124-8.
PMID: 18485141 DOI: 10.1111/j.1741-2358.2007.00189.x

This paper describes the incidence, aetiology, treatment and complications of facial fractures seen among the elderly in a developing country.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data
Pattern of maxillofacial injuries in motorcyclists in Malaysia

Ramli R, Abdul Rahman R, Abdul Rahman N, Abdul Karim F, Krsna Rajandram R, Mohamad MS, et al.

J Craniofac Surg, 2008 Mar;19(2):316-21.
PMID: 18362705 DOI: 10.1097/SCS.0b013e318163f94d

Motorcycle casualties represent significant number in road traffic accidents in Malaysia, and among all the injuries, facial injuries pose many significant problems physiologically, functionally, and aesthetically. The aim of this study was to analyze the pattern of maxillofacial as well as other injuries in motorcyclists who were seen at Hospital Universiti Kebangsaan Malaysia.Patients' records from January 2004 to December 2005 were reviewed. Data related to demographics, vehicle/object involved in collision, involvement as a rider or pillion, whether a helmet was worn or not, location of injuries on the face/facial bones, and other associated injuries were collected.A total of 113 cases of motorcycle accidents were recorded; 106 males and 7 females were involved. Mean age was 25.8 years. Among all the races, Malay had the highest involvement (72.3%), followed by Chinese (14.3%), Indians (8.9%), and others (5.4%). The types of collision were either a single-vehicle collision (i.e., skidded) or with another vehicle/s or object (e.g., tree, stone, or lamppost). The injuries were mainly seen on the lower face (46.9%) followed by midface (25.7%) and a combination of the midface and lower face (15%) and others (12.4%). The most frequent other associated injuries recorded were orthopedic and head injuries.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data*
Maxillofacial trauma of pediatric patients in Malaysia: a retrospective study from 1999 to 2001 in three hospitals

Rahman RA, Ramli R, Rahman NA, Hussaini HM, Idrus SM, Hamid AL

Int J Pediatr Otorhinolaryngol, 2007 Jun;71(6):929-36.
PMID: 17442408

Maxillofacial trauma in children is not common worldwide. Domestic injuries are frequently seen in younger children while older children are mostly involved in motor vehicle accidents (MVA). The objective of this study was to analyze the pattern of maxillofacial injuries in pediatric patients referred to three government main hospitals in different areas of West Malaysia.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data
Maxillofacial trauma with emphasis on soft-tissue injuries in Malaysia

Hussaini HM, Rahman NA, Rahman RA, Nor GM, Ai Idrus SM, Ramli R

Int J Oral Maxillofac Surg, 2007 Sep;36(9):797-801.
PMID: 17630250

Soft-tissue injuries with or without facial bone involvement are the most common presentation following maxillofacial trauma. The objective of this study was to look at the distribution, pattern and type of soft-tissue injury in relation to aetiology. Records of patients over a period of 5 years (1998-2002), who sustained maxillofacial injuries and were treated at Kajang Hospital, a secondary referral hospital, were reviewed. Out of 313 patients with maxillofacial injuries, 295 patients sustained soft-tissue injuries. Males (79%) between 21 and 30 years old (34%) were the majority of patients. Road-traffic accident was the main cause of soft-tissue injuries (75%) with motorcycle accident being the most frequent (40%). The upper lips (23%) and the lower lips (18%) were the most common extraoral site involved, while the labial mucosa and sulcular areas, both accounting for 21%, were the most common intraoral sites. Stringent road-traffic regulations should be practiced in developing countries, as morbidity arising from road-traffic accidents poses a national economic and social problem.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data
Fulltext The pattern of femoral diaphyseal fractures in children admitted in Sarawak General Hospital

Rasit AH, Mohammad AW, Pan KL

Med J Malaysia, 2006 Feb;61 Suppl A:79-82.
PMID: 17042236

Trend towards changing the face of management for pediatric femoral fractures tends to advocate operative treatment. This study was undertaken to review our current practice in the wake of recent progress in the management of pediatric femoral fractures. Fifty patients with femoral diaphyseal fracture treated in Sarawak General Hospital were reviewed retrospectively after an average follow-up of 2.6 years. There were 36 boys and 14 girls, with a mean age of 6.2 years (range five months to 14 years). Children under six years of age constituted the majority of the patients. Half of the fractures were caused by road traffic accident. Nine patients had associated injuries. The most common site of fracture was at the middle third (N=31). The treatment regimens were delayed hip spica (DHS) in 16, immediate hip spica (IHS) in 24, plate osteosynthesis (PO) in five, titanium elastic nailing (TEN) in five, and external fixation (EF) in one. The minimum hospital stay was two days, and the maximum 33 days (mean, 9.7 days). Malunion was the commonest complication. Conservative treatment is the preferred option for children under six years of age. It is cost-effective with minimal complication. The other treatment options are reserved for specific indication in older children. Diaphyseal fractures of the femur in children can be adequately managed non-operatively.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data

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