The Pattern of Fractures in Road Traffic Crashes: Findings From the National Trauma Registry in Iran

Abstract

Background: Fractures constitute a significant concern in low-income and middle-income countries, primarily due to road traffic crashes (RTCs), a leading cause of such injuries. This study aimed to analyze fracture patterns resulting from RTCs in Iran. Study Design: A cross-sectional study. Methods: A registry-based study was conducted using data from the National Trauma Registry of Iran spanning 2016-2023. The study included 10,114 trauma patients involved in RTCs, encompassing car and motorcycle crashes with at least one fracture. International Classification of Diseases (ICD-10) codes were used for data analysis, considering both orthopedic and non-orthopedic admissions related to RTCs. Fracture incidence was compared among pedestrians, drivers/riders, and passengers/pillions. Results: Males constituted a significant majority of the car (90.1 drivers, 72.1 pedestrians, and 47.0 passengers) and motorcycle (99.6 riders, 77.0 pedestrians, and 65.3 pillions) crashes (P < 0.001). Patients under 18 comprised 18.4 of the motorcycle riders and 2.5 of the car drivers. Drivers showed the highest frequency of head injuries (26.9, P< 0.010), while pedestrians had the highest frequency of upper extremity injuries (73.1, P< 0.001). Drivers also demonstrated a higher frequency of vertebral fractures than passengers (C3-C7: 3.2 vs. 1.4, P = 0.006). Riders (33.5) displayed a higher frequency of head and face fractures compared to pillions (24.8) and pedestrians (17.4) (Head: pedestrian vs. rider, P < 0.001; pedestrian vs. pillion, P = 0.018; rider vs. pillion, P = 0.005; Face: pedestrian vs. rider, P < 0.001; pedestrian vs. pillion, P < 0.001; rider vs. pillion, P = 0.033). Conclusion: The study provided valuable information on the fracture patterns associated with RTCs among road user groups.