Resumé
Background: Walking is the most basic form of mobility and forms an important part of daily activities; however, walking could often be associated with risks. This is more so when pedestrians share a common space with motorized vehicles especially in developing countries. Despite the frequency of road traffic crashes (RTC) related pedestrian injuries in many developing countries, there is a dearth of documentation of maxillofacial injuries in victims of pedestrian road traffic crashes. The aim of this study was to determine the causes, frequency, pattern, severity, concomitant injuries and outcome of pedestrian maxillofacial injuries observed at a tertiary trauma centre in Nigeria.
Method: Pedestrian victims of RTC were prospectively recruited from among all maxillofacial trauma patients seen at the Accident and Emergency department and the Department of Oral and Maxillofacial Surgery of the University College Hospital, Ibadan between April 2011 and November 2011. Ethical approval was obtained from the UI/UCH Joint Ethics Review Board before the commencement of the study and informed consent was obtained from participants. Patients’ demography, the crash events, types of maxillofacial injuries, and concomitant injuries were recorded. Severity of maxillofacial injury was estimated based on the Maxillofacial Injury Severity Scale (MFISS).
Results: Forty-six participants (22.9% of all victims of road traffic crashes seen within the study period) were victims of pedestrian RTC. Pedestrian RTC occurred in all age groups with almost 40% of the victims in their 1 st and 2nd decades of life. The most severe MFISS was observed in the 21 – 30 year age group while the least severe injury observed was in the 71 – 80 years age group. Thirty participants (65.2%) were hit by a car or minibus while fourteen (30.4%) were knocked down by a motorcycle. Two (4.4%) were hit by a truck. Soft tissue injury was the most common maxillofacial injury and head injury was the commonest concomitant injury observed. The median MFISS score of victims of motorcycle was 4.0 while the median scores for victims of car/minibus pedestrian RTC was 9.0. The most severe maxillofacial injury was seen in victim of car/minibus pedestrian crashes. Seventeen percent (8) of the victims had a fatal outcome.
Conclusion: Pedestrian RTC resulting in maxillofacial injuries are common in the studied environment. It is particularly common among the 11 -20 year age group and victims are usually hit by cars/minibuses. These injuries are often severe and fatal outcome is not infrequent. Therefore, definitive preventive measures are imperative.
Keywords: Road traffic crashes (RTC), pedestrians, maxillofacial injuries, severity.
Résumé
Contexte: La marche est la forme la plus élémentaire de mobilité et constitue une partie importante des activités quotidiennes; cependant, la marche pourrait souvent être associée à des risques. Ceci est d’autant plus lorsque les piétons partagent un espace commun avec des véhicules automatisés en particulier dans les pays en voie de développement. Malgré la fréquence des blessures
liées aux accidents de la circulation routière (ACR) parmi les piétons dans de nombreux pays en voie de développement, il ya un manque de documentation des blessures maxillo-faciale chez les piétons victimes des mésaventures routières. Le but de cette étude était de déterminer les causes, fréquence, motif, gravité des blessures concomitantes et les résultats des lésions maxillo-faciales parmi les piétons observées dans un centre de traumatologie tertiaire au Nigeria.
Méthode: Les piétons, victimes d’ACR, ont été prospectivement recrutés parmi tous les patients victimes du traumatisme maxillofacial vu au département d’Accident du d’Urgence et au département de Chirurgie Buccale et Maxillo-faciale du au Collège Hospitalier Universitaire, Ibadan Avril 2011 et Novembre 2011. La ratification éthique a été obtenue du Comité d’éthique commun
UI/UCH avant le début de l’étude et le consentement informé a été obtenu des participants. La démographie des patients, les événements d’accident, les types de blessures maxillo-faciales et les blessures concomitantes ont été enregistrés. La gravité des blessures maxillo-faciale a été estimée sur la base de l’échelle de sévérité de blessure maxillo-faciale (MFISS).
Résultats: Quarante-six participants (22,9% de toutes les victimes d’accidents de la circulation routière vus pendant la période de l’étude) ont été victimes d’ACR des piétons. L’ACR parmi les Piéton s’est produit dans tous les groupes d’âge avec près de 40% des victimes dans leur 1ère et 2ème décennies de vie. Le plus sévère MFISS a été observé dans le groupe d’âge de 21 -30 ans tandis que le moins sévère a été la dans le groupe d’âge de 71 -80 ans. Trente participants (65,2%) ont été cognés par une voiture ou un minibus tandis que quatorze (30,4%) ont été renversés par une moto. Deux (4,4%) ont été cognés par un camion. Les blessures de tissusdouces étaient les blessures maxillo-faciales les plus fréquentes etle traumatisme crânien a été la blessure concomitante fréquente observée. Le score médian de MFISS des victimes de la moto était de 4,0 tandis que les scores médians pour les piétons victimes d’ACR par la voiture / minibus était de 9,0. La blessure la plus grave maxillo-faciale a été vu dans les piétons victime de collisions avec voiture / minibus. Dix-sept pour cent (8) des victimes avaient une issue fatale.
Conclusion: L’ACR parmi les piétons entraînant des blessures maxillo-faciales sont fréquentes dans l’environnement étudié. Il est particulièrement fréquent chez le groupe d’âge 11 -20 ans et les victimes sont habituellement cognés par des voitures / minibus. Ces blessures sont souvent graves et le décès n’est pas rare. Par conséquent, des mesures définitives préventives sont impératives.
Mots-clés: accidents de la circulation routière (ACR), piétons, blessures maxillo-faciale, sévérité.
This paper was presented in part at the 21st International Congress on Oral and Maxillofacial Surgery, Barcelona, Spain in October
2013.
Correspondence: Dr. T.O. Aladelusi, Department of Oral and Maxillofacial Surgery, College of Medicine, University of Ibadan, Nigeria. E-mail: t.aladelusi@ui.edu.ng, drtimmylee@gmail.com
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