An Analysis of Orthopedic Injury Profiles of Pedestrian-Motor Vehicle in District Hospital

Abstract

Background: Until now, traffic injuries are the third leading cause of death in Thailand.  Orthopedic condition is the common problem (78%) of these patients.  Accurate data are needed to evaluate the severity of trauma patients, therapeutic management and referral system in individual district hospital of universal health care policy (30 bath policy).

Purpose: To reviews the patient demographics, severity of injury and orthopedic injuries profiles of trauma patients in responsible area of Wisetchaichan hospital.

Study design: Descriptive study

Setting: Wisetchaichan Hospital, Uang-tong, Thailand

Patients and Methods: Between January 2003 and December 2004, 1,268 patients were designated as a trauma patient in emergency department of Wisetchaichan hospital.  We collected data on all patients, by medical records and trauma registry reviews, retrospectively after discharge.  Data from the patients who had the orthopedic injuries were analyzed especially in management and referral aspects.

Results: The average age of the patients was 28±17.4 years (range, 2 to 87 years).  There were 584 male and 292 female patients.  The most common cause of traffic injury was motorcycle accident (75%), include spontaneously occur and crush with the others.  The other causes were car accident (7.5%) and bicycle accident (5.5%).  Eighty-nine of 876 patients (10.2%) had significant orthopedic conditions.  Twenty-seven of ninety were justified as an inappropriate management.  Ten cases were admitted without a strong indication.  Seventeen received unnecessary refer to the other hospital.

Discussion and Conclusion: In conclusion, significant orthopedic conditions were only 10.2% of all traffic injuries, but there were high referral rate.  The balance between the mal-practice and unnecessary refer should be concerned for all physicians.

Key words: orthopedic injury; trauma; profiles