Mahgol Sadat Hassan Zadeh Tabatabaei
1 
, Mohammad Soleimani
2, Seyyed Hossein Shafiei
2, Mohammadreza Zafarghandi
1, Vafa Rahimi-Movaghar
1, Vali Baigi
1, Esmaeil Fakharian
3, Seyed Houssein Saeed-Banadaky
4, Vahid Hoseinpour
5, Homayoun Sadeghi-Bazargani
6, Reza Farahmand Rad
7, Farideh Sadeghian
8, Mehdi Nasr Isfahani
9,10, Vahid Rahmanian
11, Amir Ghadiphasha
12, Mohammad Shahidi
13, Mohamad Kogani
14, Sobhan Pourmasjedi
1, Seyed Mohammad Piri
1, Sara Mirzamohamadi
1, Armin Khavandegar
1, Khatereh Naghdi
1, Payman Salamati
1,15* 1 Sina Trauma and Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
2 Orthopedic Subspecialty Research Centre, Tehran University of Medical Science, Tehran, Iran
3 Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran
4 Trauma Research Center, Rahnemoon Hospital, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
5 Department of Emergency Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
6 Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
7 Clinical Research Development Center, Imam Ali and Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
8 Center for Health-Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shoahroud, Iran
9 Department of Emergency Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
10 Trauma Data Registration Center, Isfahan University of Medical Sciences, Isfahan, Iran
11 Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
12 Shahid Modarres Hospital, Saveh University of Medical Sciences, Tehran, Iran
13 Department of Emergency Medicine, Qom University of Medical Sciences, Qom, Iran
14 Research Center for Environmental Contaminants, Abadan University of Medical Sciences, Abadan, Iran
15 Research Center for War-Affected People, Tehran University of Medical Sciences, Tehran, 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.