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

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.