Furthermore, the head may hit the windscreen or the frame work around it. Subsequently, the patient's lower extremities receive the initial energy impact which could result in different lower limb injuries including fracture dislocation of the ankle, femur fracture, knee dislocation, and posterior dislocation of the femoral head from the acetabulum as the pelvis override the femur. In front impact, there is deceleration of the vehicle as it hits another vehicle or a static object. The amount of the energy and the direction of impact are major factors that determine the outcome of collisions. Finally the third collision occurs when the internal organs of the body hit against the chest wall or the skeletal structure. The chest may hit the steering wheel and the head may hit the windscreen. The first collision involves the vehicle and an external object, the second collision, which is responsible for most of the injuries, and can be prevented by seatbelt use, occurs between the unbelted occupant and the vehicle interior. When occupants are unrestrained in motor vehicle crashes, there will be three collisions. They lock the belt in sudden deceleration and prevent the body from bending forward. The emergency locking retractors were provided by Volvo on 1968. On 1968 the 3 point belt was made compulsory in UK. Shoulder restraints were then introduced. They hold the body at two points and act as a fulcrum about which the body pivots causing major lumbar spine injuries. Herby, we review the literature on seatbelts and their role in reducing road traffic collision injuries. Incorrectly used seatbelts may cause fatal injuries. Seatbelt effectiveness is related to the driver's behaviour and education level. It is not clear whether these injuries were caused by the seatbelts or they have been detected more in those who survived. Restrained occupants who have survived were shown to have more incidence of vertebral and intra-abdominal injuries compared with unbelted occupants. 50 - 80% of all deaths of RTC could have been prevented by properly used seatbelt. Seatbelts reduce morbidity and mortality. Seatbelts were designed to prevent injury to the restrained passengers during RTC by preventing the occupant from hitting the vehicle components or being ejected from the vehicle. Studies on seatbelts, as early as 1960, concluded that seatbelts reduce major fatal injuries. This was not obligatory till 1964 when many USA states made it compulsory. Some physicians in USA in the 1930s equipped their own cars with lap belts pushing the manufacturers to include them in the vehicle design. The most important motor vehicle crash safety innovation which contributed to reduction in mortality has been the installation and proper use of seatbelts. A reduction in the fatality rates can be achieved by improving vehicle crash safety and roadway design. They cause further disabilities for more than 50 million injured patients. Road Traffic Collisions (RTC) are a leading cause of death, killing yearly more than 1.2 million worldwide, half of them between the age of 15 and 44. Enforcement of seatbelt usage by law is mandatory so as to reduce the toll of death of road traffic collisions. Although seatbelts were recognized as an important safety measure, it still remains underused in many countries. These injuries can be reduced if seatbelts were applied correctly. The presence of a seatbelt sign must raise the suspicion of an intra-abdominal injury. Seatbelt-related injuries include spinal, abdominal or pelvic injuries. There was a very highly significant negative correlation between the seatbelt compliance and road traffic death rates (R = - 0.77, F = 65.5, p < 0.00001). We have made a linear regression correlation between the overall seatbelt compliance and road traffic death rates in 46 high income countries to study the relationship between seatbelt use and mortality. Seatbelts reduce injury by preventing the occupant from hitting the interior parts of the vehicle or being ejected from the car. We aimed to review seatbelt development, its mechanism of action and its effects. Modification of seatbelts and their legislation played an important role in reducing morbidity and mortality of occupants in road traffic collisions.
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