AAHS Annual Meeting
Back to main AAHS site
Annual Meeting Home
Past & Future Meetings


Back to Annual Meeting Posters


Upper Extremity Injuries in Motorcyclists: Implications for Mortality and Need for Rehabilitation Services
Ebrahim Paryavi, MD, MPH1; Mohit Gilotra, MD2; Aaron J. Johnson, MD1; Raymond Pensy, MD1; W. Andrew Eglseder, MD1; Joshua M. Abzug, MD1
1University of Maryland Medical Center, Baltimore, MD; 2University of Maryland, Baltimore, MD

Background: Motorcycle crashes (MCC) constitute a disproportionately high number of roadside accidents and are characterized by higher mortality and injury rates than motor vehicle collisions. The distribution and characteristics of upper extremity injuries sustained by motorcycle riders and their implications are not well-known. The purpose of this study was to investigate the epidemiology of upper extremity injuries in the motorcyclist and determine their independent effects on mortality and need for rehabilitative services.
Methods: All motorcyclist admissions to our level I trauma center between 2006 and 2010 were retrospectively reviewed. ICD-9 codes were used to identify and categorize all upper extremity injuries. Demographic data, in-hospital mortality, disposition to a rehabilitation facility and other potential confounding covariates were obtained. Logistic regression models were used to quantify the effect of upper limb injuries on mortality and transfer to a rehabilitation facility.
Results: 35% (759/2151) of MCC victims sustained an upper extremity injury, with forearm fractures being the most common injury (272). The mortality incidence was 4% (87/2,151) for all MCC admissions. Multivariate models demonstrated that injuries distal to the humerus and scapula fractures had independent odds ratios (OR) for mortality of 0.21 (95% CI 0.08, 0.55) and 0.32 (95% CI 0.12, 0.85), respectively, when adjusted for ISS, GCS, and age. In addition, the odds of requiring rehabilitation after discharge were 1.82 (95% CI 1.47, 2.27) times higher when any upper extremity injury was sustained, independent of ISS.
Conclusion: Upper extremity injuries are common in motorcycle crashes. There is a protective effect of distal injuries and scapula fractures on mortality. This may be due to the absorption of thoracic impact by the scapulae sparing the vital organs and a "crumple zone effect" of distal upper extremities sparing the head and neck region of direct impact in a head first mechanism of injury. MCC victims with upper extremity injuries are more likely to require rehabilitation services.


Back to Annual Meeting Posters

 

© 2018 American Association for Hand Surgery. Privacy Policy.