道路交通事故所致骨折特点、致伤机制及其与交通方式关系的研究

发布时间：2019-07-06 15:26

【摘要】： 目的：研究道路交通事故所致骨折的流行病学特点、骨折的特征及致伤机制；探讨交通方式与骨折的关系及其法医学意义，为预防、控制道路交通事故、交通伤骨折的急救及法医学的鉴定提供重要的依据。方法：对2004年昆明市道路交通事故所致骨折518例临床法医鉴定及199例法医病理检验鉴定资料进行系统性分析性研究。对公安部交通管理局公布的2001年～2006年道路交通事故资料及云南省公安厅交警总队编《云南省道路交通事故统计资料汇编》资料进行研究。结果：2005年及2006年，我国的交通事故数量、死亡人数、受伤人数、直接财产损失、万车死亡率及十万人死亡率同比前四年(2001-2004年)下降明显，云南省交通事故变化趋势基本与全国相似，但万车死亡率高于全国水平；昆明市道路交通事故所致骨折年龄分布呈偏态分布，15～44岁占骨折人数的61.2％，职业以农民最多。事故的时间分布在三个高峰时期(7：00～9：00、17：00～19：00及20：00～24：00)。晚上发生交通事故导致死亡高于白天。机动车肇事导致骨折占717例骨折人数的97.2％，行人和自行车驾驶员占骨折总数的46.1％。行人以侧面被撞击最高，占行人总数的61.7％，交叉路口事故多发。骨折部位以下肢最多见，其次是颅面骨，肋骨和上肢，64.6％人员发生了多发骨折。骨盆、股骨及髌骨同时发生骨折和尺骨、肱骨及肩胛骨同时骨折常见。颅骨骨折合并颅内损伤的构成比高(60.6％)，颅内损伤以脑挫伤最多。肋骨骨折的部位以2～10肋常见，常发生多根肋骨骨折。脊椎骨折以腰椎多见，常发生压缩及爆裂骨折及多节段骨折，并常合并脊髓损伤。骨盆骨折常见耻骨骨折，多呈畸形愈合。机动车驾驶员胸肋骨骨折比前排乘员和后排乘员高。前排乘员肩锁骨骨折及脊椎骨折高于其他人群，后排乘员发生骨盆骨折高于其他人群。轿车肇事导致颅骨骨折低于其它车辆类型，轿车肇事导致脊椎骨折高于货车及客车。微型车肇事导致胸肋骨骨折最高，货车肇事导致骨盆骨折高于摩托车。小型机动车比大型机动车肇事更易导致下肢下段骨折。碾压导致的骨折货车和大客车常见。碰撞导致骨折机动车驾驶员构成比最高，车内人员由于砸压与挤压导致的骨折更常见。结论：2005年及2006年，全国与云南省的交通事故数量下降趋势明显。交通事故所致骨折有以下特点：①多处、多发性骨折常见；②骨折部位呈“离心性分布”；③暴力传导性骨折明显；④骨折创伤严重，粉碎性及开放性骨折多见，多数需手术治疗；⑤下肢骨折常见，胫腓骨是下肢骨折最常见的部位；⑥四肢多发骨折常发生同侧肢体，摩托车、电动车、自行车驾驶员及乘员和行人发生四肢骨折时以同侧肢体多见，机动车驾驶员及机动车乘员以异侧肢体多见。骨折损伤方式以碰撞为主，，其次是摔跌。骨折形成机制：①碰撞机制；②摔跌机制；③不协调运动；④牵拉损伤；⑤碾砸挤压机制。针对研究结果提出预防交通事故的相关建议。
文内图片：

图片说明：图12004年昆明市道路交通事故所致骨折损伤性别及伤亡人员分布
[Abstract]:Objective: To study the epidemiological characteristics of the fracture caused by road traffic accidents, the characteristics of the fracture and the mechanism of the injury, and to explore the relation between the way of traffic and the fracture and the significance of the forensic medicine. To prevent and control the road traffic accident, The first aid of traffic injury and the identification of forensic medicine provide an important basis. Methods: A systematic analysis of 518 cases of fracture caused by road traffic accident in Kunming and 199 cases of forensic pathology were studied. The information on the road traffic accidents from 2001 to 2006 and the compilation of the traffic accident statistics of Yunnan Provincial Public Security Department of the Ministry of Public Security of the People's Republic of China on the road traffic accident data published by the Traffic Administration of the Ministry of Public Security are studied. Results: In 2005 and 2006, the number of traffic accidents, the number of deaths, the number of injured, the direct property loss, the death rate of the ten thousand vehicles and the death rate of 100,000 people were significantly lower than that of the previous four years (2001-2004). The trend of traffic accident in Yunnan is basically similar to that of the whole country. However, the mortality of all vehicles is higher than that of the whole country. The age distribution of the fracture caused by road traffic accidents in Kunming is in a partial state, and the age of 15-44 years of the fracture is 61.2% of the number of fractures, and the occupation is at the most of the peasants. The time distribution of the accident is in three peak periods (7:00-9:00,17:00-19:00 and 20:00-24:00). Traffic accidents in the evening led to a higher death than during the day. Motor vehicle hit-and-run resulted in a 97.2 per cent of the total of 717 fractures, and 46.1 per cent of the total number of fractures for pedestrians and cyclists. The impact of the pedestrian on the side is the highest, accounting for 61.7% of the total number of pedestrians, and the intersection accident is multiple. The fracture site was up to the most in the lower limb, followed by the craniofacial bone, the rib and the upper limb, and 64.6% of the staff experienced multiple fractures. Fracture and ulnar, humeral and scapular fractures are common at the same time in the pelvis, femur and patella. The composition of the skull fracture combined with the intracranial injury was high (60.6%), and the intracranial injury was the most in the brain. The site of the rib fracture is common with 2 to 10 ribs, often with multiple rib fractures. The vertebral column is more common in the lumbar vertebra, and the compression and the burst fracture and the multi-section fracture often occur, and the spinal cord injury is often combined. The pelvic fracture is common to the pubic bone fracture, which is in the form of a malunion. The motor vehicle driver's chest and rib fracture is higher than the front passenger and the rear passenger. The fracture of the front passenger's shoulder and the fracture of the vertebra and the fracture of the vertebra were higher than that of other people, and the pelvic fracture of the rear passenger was higher than that of the other The car accident caused the fracture of the skull to be lower than that of other vehicles, and the accident of the car caused the vertebral fracture to be higher than that of the truck and the passenger car. The hit-and-run of the mini-car resulted in the highest fracture of the chest and rib, which caused the pelvic fracture to be higher than that of the motorcycle. Small-sized motor vehicles are more prone to lower limb fractures than large-scale motor vehicles. Rolling-induced fracture trucks and buses are common. The impact on the driver of the fractured motor vehicle is the highest, and the in-vehicle personnel are more common to the fracture caused by the crushing pressure and the extrusion. Conclusion: In 2005 and 2006, the number of traffic accidents in the whole country and Yunnan was significantly lower. The fracture caused by the traffic accident has the following characteristics: multiple fractures and multiple fractures are common; the fracture site is in "off-center distribution"; the conductive fracture of the lower limb is obvious; the fracture of the lower limb is serious, the comminuted and open fracture is more common, and the majority of the operation is required; the fracture of the lower limb is common, Tibia fibula is the most common part of the lower limb fracture, and the multiple fractures of the four limbs often occur on the same side limb, the motorcycle, the electric vehicle, the bicycle driver and the passenger and the pedestrian in the limb fracture, and the motor vehicle driver and the motor vehicle occupant are more common in the lateral limb. The fracture mode of the fracture is dominated by collision, followed by a fall. The mechanism of fracture formation: the mechanism of anti-collision; the mechanism of falling and falling; the non-coordinated movement; the traction damage; and the mechanism of crushing and pressing. The related suggestions on the prevention of traffic accidents are put forward for the research results.
【学位授予单位】：昆明医学院
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：D919

【相似文献】