Current pattern of road traffic accidents, maxillofacial and associated injuries in Nairobi

Abstract

Objective: To describe the characteristics and pattern of maxillofacial and concomitant injuries sustained in Road Traffic Accidents (RTAs). Study Area: Kenyatta National Hospital (KNH). Study Design: A descriptive cross sectional study including all patients involved in RTAs brought to casualty and dental departments of KNH as well as accident victims admitted to the KNH mortuary over a four- month period from September 2004 to December 2004. Results: A total of 482 people involved in RTAs were included in the study. Four hundred and thirteen (85.7%) had non-fatal injuries whereas 69 (14.3%) had sustained fatal injuries. Nonfatal injuries. The 21-30-year-old age group was the most affected. The male to female ratio was 4:1. Day time injuries were recorded among 60.3% of the participants. The incidence of RTAs was highest on Fridays. There were 245 (59.5%) pedestrians and 139 (33.7%) passengers involved. Most accidents were caused by passenger service vehicles (matatu) which were responsible for 256 (62%) casualties whereas private saloon cars were involved in 150 (36.3%) cases. Non- use of safety belts was reported in 90 (56.6%) cases whereas over-speeding was reported by 120 (29.1 %) casualties. Alcohol use by drivers was reported in 26 (6.3%) cases whereas vehicle defects accounted for 62 (15%) cases.Three hundred and seventy (89.6%) casualties had soft tissue injuries (STls) involving the craniofacial region with facial cuts being the majority (69.2%). Two hundred and seventy three (66.1 %) incidents of other STls than those of the head region were noted, the lower limbs accounting for 45.4% of these. Only 5.1% of the casualties had fractures involving the maxillofacial skeleton. Skeletal injuries other than those involving the maxillofacial region were found in 142 (34.1%) incidents. The lower limbs were more affected with 61 (43%) incidents followed by the upper limbs (24.6%). Pedestrians were IX most involved in sustaining skeletal injuries than other categories of road users. Fatal RTAs: Sixty nine (14.3%) of the 482 participants were fatally injured. The 21-30- year-old age group was the most affected (20%). The male to female ratio was 3.3:1. Matatus and minibuses were the leading cause of fatal accidents together having been responsible for 28 (40.6%) of the accidents. Pedestrians (71.4%) were by far more involved than other categories of road users. Most participants had multiple injuries with chest injuries having been the most common (50 cases). Fourty six (66.7%) victims had injuries to the head region with subdural haemorrhage having been the commonest injury found at autopsy (47.8%). Injuries to the chest were found in fifty (72.2%) victims whereas abdominal and limb injuries were recorded in 42 (60.9%) and 34 (49.3%) victims respectively. Head injury alone was the leading cause of death (37.7%) followed by head and chest injuries combined (13.0%) Conclusion: The majority of people involved in RTAs were in their third decade of life with males having been the predominant group affected. Pedestrians were the leading casualties amongst road users. Most of the accidents were caused by passenger service vehicles. The lower limbs sustained most soft tissue and skeletal injuries compared to other anatomic sites other than the craniofacial area. The leading cause of death was head injury.