Data were collected through a questionnaire and recorded by trained researchers from patients hospitalized after being involved in an accident. The information included sociodemographic characteristics, details of the different injuries sustained and exposure to risk factors from the collision context and environment. Injury severity was measured using ISS (a measure of the sum of squares of the highest Abbreviated Injury Scale-2008 codes in three critical body regions). The statistical analysis incorporated univariate and multivariate regression analyses.
Acromioclavicular Joint Separation (AC Separation)
A shoulder separation is an injury to the ligaments that connect the acromion (the flat surface at the top of the shoulder blade) and the clavicle (the collar bone). This joint is used frequently in activities such as lifting, pushing and pulling. It can be very painful when a person performs these actions or sleeps on the affected side. The injury is most commonly seen in people engaged in direct contact sports such as football, hockey or soccer or those with job-related activities that require repeated overhead movements.
A sprained AC joint is often diagnosed by taking a history and conducting a physical examination. The doctor will look for swelling, bruising, tenderness and flexibility of the joint. In more severe cases, the patient will have an obvious bump on the front of their shoulder where the clavicle and shoulder blade are misaligned.
The severity of the injury is classified according to a system developed by Rockwood based on AP, axial and Zanca radiographs to evaluate the extent of displacement. Grade I injuries are minor sprains with minimal or no clinical or radiographic evidence of instability. Grade II injuries are tears or sprains of the AC ligament but not the coracoclavicular ligaments. Grade III injuries are complete tears of both the AC and CC ligaments and result in a clearly visible external deformity.
Head Injury
If a person sustains a head injury, they should be taken to the emergency room as soon as possible. This will allow the doctor to check for any signs of brain damage or other serious problems. They will use a 15-point scale to assess the person’s mental status (called the Glasgow Coma Scale, or GCS). The doctor may also order a CT scan of the head or an MRI of the brain.
A traumatic brain injury (TBI) can range from mild to severe. The most common type of TBI is called a concussion. This is when the brain gets jarred against the skull, usually from being hit in the head, but sometimes from other forces that cause the brain to shake or vibrate. Concussions can lead to a variety of symptoms including memory loss, dizziness or drowsiness, confusion, headache and vomiting. They can even cause a clear fluid to ooze from the nose, although this is not mucus but rather cerebrospinal fluid.
Secondary brain injury occurs when the body’s inflammatory response to the initial injury causes extra fluid and nutrients to accumulate in the brain. This swelling can increase pressure inside the skull, causing additional damage to brain cells. Hematomas, a collection of blood under the skull, are another common form of secondary brain injury. They can be very dangerous if they cause a buildup of pressure inside the skull that compresses the brain itself, resulting in death.
Spinal Cord Injury
Your spinal cord is a pathway for nerve tracts that send signals from your brain to control movement, as well as messages about temperature, pressure, pain and the position of body parts. A spinal cord injury can cause paralysis in all or part of your legs, arms, chest and pelvic organs, depending on where the injury is located and how severe it is. A spinal cord injury in the neck (cervical) area may also affect your breathing muscles.
Your child’s spinal nerves, which emerge from the sacral portion of your spine, send signals to the thighs and lower portions of the feet, most of the external genital organs and most of the chest. This region is vulnerable to injury from falls, motor vehicle accidents, acts of violence and sports injuries.
Spinal cord injuries can cause complications such as pressure sores, which require frequent changes of position and proper skin care to prevent them. They can cause circulatory problems, including a drop in blood pressure when you rise from a sitting or lying position (orthostatic hypotension) and swelling of the extremities. They can also cause muscle spasticity, which is tightness or stiffness of the muscles. Your rehabilitation team will teach you ways to manage these issues. They can also help you cope with depression, which is common after a spinal cord injury.
Shoulder Injury
The shoulder joint has three bones and a complex arrangement of ligaments, muscles, tendons, and cartilage. This allows it a wide range of motion, but that also makes it more susceptible to injury. The force of impact can damage bone or soft tissue, and repetitive use can cause overuse problems.
A blow to the shoulder can damage a ligament that holds the ball of the upper arm bone in place (humerus). The shoulder blade can also become sprained when it receives a direct blow. The rotator cuff is a group of muscles that help support and stabilize the shoulder joint. A tear of the rotator cuff can happen due to repetitive overhead work, sports, or just wear and tear as we age.
Ligaments are the connective tissues that hold bones together. If a ligament is sprained it can cause short term pain. A shoulder dislocation happens when the humerus is forced out of its socket. This can damage ligaments, tendons, and nerves.
A sprained or torn rotator cuff can lead to shoulder pain that gets worse with movement and limits daily activities. The physician will assess the shoulder for tenderness, swelling, and range of motion. A sling is often used at first to control the shoulder movement and reduce inflammation, but this should be discarded as soon as the pain is controlled, usually within 72 hours. The physician may recommend icing the area 3-4 times per day for 10-15 minutes each time. Strength exercises are performed to restore strength to the shoulder and to prevent re-injury.