Download - forensic medicine

JIAFM, 2007 - 29(4); ISSN: 0971-0973
(d) Bladder 5(3.9)
(e) Gut 8(6.2)
II. Cervical
spine
injury 14(10.8)
V. Upper
limbs 33(25.6)
(a) Fracture humerus 15(11.6)
(b) Fracture BBF 18(14.0)
VI. Lower
limbs 67(51.9)
(a) Fracture femur 35(27.1)
(b) Fracture BBL 20(15.5)
(c) Fracture pelvic bones 12(93.0)
Total
cases 129
A total of 310 major injuries were seen in 129 cases,
injury per case being 2.4.
Table No. 7
Fatal Injuries
Fatal injury(s) Pedestrians
Head injury 73(56.6)
Cervical spine injury 2(1.6)
Chest injury 3(2.3)
Abdominopelvic injury 9(6.9)
Head and chest injury 8(6.2)
Thoracoabdominal injury 11 (8.5)
Head and abdominal injury 3(2.3)
Limb and fracture 10(7.8)
Multiple injuries 10(7.8)
Total cases 129
Head injury alone was fatal in 73 (56.6%) cases,
Thoraco-abdominal injury in 11 (8.5%) cases, lower
limb fractures and multiple injuries in 10 cases
(7.8%) each. The victims who died on spot had
fracture of skull, laceration of brain, rupture of liver
and lungs. Similar trend was seen in early deaths on
admission. Those surviving for more than 24 hours,
injury to brain and vital organs decreased and
incidence of SDH and Herniation of brain increased.
In victims surviving for 7-14 days, SDH and
herniation of brain or multiple fractures of lower
limbs were seen.
Discussion:
Pedestrians were the commonest group of victims
involved in fatal road accidents comprising 28.7% of
all cases. These statistics are particularly disturbing
in view of the fact that, while walking is in general,
the most pollution free, healthy and safe mode of
travel, those who venture on foot proceed at great
risk. This fact is because the pedestrians are the
most common road users but
are not segregated from the high speed vehicles.
Similar observations were made by Sevitt [1],
Chandra et al [2], Galloway and Patel [3], Srivastava
[4], Maheshwari and Mohan [5], Tirpude et al [6].
The common offending vehicles were cars and jeeps
and heavy vehicles as also reported by Chandra etal
[2] and Tirpude [6]. Pedestrians were themselves at
fault in 56 cases which is in concurrence with study
of Srivastava [4]. Multiple injuries were a rule in
pedestrian’s fatalities. Injury per case being 2.4
which is in accordance with study of Ghosh [7],
Maccerol [8], Sevitt [1], Tirpude [6], Gissane [9].
Head injury alone was fatal in majority of cases
followed by multiple and thoraco-abdominal injuries
as observed by Sevitt [1], Chandra et al [2], Ghosh
[7], Tirpude[6]. Delay in transporting the victims to
nearest hospital was due to lack of initiative, no
mobile vans or police patrol to aid in transport which
is in concurrence with study of Maheshwari and
Mohan [5]. The majority of deaths occurred in first
half an hour and then 1-6 hours after admission to
hospital. These early deaths were due to severe
brain injury and laceration of liver and lungs. In
victims surviving longer lower limb fractures and
cerebral compression accounted for death. Similar
observations were made by Sevitt [1], Chandra et al
[2] and Srivastava [4].
Conclusion:
The present study shows that pedestrians are the commonest
road user killed in road accidents and these mainly comprise of
Children and elderly victims. So specific steps should be taken to
prevent these fatalities like:
1. Completes segregation of pedestrians from the highways.
2. Zebra crossings and subways should be constructed at
appropriate places.
3. Children should be educated about traffic rules and proper
care while crossing roads.
4. Speed limits should be strictly implemented near populated
areas, residential colonies and schools.
5. Proper street lighting and traffic lights at busy cross roads.
6. Care of the injured at road site is must with provisions for
quick transport of injured person to nearest hospital.
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