OBJECTIVETo illustrate mechanisms of spine fractures and the pattern of spinal injuries characterized by the major mechanisms in urban population of Iran.

METHODSData regarding spinal injuries including demographics, mechanism and level of spinal injury, abbreviated injury score, associated injuries and final fate of the patients were extracted from the Iranian national trauma registry database from 1999 to 2004.

RESULTSA total of 619 patients with traumatic spine fractures were identified, of whom 68.5% were males. The peak frequency of these injuries occurred in the 21-40 year age-group. Accidental falls and road traffic crashes (RTCs) were the most common mechanisms of spinal fractures (47.2% and 44.1%, respectively). RTCs tended to occur in younger patients compared with accidental falls. The most common spinal region for spinal fracture was the lumbar spine (53.63%). Cervical spine fractures were significantly more common in RTCs, while lumbar spine fractures were more common in accidental falls (P less than 0.001). A total of 171 (27.6%) patients had associated non-spinal injuries, of whom 127 had associated extremity injuries, and 55 had head injuries. Thirty-six (5.6%) patients had spinal cord injury (SCI).The injury severity score of the RTC group was significantly higher than that of accidental falls (P equal to 0.002). Fifteen (4%) patients died of traumatic injuries. The rate of death was significantly higher in RTCs compared with accidental falls (5.1% vs 2.1%, P equal to 0.039).

CONCLUSIONSThe patterns of spinal fractures are similar to those reported from developed countries. RTCs tend to affect the younger age population and are associated with a higher degree of associated injuries and mortality than accidental falls. Therefore preventive strategies should be based on reduction of the number and severity of RTCs.

Accidental Falls ; Accidents, Traffic ; Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Spinal Fractures ; etiology

OBJECTIVETo analyze the data of patients with spinal cord injury (SCI) induced by road traffic crashes in southeastern Iran for better understanding the pattern of these injuries and therefore for better designing health system planning.

METHODSIn this historical cohort study, the patients who had been transferred to Level I trauma center in southeastern Iran due to road traffic accidents with radiographic documented SCI were evaluated.

RESULTSAmong 64 patients with SCI, 38 patients (59.4%, 36 males and 2 females, aged 27.42 years+/-9.44 years on average) were injured by road traffic accidents. Car and motorcycle accidents were responsible for 26 cases (68.4%) and 12 cases (31.6%), respectively. And 31 patients (81.6%) had complete SCI. Conus medularis (T12-L2) was the most affected level.

CONCLUSIONSResults are discussed in terms of preventive measures, specifically those concerning the use of restraint and helmet and driving behavior. This study should be extended nationally to gain a larger case series so that the SCI risk of particular vehicle configurations, considering other crash factors, can be more precisely quantified and the characteristics for low occurrence of SCI can be more precisely identified.

Accidents, Traffic ; statistics & numerical data ; Adolescent ; Adult ; Equipment Design ; Head Protective Devices ; Humans ; Iran ; epidemiology ; Middle Aged ; Seat Belts ; Spinal Cord Injuries ; epidemiology ; prevention & control ; surgery

OBJECTIVETo compare fatalities and injuries in road traffic crashes (RTC) in Iran with other countries.

METHODSData were obtained from national health sources of Iran. These data included population number, registered motor-vehicles number, number of RTCs and consequent fatalities and injuries from 1997 to 2006.

RESULTSRTC fatality and injury rates increased from 1997 to 2005, but decreased in 2006. The overall men/women ratio in the RTC fatalities was 4.2:1. High RTC fatality rate of 39 per 100 000 population in Iran was almost the same as some other developing countries. In Iran, RTC fatalities in recent years were almost twice as much as the highest rate among the European countries.

CONCLUSIONSThis investigation shows that in spite of reduction of RTC fatality in Iran in 2006, it is still one of the highest in the world. Moreover, this paper describes the state of RTC-related parameters in a developing country in comparison with the developed countries.

Accidents, Traffic ; statistics & numerical data ; Developed Countries ; Developing Countries ; Female ; Humans ; Iran ; epidemiology ; Male ; Wounds and Injuries ; epidemiology ; mortality

The spinal column is involved in less than 1% of all cases of tuberculosis (TB). Spinal TB is a very dangerous type of skeletal TB as it can be associated with neurologic deficit due to compression of adjacent neural structures and significant spinal deformity. Therefore, early diagnosis and management of spinal TB has special importance in preventing these serious complications. In order to extract current trends in diagnosis and medical or surgical treatment of spinal TB we performed a narrative review with analysis of all the articles available for us which were published between 1990 and 2011. Althoug h the development of more accurate imaging modalities such as magnetic resonance imaging and advanced surgical techniques have made the early diagnosis and management of spinal TB much easier, these are still very challenging topics. In this review we aim to discuss the diagnosis and management of spinal TB based on studies with acceptable design, clearly explained results and justifiable conclusions.
Congenital Abnormalities ; Early Diagnosis ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Spine ; Tuberculosis ; Tuberculosis, Spinal

OBJECTIVETo determine the patterns of traumatic extremity injuries leading to amputation in Iran.

METHODSData of Iranian National Trauma Project was used to identify patients with upper and lower extremity traumas undergoing amputation. This project was conducted in 8 major cities during 2000-2004.

RESULTSOf 17 753 traumatic patients, 164 (0.92%) had injuries to the extremities that resulted in the limb amputation. Of these, 143 (87.2%) were men. The patient's mean age was 29.0 years +/- 15.4 years and the highest incidence was seen in the age group of 21 to 30 years (34.1%). One hundred and four cases were occupational accidents (63.4%). Blunt trauma was in 54.9% of the cases. The most common reasons for amputation were respectively stabbings (37.8%) and crush injuries (31.7%). Amputation of hand fingers was the most frequent type of amputation (125 cases, 76.2 %). One patient died from severe associated injuries.

CONCLUSIONSThis study shows the patterns of traumatic limb amputation in Iran, a developing country. Results of this study may be used in preventive strategic planning.

Accidents, Traffic ; statistics & numerical data ; Adolescent ; Adult ; Aged ; Amputation ; statistics & numerical data ; Child, Preschool ; Cross-Sectional Studies ; Female ; Humans ; Iran ; epidemiology ; Lower Extremity ; injuries ; surgery ; Male ; Middle Aged ; Upper Extremity ; injuries ; surgery ; Wounds, Nonpenetrating ; epidemiology ; surgery ; Wounds, Penetrating ; epidemiology ; surgery ; Young Adult