GUEST COLUMN
The World Day of Remembrance for Road Traffic Victims (WDoR) is commemorated on the third Sunday of November each year to remember the millions of lives lost in road traffic accidents. Roads and streets are more than just connections between a point A and point B. They tell stories, some of them tragic but worth learning from.
A national awareness programme should be launched to make the general public aware about the road safety rules and regulations. It is said that health is wealth. But if you get injured then the current socio economic status of patient and current health facilities are the paramount factors which modify the course of treatment. We have encountered many such stories, and would like to mention a few.
A 17 year old boy studying in class XII was not having a valid driving licence but riding his bike on national highway for last three years. In a road accident he suffered serious fractures of both his thigh bones. His treatment elsewhere got complicated with severe and virulent infection and then he came to us. An attempt was made to manage and control the infection with certain antibiotics, he developed renal insufficiency. His parents had an altercation with local doctors and also with me during the course of treatment. He was blaming the doctors for everything but not his son who was ineligible to drive a geared bike and was overtaking a bus from the wrong side. This incident shows how ignorant we are about the consequences of road traffic accidents and how often we ignore and break the traffic rules and take life threatening risks on the roads.
Another 39 year old male came with a painful deformed left forearm. He sustained closed fracture of both forearm bones 14 years back. He was treated with open reduction and internal fixation with plating by an orthopaedic surgeon at that time. Surgery got complicated with infection, since then he was having deformity and disability of his right forearm. His family abandoned him because of his deformity and disability. He was treated for correction of deformity and fracture healing. After surgery he has regained the full range of motion and doing his job as a car mechanic.
Third, a young man in his late twenties was riding a bike with his girlfriend at IT Park road, Dehradun enjoying the ride with her who was holding his helmet but in the meantime the boy saw the police patrol car. He asked for the helmet from her but the girl in haste put the helmet on the boy’s head in the wrong way and in the meantime the bike hit a truck coming from the opposite side. The boy sustained a right knee joint fracture and the girl a complex right elbow joint fracture. Here we would like to emphasise that the joint injuries are complex in nature and are difficult to treat and it is rare to get full range of motion of affected joint in spite of the best available treatment despite spending a significant amount of money and time. Both have become disabled for the rest of their lives, the boy with a stiff knee and the girl with a stiff elbow.
Fourth, a 30 year old unemployed male, recently married, was standing at the side of the road when he was hit by a car. The man sustained open segmental fracture of left leg and left thigh bone which was treated in local hospital immediately after injury. During the treatment he developed many complications like exposed and infected bone of left leg, protrusion of nail from thigh bone to knee bone. If we recall the suffering of this young couple it was enormous.His wife became mother during the course of his prolonged treatment but was not having even enough money to purchase food. It took almost five years for his fractures to heal and that too after multiple operations. The fracture finally healed and the patient is walking but the knee is stiff. The stiffness will remind him and his family about the tragic traffic incidence he met.
Fifth, a 56 year old state government employee was going to the office by two wheeler and sustained injury when he was sandwiched between two cars one noon. He sustained multiple fractures with right hip fracture, right thigh fracture, right proximal arm and left proximal tibia fracture. He was admitted in emergency in hypovolumic shock. Here we would like to mention if such patients do not reach hospital in a couple of hours then they are likely to lose their life because there is significant amount of bleeding from these fractures which is not visible hence it is ignored by the patient and the family members and often neglected. But on other hand if they sustain an open injury with bleeding then they give a lot of importance and reach the hospital as soon as possible. Such injuries are also life threatening and the patient should be shifted to a hospital which is well equipped to deal with poly trauma patient. Inspite of such multiple and complex injuries, however, they can be managed successfully and patient can reach pre injury status in hands of experienced surgeon in a well equipped hospital and particularly if the patient can afford the expenses of the treatment.
Sixth, a 23 year old factory employee was going back home along with a friend who was riding. He had road traffic accident on Haridwar-Dehradun national highway one evening. The accident was so severe that bike rider died on the spot and pillion rider sustained head injury and open fractures of both legs. The leg injury was so severe that primary doctor had to amputate the left leg to save his life.Right leg was treated with tibial nailing after 15 days of injury which was further complicated with infection. The infection was uncontrolled. He came to us for further treatment. The limb was saved finally for that he had to undergo more than a dozen operations and spend lakhs of rupees for which he had to sell his agricultural land. It is worth mentioning here that his mother was a widow whose both children were unmarried and the patient was the only bread earner for the family. After his fracture healed, he got married and is living happily with his family.But inspite of all his treatment he has paid a very heavy price for the accident.
These are the few stories which are worth sharing and worth learning from. These are just the tips of an iceberg. According to our study, 90% of accidents are due to driver’s carelessness and if we follow the traffic rules honestly then the chances of accidents can be reduced significantly.
(The writers are orthopaedic surgeons based in Dehradun)
Monday, 16 November 2020 | Dr Gaurav Sanjay & Dr BKS Sanjay | Dehradun
