Orthopaedic Surgery/Motor Vehicle Accidents

Motor Vehicle Accidents

It seems driving a car is ease to learn and difficult to master. In fact the environment of a modern automobile with emphasis on comfort and quiet smooth ride and with numerous opportunities for quelling what is usually a tedious experience of careening along a well constructed modern highway at high speed. Inattention then to the potential hazard close at hand which can result from the rapid unexpected deceleration of the vehicle in the face of a collision. Safety improvements have also accompanied the evolution of the automobile to be sure beginning with seat belts then air  bags and evolving toward collision warning and driver consciousness monitoring, perhaps including measures to prevent a drunk from becoming a drunk driver. Some of these advances may make serious collisions more survivable thus increasing the volume of high energy extremity fractures to be treated. Regulation of driving with speed limits and video surveillance and public awareness measures pointing out the statistical relatedness of young drivers accidents and distractions, number of passengers, radio, eating cell phones, night driving. Legislation pits interest groups in ways which lead to compromise which do not always lead to a priority on safety but rather a balance of safety and commerce. Even the evolution of community planning which may lessen commuting negate the motivation for larger vehicles which offer some protection but more of a false sense of security and in some cases longer break time, and inferior collision avoidance capability. Roads and communities that do not pit drivers against heavy truck traffic may offer solutions.

While we wait for these social and technological advances we contend with injuries sustained from motor vehicle related trauma on our highways. We continue to develop new ways to meet our need for speed in our recreational activities, through ATV's, snowmobiles, personal watercraft and aircraft. The issues are largely the same from an orthopedic standpoint once a living victim has arrived at the emergency department. Injury prevention issues surrounding technological advances and regulation sometimes fueled by litigation continue to change our habits balancing our desires for safety and thrill.

Speed limits.

The issue of maximum speed limits is controversial. The argument in favor of a 55 mile per hour limit was based of safety. Today the same safety argument can lead to increasing the allowed speed limit when it is recognized that the ambient rate of speed is well in excess of the posted limit fewer accidents may occur by increasing the speed limit. This approach would seem to reflect a more nuanced understanding of driving habit. There are drivers who observe the posted limit no matter what, and then there are drivers who drive at what they believe to be a safe speed, when the posted limit seems too slow. This second category can be distinguished from a group that routinely drives at a reckless rate of speed well above the posted limit and in fact, well in excess of the ambient flow of traffic. The lowest rate of accidents may be achieved by matching the limit to what a reasonable driver is likely to feel is a safe rate of travel for a given road.

Driving Age.

The rite of passage we associate with the coming of age 16 is being reconsidered in view of statistics recognizing automotive deaths as the leading cause of death among 16 to 20 year olds accounting for twice the fatalities of the next category which is homicide according to the National Highway Traffic Safety Administration.

Over the last 10 years there has been a 12% drop in the licensure rates of 16 year olds such that presently 30% of 16 year olds hold licenses. This trend has accompanied a 26% drop in fatalities, in 16 year old drivers and their passengers. The costs of insuring a 16 year old may be partly motivating this trend as adding a 16 year old to a policy will generally double the premium, and when they are the primary driver of the vehicle, it triples the premium.