Injury, 15, 75-77 Printedin Great Britain 75

The prevention of leg injuries in motorcycle accidents

David J. Ross

Department of Orthopaedic and Traumatic Surgery, Bristol Royal Infirmary

Summary

Leg injuries due to motorcycle accidents are becoming increasingly common, and a relatively high proportion of these injuries are severe, requiring intensive and prolonged treatment with an often disappointing final result.

A total of 309 injured motorcyclists consented to take part in a study investigating the possibility that crash bars fitted to motorcycles might protect the motorcyclist’s legs from injury. In the group as a whole, it seemed possible that crash bars would afford some protection, but the figures were not statistically significant.

In the group of 150 motorcyclists injured by side impact, 8 of the 25 with crash bars escaped injuries of the legs com- pared with only 17 out of 125 who did not have crash bars. These results suggest that crash bars provide a measure of protection to motorcyclist’s legs, especially when the impact is from the side.

INTRODUCTION THE numbers of motorcycles and motorcycle accidents have been increasing (HMSO, 1982) and it is known that leg injuries are common in motorcycle accidents.

This study attempts to define the size of the problem posed by leg injuries to motorcyclists, and to investi- gate the possibility that crash bars fitted to motorcycles may prevent leg injuries.

PATIENTS AND METHODS A year long prospective study was started in March 1981 in the Accident Department of Bristol Royal Infirmary. The number of patients injured in motor- cycle accidents was recorded, as was the number of these patients who had sustained leg injuries. As many as possible of the patients injured in motorcycle acci- dents were asked to give name, age, address, date and time of accident, site of accident, type of motorcycle, and whether or not the machine was fitted with crash bars, leg shields or a fairing. The patient was asked to describe the nature of the accident, and to indicate the mechanism of injury. Information was also obtained from police officers, ambulancemen and other wit- nesses. The presence or absence of leg injuries was recorded, and these injuries graded on the modified Abbreviated Injury Scale (1980). A survey of the dif- ferent types of crash bars, leg shields and fairings was made. Leg shields (Fig. l(a)) were found to be lightly constructed of plastic or glass fibre and appeared to give way easily on impact and did not seem to provide much protection to the motorcyclists legs. Many crash bars are intended to protect the engine, not the rider.

Motorcycles often fall over at rest and the engines of the larger machines stick out sideways. Crash bars are sold to protect the cylinders against damage in such circumstances.

Crash bars (Fig. l(b)) or a full fairing as in Fig. l(c), combined with crash bars which was commonly found appeared to protect the motorcyclist’s legs by absorb- ing a considerable amount of energy on impact. Two groups, each consisting of a hundred motorcyclists, were studied to discover the percentage of motorcycles fitted with crash bars, fairings or leg shields. One group consisted of commuters’ motorcycles seen on a week- day morning on a main road in Bristol, the other group consisted of motorcycles parked at a shopping precinct motorcycle park on a Saturday afternoon. These two groups were felt to be representative samples of the widely differing types of motorcycles in common use.

RESULTS The total number of new patients attending the Acci- dent & Emergency Department of Bristol Royal Infirmary in 1981 was 46 179. Of this number 8339 (18 per cent) were injured in road traffic accidents and 78 1 of these were motorcyclists. Injured motorcyclists, therefore, accounted for 1.69 per cent of all new patients and 9.36 per cent of patients injured in road traffic accidents (Table I). Of the 78 1 injured motor- cyclists, 501 (64 per cent) were recorded as having leg injuries (this number is likely to be too low because only the most severe injuries to each patient were recorded in the admission book). Three hundred and nine patients gave their informed consent to take part in the study investigating the relationship between crash bars and leg injuries. Seventeen per cent of these motorcyclists had crash bars fitted to their machines: and this percentage is comparable with the percentages found in the two surveys that we (D.R. and S.R.) car- ried out independently, that is 19 per cent and 2 1 per cent. A total of 223 (72 per cent) of the 309 patients had leg injuries (Table IZ) and this percentage and pat- tern of severity of injuries is similar to that found by Whitaker (1976). Of the 223 patients with leg injuries 37 (16 per cent) had crash bars fitted to their motor- cycles, compared with the 18 (2 1 per cent) with crash bars of the 86 patients without leg injuries (Table III). The X2 test gives a result of 0*50> P> 0.10, which is not significant. The mechanism of injury was recorded and it was found that 150 of the 309 injured motorcyc- lists were struck from the side. In this group of 150

76 Injury: the British Journal of Accident Surgery Vol. 1 ~/NO. 2

Fig. 1. (a) Leg Shields. (b) Crash Bars. (c) Full fairing in combination with Crash Bars.

Tab/e 1. Injured motorcyclists as a percentage of patients Tab/e //. Numbers and Severity (AIS scale 1980) of Leg treated in the Accident Department Injuries to Motorcyclists

Total Number of New Patients % of total seen in the Accident Department 46,179 number

Injured in Road Traffic Accidents 8,339 18% Injured Motorcyclists 781 1.69%

Number of Se verity Se verity Injury Patients %age Code Category Description

Table Ill. Leg Injuries and Crash Bars. Total number of injured Motorcyclists-309

Crash Bars No Crash Bars

0~50>P>0~10

Leg Injuries

37 186

No Leg injuries

18 68

164

30

25

4

223

74 I Minor Contusion, sprain

13 II Moderate Distal closed fracture, laceration.

11 III Serious Distal crush, open fracture, below knee amputation

2 IV Severe Above knee amputation or crush or severe open femoral fracture.

100 motorcyclists, 125 sustained leg injuries, and 17 of these had crash bars fitted to their machines, of the 25 who did not have leg injuries, 8 had crash bars fitted (TubleW).TheX2testgivesaresultof0~05>P>0~02, which is significant, and suggests that crash bars fitted to motorcycles protect against leg injuries when the impact is from the side.

Table /V. Leg Injuries following Side Impact. Number of motorcyclists injured by side impact-l 50

Leg Injuries No Leg Injuries

DISCUSSION Crash Bars 17 8 No Crash Bars 108 17

Injured motorcyclists were only a small percentage (1.69 per cent) of patients seen in an Accident Depart- ment but the majority (72 per cent) had leg injuries, and 26 per cent of these leg injuries were graded as moderate to severe.

0.05 > P> 0.02

Findlay (1972) described the severity of injury to the ‘motorcycle tibia’ and Hutchins (1981) described the slow rehabilitation and poor final results following

severe tibia1 injuries. Any means of reducing the inci- dence of severe leg injuries would be of value and while the major aim should be to decrease the number of motorcycle accidents by better education and training of motorcyclists and other road users, the value of pro-

Ross: Prevention of leg injuries 77

tection of the motorcyclists legs should not be over- looked. The most practical form of protection may well be adequate crash bars fitted to the motorcycle, and this study has shown that crash bars may protect the motorcyclist’s legs, particularly when the impact is from the side.

Acknowledgements I would like to thank Simon Ray, medical student at Bristol University, the staff of the Accident Depart- ment at Bristol Royal Infirmary, and Avon and Somerset Constabulary for their help and co- operation. I would also like to thank Gary James of

the Department of Medical Illustration, Bristol Royal Infirmary.

REFERENCES Committee on Injury Scaling (1980) The Abbreviated Injury

Scale 1980 Revision. American Association for Auto- motive Medicine.

Findlay J. A. (1972) The Motor Cycle Tibia. Injury 4, 75. Hutchins P. M. (198 I) The Outcome of Severe ‘Tibia1 Injury.

Injury 13, 2 16. Road Accidents in Great Britain 1980 (1982) HMSO

London. Whitaker J. (1976) Motorcycle Safety-Accident Survey and

Rider Injuries. T.R.R.L. Supplementary Report 239 13-16.

Requestsfar reprints should be addressed to: D. J. Ross, Department of Orthopaedic Surgery, Princess Margaret Rose Hospital, Edinburgh, EHlO 7ED.