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Related Experiment Videos

Devastating consequences of subway accidents: traumatic amputations.

Alexandra A Maclean1, Andrea M O'Neill, H Leon Pachter

  • 1Ryder Trauma Center, University of Miami, Miami, Florida, USA.

The American Surgeon
|February 24, 2006
PubMed
Summary

Subway accidents frequently cause devastating traumatic amputations. Despite high complication rates, patients with subway-related amputations have a good chance of survival to hospital discharge.

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Area of Science:

  • Trauma surgery
  • Public health
  • Emergency medicine

Background:

  • Subway systems, while efficient, pose risks of severe accidents.
  • Traumatic amputations are devastating injuries resulting from these accidents.

Purpose of the Study:

  • To analyze the clinical experience with traumatic amputations resulting from subway accidents.
  • To identify factors influencing outcomes in these specific trauma cases.

Main Methods:

  • Retrospective review of a trauma registry from 1989-2003.
  • Analysis of 41 patients with amputations from subway accidents at Bellevue Hospital, New York City.
  • Inclusion of data on patient demographics, injury characteristics, treatment, and outcomes.

Main Results:

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  • The most common amputation was below the knee.
  • Limb salvage was attempted in 8 patients with no success.
  • Amputation wound infection occurred in 32% of patients, with a 5% mortality rate.
  • Elevated alcohol levels (39%) and psychiatric diagnoses (17%) were noted.

Conclusions:

  • Victims of subway trauma with amputations have a high survival rate to discharge.
  • Limb salvage is not successful in these cases.
  • Subway trauma necessitates specific management protocols for amputations.