: Dr Himanshu Tyagi.
Mrs Sudha 73 year old housewife, had a painful lock down period recently due to a fracture in her lower spine.
She suffered this spinal fracture 5 months ago while traveling in a bus which jolted over a speed-breaker.
There are many similar stories where passengers have suffered serious injuries due to flawed speed breaker designs.
Common injuries in 4 wheeler-
1) Lower spine fractures (40%)
2) Neck injuries (30%)
3) Head injuries(25%)
4) Tail bone injury and others (5 %)
Medically speaking injuries due speed-breaker bumps can be life-threatening. 2 wheeler drivers are at a greater risk when it comes to fatal injuries or limb amputation.
Common injuries 2 wheeler-
1) Head injury & Limb injuries. (80%)- without helmet.
2) Limb injuries exclusive -40 %.
3) Spine/chest/pelvic – 40 %
Types based on mode of injury –
1) LAUNCHING IMPACT – Head injury and neck/cervical fracture. (Occurs when passengers bounces and hit the roof of the car).
2) LANDING IMPACT – lower spinal (Lumbar spine) fractures. (Occurs when passengers lands on buttock in flexed spinal position).
Relation between vehicle & injuries –
1) 2 wheelers : skid over flawed speed-breaker. Head injury, limb injuries, cuts, bruises.
2) Car : Jolt over speed-breaker. Head injury, neck injury, lower back fractures.
3) Bus : Landing Impact. Lower back fractures.
4 wheeler’s are comparatively safer as life-threatening injuries are rare even though spinal fractures are common, which may require bed rest up to 2 months or occasionally a surgery.
People at risk for fracture –
1) People above the age of 75.
2) Cancer patients.
3) Osteoporosis patient.
4) Passenger at the back seat of car (Launching impact).
5) Tall individual in a car with low head clearance.
6) Passengers at the rear end of bus (Landing impact).
7) Public transport/Bus with poor shock absorbing mechanics.
8) Speeding vehicles (speed about 65km/h is the critical velocity).
9) Not wearing seat belts.
Though as per the official dimensions, a speed-breaker should be at least 3.7 metres wide, should have a radius of curvature (ROC) of 17 metres and height of 10 cm but many a times we see speed-breakers with flawed design in India (Narrow & high speed-breakers)
Official recommendation for Speed limit over a speed breaker is less than 25 km/h in India. However we see people over-speeding on a speed-breaker and getting impact in spine due to the jolt.
DR HIMANSHU TYAGI
Senior consultant Spine surgeon, Delhi NCR.