The article by Al-Qahatani and O’Connor in this issue of the Canadian Journal of Surgery (pages 317 to 320) raises important issues regarding the incidence and severity of acetabular fractures seen in a regional trauma centre. These authors present convincing evidence that the incidence of such injuries is significantly diminished by the use of seat belts. In addition, they point out that associated injury in these same patients is reduced both in incidence and severity. This is important for the surgical community in Canada since it influences current practice and encourages us to continue to promote safe driving practices, including the use of seatbelt restraint.
The high incidence of significant associated injuries in patients with acetabular fractures should suggest to the practising surgeon that acetabular fractures sustained in motor vehicle accidents are rarely isolated injuries, and significant associated injury should be carefully sought in such patients. The corollary is also true — patients with multiple injuries suffered in motor vehicle accidents should be carefully examined for pelvic and acetabular injury.
The overwhelming evidence that the use of seat belts diminishes the incidence and severity of both acetabular fractures and other injuries must be vigorously promoted by the surgical community to the public.
It is anticipated that the incidence of pelvic and acetabular fractures will further diminish with the implementation of side-impact protection as a routine feature in imported and North American cars in the years to come.
The authors are to be congratulated for a careful study of a frequently overlooked problem and encouraged to continue their ongoing analysis of this injury pattern.