Early seizures, prophylactic antiepileptics drugs, and surgical intervention did not significantly affect long-term outcome in regard to persistence of seizures.

As other studies conducted in our society, traffic accidents are the major cause of morbidity and mortality and this can emphasize on the obligation to take legislative action in the field of driving and road safety, directing resources and educating the public and raising the awareness of the community in prevention of this iceberg-like problem.

CONTEXT AND OBJECTIVE: The presence of scapular fracture is believed to be associated with high rates of other injuries and accompanying morbidities. The aim was to study injury patterns and their overall outcomes in patients with scapula fractures. DESIGN AND SETTING: Cross-sectional study of trauma patients treated at six general hospitals in Tehran. METHODS: One-year trauma records were obtained from six general hospitals Among these, forty-one had sustained a scapular fracture and were included in this study. RESULTS: Scapular fracture occurred predominantly among 20 to 50-year-old patients (78%). Road traffic accidents (RTAs) were the main cause of injury (73.2%; 30/41). Pedestrians accounted for 46.7% (14/30) of the injuries due to RTAs. Falls were the next most common cause, accounting for seven cases (17.1%). Body fractures were the most common type of scapular fractures (80%). Eighteen patients (43.9%) had isolated scapular fractures. Limb fracture was the most common associated injury, detected in 18 cases (43.9%). Three patients (7.3%) had severe injuries (injury severity score, ISS > 16) which resulted in one death (2.4%). The majority of the patients were treated conservatively (87.8%). CONCLUSIONS: Patients with scapula fractures have more severe underlying chest injuries and clavicle fractures. However, this did not correlate with higher rates of injury severity score, intensive care unit admission or mortality.

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This study shows that overtriage in HEMS (transportation of patients without severe injuries) and the long transportation time is mainly a result of not having a trauma system. The study has shown HEMS to be an effective and feasible option in countries with heavy traffic and no trauma system.