Amputações por acidentes de transporte : epidemiologia da ocorrência e reabilitação do paciente

Abstract

The physical handicaps resultant of transportation accidents (TA) cause great locomotion, professional and financial losses to the individual and his or her family. Besides, they affect society as a whole because they bring about productivity losses in the workplace and material losses as well. Studies with the victims who survived and developed sequels are still scarce, especially in developing countries. The goal of this study was to recognize the epidemiological aspects of TA victims that led to limb amputation and characteristics related to the rehabilitation. A series of cases were studied through interviews based on a semi-structured questionnaire composed of multiple-choice and discursive questions. 43 people that went through amputation due to TA took part in the interviews and were filed as research subjects in the period ranging from December of 2002 to December of 2004, after they were discharged from treatment at the Association for the Aid of Handicapped Children of Minas Gerais, Brazil (Associação de Assistência à Criança Deficiente - AACD/MG). Most victims ranged from 20 to 39 years old (22; 51,1%), were men (36; 83,7%) and single (22, 51,1%). 25 (58%) of them had not finished elementary school, 40 (93%) had a job/occupation and, after the accident, all the subjects became inactive for an average 27,6. At the time of the interviews, amputated people ranged from 20 to 49 years old (29; 67,4%), 22 (51,1%) were single and 27 (62,8%) hadn t concluded elementary school. Out of the 35 subjects that worked for an income, 14 (40%) returned to their jobs but only six (17,1%) to the same professional activity they had before and 12 (34,3%) retired due to invalidity. Most TA (29; 67,4%) occurred in Uberlândia, 26 (60,5%) within the city limits, and motorcycles were the vehicles most involved in TA (21; 48,8%). Out of these 21 cases, 17 (81%) were motorcycle riders and, out of these, 14 (82,4%) used helmets at the moment the accident happened. Collision (31; 72%) and trampling (12; 28%) were the most common types of TA. 41 (95,3%) people had lower limb amputations and 16 (37,2%) were rescued by Fire Department personnel. 28 (65,1%) individuals went to the Uberlândia Federal University Hospital (Hospital de Clínicas de Uberlândia da Universidade Federal de Uberlândia/HCU-UFU) for initial care and the overall length of treatment decreased after AACD/MG began service. All the lower limb amputated people (41; 95,3%) received their prosthesis but found some difficulties using it, after discharge. The Unified Public Health System (Sistema Único de Saúde - SUS) afforded more than half the rehabilitations (24; 55,8%) and the majority of the prosthetic (31; 75,6%). One of the conclusions regarding the TA that lead to limb amputation is that they are more frequent among young, single men who, at the time of the accident, when riding motorcycles, often wore helmets. The Fire Department usually rescues these victims who are, then, taken to the HCU-UFU. The presence of a AACD unit seems to favour an specialized and early treatment of the amputations that are often located in the lower limbs region. The pacients ended their rehabilitation with the prosthetic adaptation but some difficulties with the prosthesis remain after they are discharged from treatment. SUS affords approximately half the rehabilitations and most of the prosthetic. Few amputated people return to the same professional activities they had before and many retire due to invalidity. The implementation of public policies that reduce the cases of TA is indispensable, specially those that are more serious and involve a motorcycle because these are the ones that lead the most to amputation, incapability and invalidity, when not death.