Turret truck-related head and neck injuries in a Japanese wholesale market: Clinical characteristics, risk factors, and the need for preventive measures.

Abstract

Turret trucks are widely used to handle cargo in Japanese wholesale markets. Under Japanese law, helmet use is not mandatory for turret truck operators, which potentially increases the risk of head and neck injuries. This study aimed to describe the clinical characteristics, risk factors, and outcomes of turret truck-related head and neck injuries as the first reported analysis of this injury mechanism. We conducted a retrospective observational study of patients with turret truck-related head and neck injuries who were transported to St. Luke's International Hospital between January 2011 and June 2024. Demographic data, injury characteristics, and outcomes were collected. The primary outcome was the necessity for hospital admission, and the secondary outcome was functional status at discharge, measured using the modified Rankin Scale (mRS). Of the 67 patients analyzed, 48 (72%) were turret drivers and 19 (28%) were non-drivers. The cohort was predominantly male (97%) with a median age of 64 years. Twenty-four patients (36%) required hospital admission, with a higher proportion among turret drivers (44%) than among non-drivers (16%). Among turret drivers, all patients with severe injuries (Injury Severity Score ≥16) and those with significant head and neck injuries (Abbreviated Injury Scale ≥3) required hospitalization. Despite injury severity, most patients achieved favorable functional outcomes, with 97% having an mRS score of 0-2 at discharge. One fatality occurred in a 70-year-old female passenger without helmet who fell from a turret truck. Although most turret truck-related head and neck injuries result in favorable outcomes, a substantial proportion of patients require hospitalization. Given the predominantly older male population and the occurrence of fatal outcomes even at low speeds without helmet protection, mandatory helmet use and comprehensive safety measures should be considered to reduce injury severity in this population.