Whether or not you are in agreement with the idea of motorcycle riders wearing helmets is your own personal view.  However, your own personal view should be made on the basis of relevant information that allows you to make an educated decision whether or not to wear a helmet.  Over the last motorcycle riding season I have been running a poll on my website asking if all motorcycle riders should be required by law to wear a helmet when riding.  The results are interesting - 55% say yes and 45% say no.  I would like to think that these are educated opinions.

There are many reasons to wear and not wear a helmet.  In favor of not wearing a helmet is what I call the freedom of choice argument.  This argument essentially states that "I am responsible for myself and if I choose to not wear a helmet that should be my right."  Another way of putting it would be "the government should stay out of my business - if I do not want to wear a helmet I should not be required by law to do so."  This argument has a certain amount of appeal and for the most part I personally agree.  Pundits also agree that it may be your right to decide if the decision is only impacting you alone but they claim that if you are injured while not wearing a helmet it is society that pays.  I agree with this statement too.  I think, as a motorcycle injury attorney and a motorcycle rider, I have a uniqueappreciation for both views.  My personal opinion is that you should not be required by law to wear a helmet by law but you should also carry enough insurance to ensure that if (or when) you are injured that you can care for yourself and not have to rely on society to support you.

Whatever your sentiment or view you should make an educated decision about wearing a helmet when riding your motorcycle or scooter.  Brain injury often occurs when you do not wear a helmet and you are involved in a crash.  Let's face it - car or truck versus motorcycle or scooter - motorcycle or scooter (and rider) lose every time.  Whether helmets actually decrease brain injury may be argued but I think most would agree that given the same crash you are better off wearing a helmet.

Brain injury is usually divided into traumatic brain injury (TBI) or acquired brain injury (ABI).  Traumatic brain injury includes concussion, contusion, coup-countercoup, diffuse axonal and penetration.  Acquired brain injury includes anoxic and hypoxic injuries.  All, some or none of these injuries can be the result of a motorcycle crash.  An excellent web resource that describes all of these injuries is the Brain Injury Association of Utah.  Furthermore, brain injury can be mild, moderate or severe.

The Brain Injury Association of Utah is a non-profit organization in existence since 1984 and it's mission is to create a better future through brain injury prevention, research, education and advocacy. This organization is sponsoring their 19th Annual Family Professionals Conference in Layton October 9th and 10th.  Another fantastic resource is the Brain Injury Association of America. 

You can get a feel for how those with brain injuries cope and the impact that the injury has had on them and their families by visiting this Deseret NewsArticle titled Coping with Brain Injury is a Daily Struggle.  One of the most debillitating symptoms of brain injury is the fact that those injured look normal and I think are therefore expected to be normal functioning. When impulse control is altered because of the injury these injured persons are at greater risk for injury - physical, emotional and financial.

Here are some quick facts copied from the Brain Injury Association of Utah website:

• Every 23 seconds, one person in the U.S. sustains a brain injury
• Over the past 12 years, mortality from brain injury has exceeded the cumulative number of American battle deaths inclusive of all wars since the founding of the Republic.
• Traumatic Brain Injury (TBI) is a silent yet serious epidemic currently leaving 5.3 million Americans with disabilities. This represents over- 2% of the US population; 40,000 victims in Utah alone!
• 50% of brain injuries are caused by vehicle crashes, 26% by falls.
• In September 2000 alone, 8600 children under the age of 15 suffered a brain injury from scooter accidents... almost 300 children per day!
• Every 7 minutes, someone dies of a brain injury
• One death every day and one brain injury every four minutes can be prevented by the use of helmets in recreational activities, including skiing and biking.
• 80 % of brain injury victims end up in a divorce
• 75% of persons with TBI who return to work will lose their job within 90 days if they do not have supports.
• The estimated lifetime cost for each survivor of a severe brain injury exceeds $4 million.
• According to a study conducted by The National Foundation for the Brain, the cost of brain injury in the United States was $48.3 billion in 1992. Hospitalization accounts for $31.7 billion, and fatal brain injuries cost the nation $16.6 billion each year. We estimate that this figure may be substantially higher today.
• Traumatic Brain Injury (TBI) is a silent yet serious epidemic currently leaving 5.3 million Americas with Disabilities. This represents over 2% of the US population; estimated 40,000 individuals in Utah alone suffer from a long-term disability from brain injury!
• Each year, approximately 567,000 people go to the hospital emergency departments with bicycle related injuries; about 350,000 of those are children under 15 years of age. Of those children, about 130,000 sustain brain injuries.
• 1 million children sustain brain injuries every year ranging from mild to severe, with approximately one-third of all pediatric injury cases are related to brain injury. This public health concern ranks as the leading cause of death and disability in children and adolescents in the United States.
• In Utah, during the school year 1997-98, there were 900 injuries that affected those from kindergarten through sixth grade. Of these injuries, 276 were possible concussions or loss of consciousness. This is disconcerting because these types of head injuries can cause long term problems.

Utah Attorney General Mark Shurtleff has undergone his sixth surgery to his left leg sustained in a motorcycle accident he had in September 2007.  His left leg was badly fractured when he was riding his Harley in preparation for a motorcycle rally to raise money for a memorial for murdered Utah police officers.  Shurtleff hit a patch of gravel and his bike landed on his left leg shattering it.

Originally the surgery was thought to be a success however recurrent infections occured.  These infections in and around the metal plates, screws and pins retarded healing finally leading to a condition doctors refer to as nonunion."  

Nonunion is a serious complication of a fracture and may occur when the fracture moves too much, has a poor blood supply or gets infected.  The normal process of bone healing is interrupted or stalled.  In some cases the pseudo-joint (pseudarthrosis) develops between the two fragments with cartilage formation and a joint cavity.  More commonly the tissue between the non-united fragments is scar tissue.  Generally a nonunion, if showing no signs of bone scab formation or healing for greater than 6 months chances are the nonunion is not going to heal without more surgery.

Nonunion can be very painful and treatment may be limited.  Essentially there are two options -  surgery that may or may not work and amputation.  Oftentimes an external fixator is used to hold wires absolutely stable - the wirse pass through each end of the bone and new bone is hoped to heal between the two healthy bone ends.  This technique was developed by Gavril Ilizarov during WWII and consists of the Ilizarov Apparatus.  This is probably a last hope measure for Shurtleff.  We hope it works for him.

I bring all of this up for two reasons.  First many motorcycle accidents involve bone fractures especially of hte long bones of the leg - the femur and the tibia.  Sometimes these fractures are open fractures - meaning the fractured bone penetrates and sticks out of the skin.  This means the bone is often contaminated and the risk for bone infection is high.  With a relatively high rate of infection there is a distinct possibility that the bone will not heal yielding nonunion.  Nonunion will result in a long convalesence.

The second reason I bring this up is that nonunion is usually not diagnosed for at least 6 months after teh initial injury.  This means that an injured motorcycle rider may settle their claim too early only to find out later that the injury will cause their leg will need extended care at best and be amputated at worst.  If you settle too early you will not get another bite at the apple.  What I mean by this is that once you settle with an insurance company they insist that you sign a waiver or release.  This document will bar you from bringing a legal action forward to seek recovery from th e"unforseen" extended recovery or amputation.

In summary, if you have any suspicion whatsoever thet your injury will cause you extended healing that may eventually result in an amputation wait to ssettle your claim.  Be absolutely clear that youa re what is often termed MMI (maximum medical improvement) before you settle.  Also make sure the possibilities of future complications are calculated intot he value of the settlement.  You need to be patient and work with your attorney to make sure you make one good claim that addressed all of the losses already incurred and all those losses that will occur in the future.

A 13-year-old girl from Arco Idaho is in critical care at the Burn Trauma Center at the University of Utah after a crash when riding a 2003 Yamaha motorcycle. According to police the girl failed to stop at a stop sign and collided with a Jeep Cherokee. Apparently the gas tank ruptured and the motorcycle burst into flames. The girl sustained third degree burns from the fire and was life-flighted to the University Burn Unit.

Burn injuries are devastating injuries. They are devastating physically and emotionally.

The burned skin requires repeated surgical operations to remove the dead tissue and then remaining good skin is surgically harvested and grafted to the burned areas. The harvested areas heal because the surgical removal does not go deep enough to stop it from healing. The deeply burned areas need to be grafted because, although they too will eventually heal without grafting, the healed skin without grafting is of poor quality and often heals with heavy scarring. Grafting will in all likelyhodd be required.

Sometimes the grafting is successful and sometimes not. Invasion of infection onto the grafted areas may prevent the areas from healing. Meticulous cleaning and daily dressing changes are required to keep the bacteria at bay while healing continues. During this time the patient will have to lay still in bed or me chemically paralyzed and placed on a ventilator to prevent her from moving and disrupting the grafted skin until it has a chance to begin healing.

The repeated surgical procedures are just the beginning. After the wounds begin to heal physical therapy becomes very important. Physical therapy will start with gentle range of motion and progress to sitting, then standing, then walking and then active range of motion. All of this physical therapy is done while the patient is still trying to complete healing and the pain is often itself debilitating. The goal of the physical therapists is to return the patient to a productive life.

The emotional problems not only belong to the injured patient but oftentimes extend to the family. In this particular instance, being a 13-year-old and being a girl, she will need the expertise offered by social services at the University. The patient and family will be involved in counseling and receive support from other family members that have already dealt with similar situations.

This young girl will have scars for the rest of her life and unfortunately be stigmatized by society and reminded of the injury every day. We need to treat burn victims just like any other member of society and accept them for who they are. This young girl is first and foremost just a young girl - she just happens to be burned.

Sometimes it is necessary to amputate part of the body of an injured motorcycle rider. Physicians do not make these decisions lightly and will sometimes wait for some time before making the decision after talking about the ramifications with the patient. This often means that the motorcycle accident victim may emerge from the emergency room without going to the operating room only having to return later for the amputation to be completed.

In motorcycle accidents the most commonly amputated portion of the body is part of the leg. This makes sense because the legs are that part of the body greatest at risk for crushing injuries.

The Amputee Coalition of America (ACA) is an excellent website whose mission is to reach out to people with limb loss and empower them through education, support and advocacy. Most importantly for the victims and their families are support networks. Amputations can be devastating injuries, not only physically but psychologically as well. All too often those with amputations are young motorcycle riders and being young and experiencing a loss of a body part alters their sense of self through how they r=perceive their body image. Of course it is necessary to deal witht he amputation from a physical perspective but the psychological aspect also has to be tended to.

Good physical and psychological support will help the injured motorcycle rider and their family to deal with the hard part of rehabilitation. The amputation is not the hard aprt - rehabilitation is the hard part and spending the rest of your life without an important part of your body can be self-limiting or liberating. Sounds silly doesn't it? How can an amputation be liberating. Oftentimes a amputee emerges from the ordeal with a better sense of self and new-found appreciation for life and family.

With the Iraq War some of the worst injuries result from roadside bombs requiring amputations. As a result of work done by army physicians and prosthetic engineers great strides have been made in the use and functionality of prosthetics. One of the most promising ares of work is in the use of direct neural interface. Perhaps you have heard of the olympic runner Oscar Pistorius who use this technology that will help him compete at the Beijing Olympics.

Retraining is also an option for reentry into the job market. Maybe now is the time to go to college or switch careers into who knows - computer engineering?

My message here is that an amputation does not mean the end but the start of a new beginning.

Motorcyle injuries can be among some of the most devestating injuries that a person ever has to deal with. Motorcycle riders are not surrounded by steel, air bags or seat-belted in. You have to watch everything around you at nearly every moment - you not only need to manouver your bike but you have to plan for what the other drivers around you are going to do wrong. That's right - what they are going to do wrong. Almost every motorcycle rider that I represent in a motorcycle accident has been hit by another vehicle. Do you know what the offending driver says nearly every time? I did not see you / him / her!

Fractured bones: Almost all motorcycle accidents end up with the rider landing hard on the pavement. If you are not wearing the proper gear you will likely end up with fractured bones. Oftentimes the bones fractured are in the limbs - especially the wrists and the ankles. It is only natural for an individual to reach out when thrown from their motorcycle in an effort to cushion the impact. The small bones of the wrist are particulary vulnerable when hitting the pavement. Furthermore, it is almost impossible to protect the hands and wrist. Yes you can wear gloves but this will only protect the hands from road rash and often that protection will be less than ideal.

Check out the motorcycle injury blog