Fractures on the Roadside: Public Knowledge, Attitudes, and First Response to Orthopedic Trauma from Road Accidents in Himachal Pradesh
Background: Road traffic accidents (RTAs) are a leading cause of orthopedic trauma, particularly fractures, in India. In geographically complex and infrastructurally limited states like Himachal Pradesh, timely and appropriate first-response actions by bystanders can significantly influence outcomes. However, public knowledge regarding fracture management remains largely underexplored. This study aimed to assess the level of public knowledge, attitudes, and first-response practices related to orthopedic trauma following RTAs among residents of Himachal Pradesh. Materials and Methods: A descriptive, cross-sectional study was conducted using a self-administered, Google Form-based questionnaire disseminated digitally across Himachal Pradesh. The survey, available in English and Hindi, included 400 adult participants selected through convenience sampling. The questionnaire consisted of four sections: socio-demographic details, 20 multiple-choice questions assessing awareness and misconceptions related to orthopedic trauma, knowledge classification, and response attitudes. Descriptive statistics were applied, and Chi-square tests were used to assess associations between knowledge levels and socio-demographic variables, with p < 0.05 considered statistically significant. Results: Of the 400 respondents, the largest age group was 26–35 years (28.0%), and 53.0% were from rural areas. Educational attainment varied, with 30.5% holding undergraduate degrees and 5.5% having no formal education. While 29.8% demonstrated a very good knowledge level (score 17–20), 35.8% were classified as good, 22.8% fair, and 11.8% poor. High awareness was observed regarding immobilization (69.5%), fracture signs (70.5%), and the role of first aid (73.0%), but misconceptions persisted—only 59.5% knew to avoid giving food or water to trauma victims. Knowledge levels were significantly associated with age (p = 0.021), education (p < 0.001), and residence (p = 0.029), but not with gender (p = 0.317). Conclusion: The study highlights moderate overall public awareness regarding orthopedic trauma management in RTAs, with notable deficiencies in critical first-response actions. Education, youth, and urban residency were linked to better knowledge. To improve trauma outcomes in hilly, high-risk regions like Himachal Pradesh, public health strategies must prioritize community-based first-aid training, especially in rural and underserved populations.