title: A case report of a severe musculoskeletal injury in a wheelchair user caused by an incorrect wheelchair ramp design.
abstract: The Americans with Disabilities Act (ADA) gives all Americans with disabilities a chance to achieve the same quality of life that individuals without disabilities enjoy. In this case report, we will be discussing the consequences of having inaccessible ramps to persons with disabilities that can result in severe musculoskeletal injuries in a wheelchair user. While going down an inaccessible ramp in the garage of a hospital, a wheelchair tipped over, causing a fracture to the user's right femur. The injured patient was taken to the Emergency Department, where the diagnosis of a fracture of the right femur was made. The fracture then had to be repaired with an intramedullary rod under general anesthesia in the hospital. It was discovered that the ramps in the hospital garage did not comply with the guidelines of the ADA. The wheelchair ramps had a ramp run with a rise > 6 inches (150 mm) and a horizontal projection > 72 inches (1830 mm). This led to the redesign and construction of safe ramps for individuals using wheelchairs as well as for pedestrians using canes, within 1 month after the patient's injury, making it safe for wheelchair users as well as pedestrians using the parking facilities. The ADA specifies guidelines for safe ramps for patients with disabilities. It is important to ensure that hospital ramps comply with these guidelines.
authors.affiliation: Distinguished Professor Plastic Surgery, University of Virginia Health System, USA.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Edlich
authors.forename: Angela R
authors.initials: AR
authors.lastname: Kelley
authors.forename: Karrie
authors.initials: K
authors.lastname: Morton
authors.forename: Richard E
authors.initials: RE
authors.lastname: Gellman
authors.forename: Richard
authors.initials: R
authors.lastname: Berkey
authors.forename: Jill Amanda
authors.initials: JA
authors.lastname: Greene
authors.forename: Larry
authors.initials: L
authors.lastname: Hill
authors.forename: Roy
authors.initials: R
authors.lastname: Mears
authors.forename: William B
authors.initials: WB
authors.lastname: Long
mesh_terms: D000368:Aged; D001107:Architectural Accessibility; D006233:Persons with Disabilities; D004867:Equipment Design; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000293:injuries*; D014910:Wheelchairs / Q000706:statistics & numerical data*