Lower Limb Trauma Caused by Wheelchair Collision During Hajj Pilgrimage: A Case Report Integrating Crowd Dynamics, Ergonomic Risk, and Pilgrim Safety

Abstract

Introduction: Mass gatherings such as the Hajj pilgrimage pose unique challenges for mobility-impaired individuals, particularly those using wheelchairs. In high-density environments, unintended collisions between wheelchairs and pedestrians can result in physical injuries and psychological distress. Despite the scale of such events, limited attention has been given to the ergonomic and crowd-related risks associated with wheelchair use. Case Presentation: A 58-year-old male pilgrim from Indonesia sustained a soft tissue injury to his left ankle after being struck by the front wheel of a manual wheelchair during Tawaf. The incident occurred in a zone with crowd density exceeding 5.5 persons/m². Clinical examination revealed mild swelling, ecchymosis, and pain during dorsiflexion. Radiography ruled out fracture, and the patient was diagnosed with Grade I contusion and mild ligament strain. He was treated conservatively and experienced psychological discomfort following the incident. Conclusions: Wheelchair-related injuries in mass gatherings are preventable through strategic design and proactive management. This case emphasizes the importance of combining clinical insight with crowd engineering and ergonomic principles to enhance safety for all participants.