The biomechanics of lower limb injuries in frontal-impact road traffic collisions

Aim: We aimed to review the biomechanics of lower limb injuries caused by frontal-impact road traffic collisions.Methods: In this narrative review, we identified articles through pubmed, Scopus and Science Direct search engines for the period of 1990-2014. Search terms included: “biomechanics”, “lower limb injury”, “hip injury”, “knee injury”, “foot and ankle injury” and “frontal impact collision”. We studied factors affecting the anatomical site, frequency and severity of the injuries.Results: The most common reported mechanisms of injury were: the impaction of the knee with the dashboard resulting in acetabular fracture or posterior hip dislocation; and toepan intrusion in combination with forceful application of the brake resulting in foot and ankle fractures. The probability of an occupant sustaining significant injury to the hip is increased in taller males, and being out of position during the collision. The probability of an occupant sustaining a fracture to the foot and ankle is increased in shorter female occupants with a large overlap impact or a near oblique collision.Conclusion: Understanding the biomechanics of frontal-impact road traffic collisions is useful in alerting clinicians to the potential lower limb injuries sustained in these collisions.Keywords: Biomechanics, frontal-impact collisions, lower limb injury, knee, thigh and hip injury, lower leg, foot and ankle injury

Lower limb and associated injuries in frontal-impact road traffic collisions

Objectives: To study the relationship between severity of injury of the lower limb and severity of injury of the head, thoracic, and abdominal regions in frontal-impact road traffic collisions.Methods: Consecutive hospitalised trauma patients who were involved in a frontal road traffic collision were prospectively studied over 18 months. Patients with at least one Abbreviated Injury Scale (AIS) ≥3 or AIS 2 injuries within two AIS body regions were included. Patients were divided into two groups depending on the severity of injury to the head, chest or abdomen. Low severity group had an AIS < 2 and high severity group had an AIS ≥ 2. Backward likelihood logistic regression models were used to define significant factors affecting the severity of head, chest or abdominal injuries.Results: Eighty-five patients were studied. The backward likelihood logistic regression model defining independent factors affecting severity of head injuries was highly significant (p =0.01, nagelkerke r square = 0.1) severity of lower limb injuries was the only significant factor (p=0.013) having a negative correlation with head injury (Odds ratio of 0.64 (95% CI: 0.45-0.91).Conclusion: Occupants who sustain a greater severity of injury to the lower limb in a frontal-impact collision are likely to be spared from a greater severity of head injury.Keywords: Frontal-impact, road traffic collision, lower limb injur

The biomechanics of lower limb injuries in frontal-impact road traffic collisions

Aim: We aimed to review the biomechanics of lower limb injuries caused by frontal-impact road traffic collisions. Methods: In this narrative review, we identified articles through pubmed, Scopus and Science Direct search engines for the period of 1990-2014. Search terms included: \u201cbiomechanics\u201d, \u201clower limb injury\u201d, \u201chip injury\u201d, \u201cknee injury\u201d, \u201cfoot and ankle injury\u201d and \u201cfrontal impact collision\u201d. We studied factors affecting the anatomical site, frequency and severity of the injuries. Results: The most common reported mechanisms of injury were: the impaction of the knee with the dashboard resulting in acetabular fracture or posterior hip dislocation; and toepan intrusion in combination with forceful application of the brake resulting in foot and ankle fractures. The probability of an occupant sustaining significant injury to the hip is increased in taller males, and being out of position during the collision. The probability of an occupant sustaining a fracture to the foot and ankle is increased in shorter female occupants with a large overlap impact or a near oblique collision. Conclusion: Understanding the biomechanics of frontal-impact road traffic collisions is useful in alerting clinicians to the potential lower limb injuries sustained in these collisions

Lower limb and associated injuries in frontal-impact road traffic collisions.

Objectives: To study the relationship between severity of injury of the lower limb and severity of injury of the head, thoracic, and abdominal regions in frontal-impact road traffic collisions. Methods: Consecutive hospitalised trauma patients who were involved in a frontal road traffic collision were prospectively studied over 18 months. Patients with at least one Abbreviated Injury Scale (AIS) 653 or AIS 2 injuries within two AIS body regions were included. Patients were divided into two groups depending on the severity of injury to the head, chest or abdomen. Low severity group had an AIS < 2 and high severity group had an AIS 65 2. Backward likelihood logistic regression models were used to define significant factors affecting the severity of head, chest or abdominal injuries. Results: Eighty-five patients were studied. The backward likelihood logistic regression model defining independent factors affecting severity of head injuries was highly significant (p=0.01, nagelkerke r square = 0.1) severity of lower limb injuries was the only significant factor (p=0.013) having a negative correlation with head injury (Odds ratio of 0.64 (95% CI: 0.45-0.91). Conclusion: Occupants who sustain a greater severity of injury to the lower limb in a frontal-impact collision are likely to be spared from a greater severity of head injury