The reconstruction of traffic accidents involving powered two-wheelers (PTWs) frequently proves to be a challenging task. A case in which a fatal head-on crash of a PTW with a small truck where only minor vehicles damage was observed but resulted in isolated fatal chest trauma is discussed here. External examination of the corpse revealed two lacerations on the back, at the first glance implying sharp trauma. Based on the accident traces, the technical expert assumed an emergency break of the PTW rider resulting in a rotation of the PTW in terms of a wheelie on the front wheel. The first contact between the PTW rider and the tail end of the small truck probably occurred with the upper side of the helmet, and then, the back handle of the PTW caused the stab-like injuries followed by compression of the rider between the small truck or asphalt and the PTW. Based on the few accident traces available, neither a reconstruction of the pre-impact velocity nor a detailed reconstruction of the PTW rider kinematics was possible. However, using an interdisciplinary approach, the principal collision position as well as the injury mechanisms could be reconstructed.

Chronic aortic dissections and pseudoaneurysms caused by chest trauma are rare and generally have to be critically distinguished from non-traumatic dissections and aneurysms. We present a well-documented case of a post-traumatic aortic dissection that ruptured about 9 months after chest trauma. A motorcyclist sustained fractures of the forearm and chest trauma with paravertebral rib serial fractures and hemopneumothorax. Nine months after the accident, echocardiography revealed a pseudoaneurysm that ruptured 3 months later and 1 month prior to the planned surgery. An autopsy showed pericardial tamponade following a rupture of the dissected aorta. Accident scene documentation was consistent with a head-on collision of the motorcycle against the left front side of the car. The relative speed was about 55 km/h. Aggravation of unspecific symptoms after discharge, initial CT imaging, and the absence of atherosclerosis or medial necrosis hold for a post-traumatic genesis of the dissection in our case. Initially, the accident insurance company rejected the regulation. In the second instance, they revised rejection based on our interdisciplinary expert opinion.