Pattern Recognition: A Mechanism-based Approach to Injury Detection after Motor Vehicle Collisions

Abstract

Motor vehicle collisions cause substantial mortality, morbidity, and expense worldwide. Certain types of injuries are more likely to result from frontal versus side-impact collisions, and knowledge of these specific patterns and why they occur aids in accurate and efficient diagnosis of traumatic injuries. Although the proper use of seat belts decreases crash-related mortality during frontal impact, certain injury patterns to the torso are directly attributed to restraint use. The spectrum of seat belt-related injuries ranges from mild skin and soft-tissue contusions to traumatic bowel injuries and unstable spine injuries that require surgery. Impact with the steering wheel or windshield during a frontal crash can cause characteristic injuries to the head, neck, torso, and distal upper extremity. Steering wheel deformity is an independent predictor of serious thoracic and abdominal injury among front-seat passengers. Impact of a flexed knee with the dashboard during a frontal collision can cause knee, thigh, and hip injuries. Distal lower extremity injuries are encountered frequently when the floorboard is driven into the foot. Lateral impact crashes often result in traumatic brain, thoracic, abdominal, and pelvic injuries, which are more often fatal to occupants on the side of the impact. The specific mechanism-based injury patterns are reviewed to establish a structured systematic search pattern that enables the radiologist to identify traumatic injuries with greater accuracy and speed, thereby improving the care of patients who experience acute trauma. ©

Sex-disaggregated analysis of the injury patterns, outcome data and trapped status of major trauma patients injured in motor vehicle collisions: a prespecified analysis of the UK trauma registry (TARN)

“…Male patients experience a higher rate of frontal collisions, which may account for the increased rate of head, face and chest injury found in this study, through interactions and resultant energy transfer with the steering wheel and/or air bag 20 21. The higher rate of male drivers and their interactions with the pedals and the ‘bracing’ experienced by drivers precollision may explain the higher rate of limb injury seen in male patients in this study 22 23…”

A Retrospective Cohort Study on the Clinical Characteristics of Patients with Surgical Blunt Bowel and/or Mesenteric Injuries among Motorcyclists and Car Occupants

“…In addition, the ratios of surgical BBMI among motorcyclists and car occupants after BAT (3.5% and 19.7%, respectively) were also similar to those in our previous study on high-grade blunt hepatosplenic trauma between motorcyclists and car occupants (2.4% and 14.1%, respectively) [ 22 ]. Considering that motorcyclists account for 87% (whereas car occupants account for only 3.1%) of the trauma population associated with road transportation accidents in Taiwan [ 7 ], these abdominal injuries are more common among victims of car crashes [ 22 , 23 ] but not motorcycle accidents [ 10 , 24 ]. The risks of surgical BBMI among motorcyclists and car occupants were in accordance with the report by Raharimanantsoa et al [ 13 ].…”

The impact of BMI on morbidity and mortality after femoral fractures

“…These findings may contribute to why obese patients sustained more shaft and distal femur fractures. The shaft and distal femur, along with the knee, especially during motor vehicle trauma, may absorb most of the force from the impact of the dashboard [ 19 ]. Since patients with higher BMI were associated more high energy traumas, distal and femur fractures, and high ISS, it is comprehensable that these patients developed more complications as a result.…”