Skip to main content
Log in

Lower extremity injuries in side-impact vehicle crashes

  • Published:
International Journal of Crashworthiness

Abstract

Lower extremity (LE) fractures and dislocations resulting from car crashes are costly and debilitating. In particular, occupant safety regulations for side-impact crashes are deficient in protecting the knee, lower leg and ankle/foot. Hence further side-impact research is required to understand injury mechanisms of these parts of the LE. In addition, side-impact dummies so far cannot measure forces and injury criteria in these lower parts of the LE. The aim of this paper is to identify and characterise LE fractures and dislocation injuries in side-imacts and propose some injury mechanisms. There appears to be some consensus on mechanisms describing how fractures and/or dislocations of the LE occur in frontal crashes. However, as far as the authors are aware, the mechanisms for side-impact have yet to be described and published. This paper presents some preliminary results of case studies of LE injuries incurred in vehicles subjected to side-impact crashes in Australia between 1989 and 2002. A summary of the findings to date is presented. Three basic injury mechanisms have been identified. They are: (1) Intrusion causing entrapment resulting from leg area volume reduction with a bending side-force, acting alone or together; (2) High-energy, side-impact, striking force resulting from being in direct contact with the struck portion of the vehicle; and (3) Inertial movement of the body causing loading of the LE resulting from its interaction with the vehicle interior and where intrusion is not the cause of the injury. This paper also proposes some injury mitigation strategies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  1. Begeman, P Balakrishnan, P Levine, R and King, A. ‘Dynamic human ankle response to inversion and eversion', 37th Stapp car crash conference, San Antonio, Texas, SAE, 1993 p. 83–93.

  2. Crandall, J R and Martin, P G. ‘Lower limb injuries sustained in crashes and corresponding biomechanical research', International Symposium on Real World Crash Injury Research, UK, 1997 p. 3.5.1–3.5.16.

  3. Crawford-Adams, J. ‘Outline of fractures', 4th Edition ed, E & S Livingston Ltd, 1964.

  4. Dischinger, P C, Schmidhauser, C B, Burgess, A R, Ho, S M, Cushing, B M, O'Quinn, T D, Juliano, P J and Bents, F D. ‘Lower extremity trauma in vehicular front seat occupants: patients admitted to a level 1 trauma centre', SAE international congress and exposition. In depth accident investigation: trauma team findings in late model vehicle collisions, SAE Paper No. 940710, ISBN 1–56091–494–7, Detroit, Michigan, SAE, 1994 p. 11–18.

    Google Scholar 

  5. European Transport Safety Council, Reducing Traffic Injuries Through Vehicle Safety Improvements–The Role of Car Design, in Technical Annexes, Annex C, European Transport Safety Council, 1993 p. 55–193.

  6. Fildes, B, Lenard, J, Lane, J, Vulcan, P and Seyer, K. ‘Lower limb injuries to passenger car occupants', Accident Analysis and Prevention., 1997 Nov; 29(6) 785–91.

  7. Fildes, B, Sparke, L and Seyer, K. ‘Improved Side Impact Protection (ISIP) in Australia: Overview of a Collaborative Approach', 17th International Conference on the Enhanced Safety of Vehicles, Amsterdam, 2001 p. 1–10.

  8. Fildes, B N, Lane, J C, Lenard, J, Vulcan, A P and Wenzel, J. ‘Lower Limb Injuries to passenger car occupants', Monash University Accident Research Centre CR 137, Clayton, 1994.

  9. Forssell, J, Jakobsson, L, Lund, A and Tivesten, E. ‘Foot and leg injuries in frontal car collisions', Volvo Car Corporation Paper No. 96-S3-O-05, Melbourne, 1996.

  10. Gibson, T. ‘Pelvic and lower limb injury biomechanics', Crash Injury Biomechanics, Sydney, 1995 p. 8.

  11. Gibson, T, Fildes, B, Deery, H, Sparke, L, Benetatos, E, Fitzharris, M, McLean, J and Vulcan, P. ‘Improved Side Impact Protection: A Review of Injury Patterns, Injury Tolerance and Dummy Measurement Capabilities', Monash University Accident Research Centre Report 147, Melbourne, 2001.

  12. Haland, Y, Lovsund, P and Nygren, A. ‘Life-threatening and disabling injuries in car-to-car side impactsimplications for development of protective systems', Accident Analysis and Prevention, 1993 Apr; 25(2) 199–205.

    Google Scholar 

  13. Hayashi, S, Choi, H-Y, Levine, R S, Yang, K H and King, A I. ‘Experimental and analytical study of knee fracture mechanisms in a frontal knee impact', Proc. 40th Stapp Car Crash Conference, Paper No. 962425, ISBN 0585–086X, New Mexico, 1996 p. 161–171.

  14. Lau, I V, Capp, J M and Obermeyer, J A. ‘Comparison of frontal and side impact. Crash dynamics, countermeasures and subsystem tests', Proceedings of the 35th Stapp Car Crash Conference, SAE, P–251, San Diego, 1991 p. 109–124.

  15. Lestina, D C, Kuhlmann, T P, Keats, T E and Alley, R M. ‘Mechanisms of fracture in ankle and foot injuries to drivers in motor vehicle crashes', 36th Stapp Car Crash Conference Proceedings, Seattle, Washington, USA, Society of Automotive Engineers, 1992 p. 59–67.

    Google Scholar 

  16. Mackay, G M, Chang, L, Smith, M and Parkin, J H. ‘Restrained front seat car occupant fatalites–the nature and circumstances of their injuries', 34th annual proceedings. Association for the Advancement of Automotive Medicine. Oct 1–3, Arizona, 1990 p. 139–161.

  17. Mackay, S M, Parkin, S and Hill, J. ‘Restrained occupants on the non-struck side in lateral collisions', Proceedings of FISITA 92, Institute of Mechanical Engineers, 1992 p. 13–24.

  18. Mackenzie, E J. ‘The Public Health Impact of Lower Extremity Trauma', Biomechanics and Medical Aspects of Lower Limb Injuries., Warrendale, PA, USA., Society of Automotive Engineers, Inc., 1986 p. 161–169.

    Google Scholar 

  19. Manning, P, Wallace, A, Owen, C, Roberts, A, Oakleigh, C and Lowne, R. ‘Dynamic Response and Injury Mechanism in the Human Foot and Ankle and an Analysis of Dummy Biofidelity', 16th International Technical Conference on the Enhanced Safety of Vehicles. Proceedings, Vol. 3, Ontario, Canada, 1998 p. 1960–1999.

    Google Scholar 

  20. Moore, K L. ‘Clinically Oriented Anatomy', Second ed, Baltimore, Williams and Wilkins, 1985.

  21. Morgan, R M, Eppinger, R H and Hennessey, B C. ‘Ankle joint injury mechanism for adults in frontal automotive impact', 35th Stapp Car Crash Conference, P-251, ISBN 1–56091–190–5, San Diego, SAE, 1991 p. 189–198.

  22. Morris, A, Thomas, P, Taylor, A M and Wallace, W A. ‘Mechanisms of ankle and hind-foot injuries to drivers and passengers in frontal crashes as deduced from field studies', International Journal of Crashworthiness, 1999 4(3) 505–315.

    Google Scholar 

  23. Nagel, D A, Burton, D S and Manning, J. ‘The dashboard knee injury.', Clinical Orthopaedics and Related Research., 1977 126 (July–Aug) 203–208.

  24. Otte, D, VON-Rheibaben, H and Zwipp, H. ‘Biomechanics of injuries to the foot and ankle joint of car drivers and improvements for an optimal car floor development', 36th Stapp Car Crash Conference Proceedings, Seattle, Washington, 1992 p. 43–58.

  25. Pattimore, D, Ward, E, Thomas, P and Bradford, M. ‘The nature and cause of lower limb injuries in car crashes', 35th Stapp Car Crash Conference Proceedings, Paper No. 912901, San Diego, California, Society of Automotive Engineers, 1991 p. 177–198.

    Google Scholar 

  26. Sparke, L J. ‘An Australian Perspective on side impact protection', Holden Australia 96-S6-O-07, Melbourne, 1996.

  27. States, J D. ‘Adult occupant injuries of the lower limb', Symposium on Biomechanics and Medical Aspects of Lower Limb Injuries, Paper No. 861927 Warrendale, PA, SAE, 1986 p. 97–107.

  28. Stolinski, R and Grzebieta, R. ‘Priorities to reduce vehicle side impact trauma: which countermeasures matter most?', Proceedings of the 15th Enhanced Safety of Vehicles Conference, Melbourne, 1996 p. 1–14.

  29. Stolinski, R, Grzebieta, R and F B. ‘Modelling the Societal Costs of Vehicle Far-Side Impact Crashes', Monash University, Melbourne, 1997.

    Google Scholar 

  30. Stolinski, R, Grzebieta, R and Fildes, B. ‘Side Impact Protection–occupants in the far-side seat', International Journal of Crashworthiness, 1998 3(2) 93–121.

    Google Scholar 

  31. Stolinski, R, Grzebieta, R and Fildes, B. ‘Vehicle far-side impact crashes', 16th International Technical Conference on the Enhanced Safety of Vehicles, Windsor, Canada, 1998 p. 1819–1826.

    Google Scholar 

  32. Strother, C E, Smith, G C, James, M B and Warner, C Y. ‘Injury and intrusion in side impacts and rollovers', SAE Transactions, 1984 93(3) 3.1–3.24.

    Google Scholar 

  33. Tamura, A, Furusu, K K, Miki, H J and Yang, K H. ‘A Tibial Mid-Shaft Injury Mechanism in Frontal Automotive Crashes', 17th International Conference on the Enhanced Safety of Vehicles, Amsterdam, 2001 p. 1–9.

  34. Thomas, P and Frampton, R. ‘Injury patterns in side collisions–a new look with reference to current test methods and injury criteria', 43rd Stapp Car Crash Conference, San Diego, California, SAE, 1999 p. 1–12.

    Google Scholar 

  35. Ward, E G W, Bodiwala, G G and Thomas, P D. ‘The importance of lower limb injuries in car crashes when cost and disability are considered', Accident Analysis and Prevention, 1992 25(No 6) 613–620.

    Google Scholar 

  36. Zeidler, F, Scheunert, D, Breitner, R and Krajewski, R. ‘The reduction of the risk of lower leg injuries by means of countermeasures optimized in frontal crash tests', 15th International Technical Conference on the Enhanced Safety of Vehicles, Paper No. 96–s3–O-06, Melbourne, 1996 p. 1–11.

Download references

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Arndt, N., Grzebieta, R.H. Lower extremity injuries in side-impact vehicle crashes. International Journal of Crashworthiness 8, 495–512 (2003). https://doi.org/10.1533/ijcr.2003.0255

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1533/ijcr.2003.0255

Navigation