Motor Vehicle injuries

D i.e. Upper trunk injury

B i.e. Hinge fracture of base of the skull

Hinge fracture of base of the skull, in which the base of the skull is divided into two halves, each moving independently of each other like a hinge, is termed as motor cyclist’s facture.

A. i.e. Ring fracture:

• Motorcyclist’s fracture is a ring fracture of skull baseQ, separating the rim of foramen magnum from rest of the base. It usually results due to sudden anteroflexion of cervical spine without impact on occiput caused usually by vertical deceleration injury (fall from height) or rarely motorcycle accident.
• Motorcyclist can sustain ring fracture and pillion rider (i.e. atlantooccipital avulsion with dural tear).

A i.e. Lumbar spine is commonly involved

Whiplash Injury

• It is the acceleration , de-acceleration injury of the cervical spine caused usually by rear end collision, in which occupants body is thrown forwards and the head jerked backwards with hyperextension of the lower cervical spineQ. However it can also occur with flexion and rotation injuries.
• It commonly affects cervical columnQ and rarely lumbo- dorsal columns.
• It most commonly presents as soft tissue sprain & strain (wrenching injuries) of the neck usually causing restriction of range of all movements of the cervical spine with pain and spasmQ. But rarely radicular signs, neurological deficit and fracture.

C i.e. Chance fracture

A horizontal fracture of the vertebra extending from body to the posterior element, caused by a strong distraction force

D i.e. Seat belt injury

Chance fracture is flexion – distraction failure of mid lumbar spine (L₁ – L₃) due to seat belt injuryQ

Lap seat belt injury/Jack- knife injury/ Chance fracture

• Occurs when an automobile passenger wearing a seat belt over a lap is thrown forward, so also k/a ‘lap seat belt injuriesq2
• Combined flexion & distractionQ may cause mid lumbar spine to ‘Jack- Knife’ around an axis that is placed anterior to the vertebral column leading to vertebral body fail (#) in flexion and posterior & middle element fail (#) in distraction.
• The tear passes transversly through the bones or ligament structures or bothQ. The classical example (as described by chance) was split running through spinous process, transverse processes, pedicle & vertebral body.
• As the injuries retain the anterior longitudinal ligament neurological damage is uncmmonQ (though the injury by definition is unstable) and hyper extension will usually bring them into a satisfactory position.
• X- Ray may show horizontal fractures in pedicles & transverse processes & in anteroposterior view apparent height of vertebral body may he increased. In lateral veiw there may be opening up of the disc space posteriorly .

‘All bone’ injuries heal rapidly in hyperextension casting or bracing in 3 months. Severe ligamentous injuries are not likely to heal and surgical stabilization (posterior spinal fusion) is recommended.

Ans. is ‘a’ i.e., Dudoenum

Ans. Basilar fracture

Ans. Wind screen impact

Ans. Rupture of mesentery

Ans. is ‘c’ i.e., Horizontal tears of aortic intima

• Ladder tears are the horizontal tears of intima
• It is injury to aorta due to deceleration.
• It is so called be cause it resembles the rungs of a ladder.