Pedestrian Injury

Injuries to Pedestrian

Three types of injuries are seen:

1) Primary impact injuries:

• Caused by initial strike, i.e., the first part of the vehicle that strikes the victim (usually legs).
• Overall, the most common site is leg 85%, followed by head (50-80%) > arms > pelvis > chest orabdomen > neck and spine

Site and nature of injuries depend on

• The height of the pedestrian and upon the position of the person in relation to the vehicle when struck
• Relative heights of various parts of the vehicle, i.e. bumper, radiator, fenders.
• In a typical case, the victim is struck by the front of the vehicle. An adult usually sustains injuries on the legs and a child on the head.

• Bumper’s fracture is the comminuted, depressed fracture of the lateral tibial condyle.
• Anterior cruciate ligament may be injured.
• The fracture is usually spiral or wedge shaped.
•  The base of the triangular fragment of bone indicates the site of the impact and the apex points in the direction in which the vehicle was travelling.
• If the pedestrian is hit from the side, there may be unilateral fracture of the nearest leg.
• If the pedestrian is facing the vehicle. he may sustain intra-abdominal injuries and/or injuries to the chest wall and thoracic contents.
•  Sometimes the pelvis is fractured.

2) Secondary impact injuries:

• After the primary impact, the victim is then again thrown back over the vehicle, causing further injuries.

3) Secondary injuries:

• Then the victim is thrown on the ground causing secondary injuries.
• These are found on parts opposite to primary impact or on head.
• Injuries due to contact with ground include abrasion  and bruises over the face, hand, hips and legs, and laceration over the bony prominence

4.) Rolling/Runover (degloving injuries) : Caused by wheel of vehicle or rolling over the victim. Children are oftenly involved.

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