Motor Vehicle Occupant Injuries

When a motor vehicle is involved in an accident, the driver and passengers will travel toward the site of the impact. For example, an impact to the front left of a car during a head-on crash will cause occupants to move to the left, especially if unrestrained. The driver may hit the steering wheel, dashboard or windshield, and the passenger the dashboard, windshield or rear-view mirror. Each may have significant injuries even though they hit different objects.

There may be few external marks when there are seat belts and airbags, however, internally, there may be impressive injuries to the heart and aorta. Seat belt abrasions on the shoulder and hips are common. The location of the marks help differentiate between the driver and the passenger.

Side-window glass causes a characteristic injury because it is made of tempered glass which will shatter into numerous small fragments upon impact. These fragments will cause a characteristic "dicing" pattern of lacerated abrasions on the face, shoulders, or arms. A driver will have dicing injuries on the left side of the body and a passenger will have them on the right.

Other common injuries involve fractures of the patella (knee) and femur caused by hitting the dashboard and the extremities caught under the seat. High-speed collisions can cause multiple severe injuries. There may be extensive skull fractures and facial lacerations, contusions, and abrasions. Common injuries to the trunk include rib and pelvic fractures with associated internal injuries. Lacerations of these internal organs may occur without associated rib fractures. If any of the occupants are ejected during a crash, obviously the injuries may be quite variable and very severe. Head trauma is common in these situations. In addition, when an occupant is ejected, a vehicle may roll over and compress the occupants, causing compressive asphyxia, often with few other injuries.

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