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In a frontal automotive crash, the driver's foot is usually stepping on the brake pedal as an instinctive response to avoid a collision. The tensile force generated in the Achilles tendon produces a compressive preload on the tibia. If there is intrusion of the toe board after the crash, an additional external force is applied to the driver's foot. A series of dynamic impact tests using human cadaveric specimens was conducted to investigate the combined effect of muscle preloading and external force. A constant tendon force was applied to the calcaneus while an external impact force was applied to the forefoot by a rigid pendulum. Preloading the tibia significantly increased the tibial axial force and the combination of these forces resulted in five tibial pylon fractures out of sixteen specimens.

The mechanisms of knee fracture were studied experimentally using cadaveric knees and analytically by computer simulation. Ten 90 degree flexed knees were impacted frontally by a 20 kg pendulum with a rigid surface, a 450 psi (3.103 MPa) crush strength and a 100 psi (0.689 MPa) crush strength aluminum honeycomb padding and a 50 psi (0.345 MPa) crush strength paper honeycomb padding at a velocity of about five m/s. During rigid surface impact, a patella fracture and a split condylar fracture were observed. The split condylar fracture was generated by the patella pushing the condyles apart, based on a finite element model using the maximum principal stress as the injury criterion. In the case of the 450 psi aluminum honeycomb padding, the split condylar fracture still occurred, but no patella fractures were observed because the honeycomb provided a more uniform distribution of patella load. No bony fractures in the knee area occurred for impacts with a 50 psi paper honeycomb padding.

From our crash investigations of air bag equipped passenger cars, a subset of upper extremity injuries are presented that are related to air bag deployments. Minor hand, wrist or forearm injuries-contusions, abrasions, and sprains are not uncommonly reported. Infrequently, hand fractures have been sustained and, in isolated cases, fractures of the forearm bones or of the thumb and/or adjacent hand. The close proximity of the forearm or hand to the air bag module door is related to most of the fractures identified. Steering wheel air bag deployments can fling the hand-forearm into the instrument panel, rearview mirror or windshield as indicated by contact scuffs or tissue debris or the star burst (spider web) pattern of windshield breakage in front of the steering wheel.

An understanding of the injuries of the lower limb requires a knowledge of the terminology describing the injuries. To understand injuries one should also appreciate how injured tissue recovers. This paper summarizes the terminology of lower limb injuries. It also explains the basic concepts of injury healing and the classification of injuries.

The lower limb is frequently injured during motor vehicle accidents. Some injuries, such as severe pelvic fractures, posterior dislocations of the hip, fractured femurs, and tibial plateau fractures, have their most common cause as motor vehicle related trauma. Musculoskeletal injuries usually take months to heal. Even optimal treatment leaves a significant percentage of those injured with permanent impairments. For some injuries the impairment may develop and/or worsen as the “recovered” victim ages. The long term consequences of major injuries of the musculoskeletal system are discussed in this paper.

The biodynamic response of the femur during passively restrained -Gx impact acceleration is reported in this paper. Eleven unembalmed cadavers, ranging in age from 21 to 65 and weighing from 50 to 96 kg, were tested in a VW Rabbit seat with a passive belt and knee restraint. Sectioned parts of the VW knee bolster were placed about 130 mm away from the patella at the initiation of the tests. The height of the knee bolsters was adjusted individually in the eleven tests. Ten were set for loading directly through the patella. In one run, the impact was below the knee joint. The sectioned bolsters were mounted on a rigid frame and instrumented with triaxial load cells. A six-axis load cell was installed in the right femur. Photo targets were attached directly to the femur and tibia. Sled runs were made at 22 and 35 g. Only one cadaver sustained bilateral femoral fractures at 35 g.

A series of volunteer and dummy impact experiments was performed on a Hyge-type (accelerator) sled to study the relative motion between the upper torso restraint and the torso surface. Kinematic measurements were made using a three-dimensional photogrammetric analysis of high-speed film data. Belt slip was found to be in the range of approximately 10 to 30 mm with more slip experienced by volunteers than the dummy. The dummy showed a slight change in amount of slip with acceleration level and all slip takes place within the first 80 ms of belt loading.

Spinal kinematics and kinetics of human cadaveric specimens subjected to -Gx acceleration are reported along with an attempt to design a surrogate spine for use in an anthropomorphic test device (ATD). There were a total of 30 runs on 9 embalmed and 2 unembalmed cadavers which were heavily instrumented. External photographic targets were attached to T1, T12, and the pelvis to record spinal kinematics. The subjects were restrained by upper and lower leg clamps attached to an impact seat equipped with a six-axis load cell. A rigid link 486 mm long and pinned at both ends was proposed for use in an ATD as a surrogate spine. An optimization method was used to obtain the location and length of a linkage which followed the least squares path of Tl relative to the pelvis.

Knee bolsters on the lower instrument panel have been designed to control occupant kinematics during sudden deceleration. However, a wide variability in car occupant anthropometry and choice of seating posture indicates that lower-extremity contacts with the impingement bolster could predominantly load the flexed leg through the knee (acting through the femur) or through the tibia (acting through the knee joint). Potential injuries associated with these types of primary loading may vary significantly and an understanding of potential trauma mechanisms is important for proper occupant restraint.