An in-depth analysis of 194 fractures of the lower extremity has been performed. The principal aims of the study were to determine the incidence and mechanisms of lower extremity injuries to front seat car occupants in frontal impacts and to resolve the question of which injuries are a priority for prevention based on their potential for causing long term impairment and disability using new injury severity and impairment scales.

The majority of the most severe and impairing below knee injuries were considered to be caused by footwell intrusion. Although pedals were implicated as the cause of over one fifth of below knee injuries, the majority of pedal related injuries were of low severity and not a source of long term impairment.