Pattern of organ injuries in pelvic fracture:​ impact force implications for survival and death in motor vehicle injuries

Siegel, John H.; Dalal, Samir A.; Burgess, Andrew R.; Young, Jeremy W. R.

Affiliations

¹The Maryland Institute for Emergency Medical Services Systems and the Departments of Surgery, Orthopedics and Radiology, University of Maryland, Baltimore, Maryland

Abstract

The direction of force impact, lateral or frontal crash force, was estimated from the mechanism of pelvic fracture (PF) and related to the pattern of organ injuries, physiologic consequences and outcomes in 197 motor vehicle accident (MVA) patients who had all sustained a PF. These data showed that injuries due to anterior-posterior compression (APC) (frontal crashes) were associated with injuries of major severity to the bony pelvis with major retroperitoneal bleeding and massive volume loss shock. Death in the APC patient was frequently due to a late complication of the shock; sepsis, ARDS or lung infection. However in lateral compression (LC) injuries (lateral crashes) with fatal outcomes there was a significant increase in severe brain injuries and a rise in lung and upper abdominal visceral injuries with relatively minor PF. These data suggest the great vulnerability of the MVA patient, driver or passenger, to lateral crash forces and suggest important areas for occupant protection.

Cited By (4)

Year	Entry
1990	Siegel JH, Mason-Gonzalez S, Cushing BM, Dischinger PC, Cornwell EC III, Smialek JE, Heatfield BM, Soderstrom CA, Read KM, Robinson RM, Parkinson K, Dailey JT, Hill WJ, Jacksona JW, Livingston DJ, Bents FD, Shankar BS. A prospective study of injury patterns, outcomes and costs of high speed frontal versus lateral motor vehicle crashes. In: 34th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 1-3, 1990; Scottsdale, AZ.289-313.
1991	Luchter S, Isenberg R. The incidence of multiple injuries in motor vehicle crashes. In: Proceedings of the 13th International Technical Conference on Experimental Safety Vehicles (ESV). November 4-7, 1991; Paris, France.148-155.
1993	Siegel JH, Mason-Gonzalez S, Dischinger P, Cushing B, Read K, Robinson R, Smialek J, Heatfield B, Hill W, Bents F, Jackson J, Livingston D, Clark CC. Safety belt restraints and compartment intrusions in frontal and lateral motor vehicle crashes: mechanisms of injuries, complications, and acute care costs. J Trauma. May 1993;34(5):736-759.
1996	Loo GT, Siegel JH, Dischinger PC, Rixen D, Burgess AR, Addis MD, O'Quinn T, McCammon L, Schmidhauser CB, Marsh P, Hodge PA, Bents F. Airbag protection versus compartment intrusion effect determines the pattern of injuries in multiple trauma motor vehicle crashes. J Trauma. December 1996;41(6):935-951.