Commonly Seen Injuries

TABLE 34—1 Commonly Seen Injuries Pedestrian hit by automobile Adult: Fractures of femur, tibia, and fibula on side of impact; ligamental damage to impacted Adult ; knee; mild contralateral brain injury Chi/d Child: Fractures of femur, chest injury, contralateral brain injury Unrestrained driver 5 Head and/0r facial injury, rib fractures, sternum with underlying myocardial or pulmonary ' contusion, cervical spine fractures, laryngotracheal injuries, spleen injuries, liver injuries, small bowel injuries, posterior fracture—dislocation of hip, femur fractures Unrestrained front seat Head and/or facial injuries, laryngotracheal injuries, posterior fracture—dislocation of femoral passenger 5 head, femur/patellar fractures Restrained driver (lap and Contusions of structures underlying harness (Let, pulmonary contusion, contusion of small shoulder harness) bowel) Restrained passenger (lap belt Flexion-distraction fractures, especially lumbarvertebrae (Ll—L4), duodenal injuries, cervical onlYl spine injuries Fall injuries 3 Compression fractures of lumbosacral spine and calcaneous fractures; fractures of radius/ulna, patella if victim falls forward Vehicular ejection Multiple injuries, especially head and cervical spine injuries; injury risk increases by 300% ' when ejection occurs Low-velocity impalement Local tissue/organ disruption, little or no cavitation High—velocity missile, short Entrance wound larger than missile caliber; large ragged exit wound with cavitation missile path 2 _. High-velocity missile, long Entrance wound larger than missile caliber; exit wound slightly larger than or equal to missile missile path caliber; extensive cavitation (blast effect to deep structures absorbing lost kinetic energy) High—velocity missile hitting Entry wound larger than missile caliber; possibly no exit wound with missile fragmentation; bone or teeth 5 secondary missile injury in unpredictable, erratic pattern