Læknablaðið - 15.03.1980, Qupperneq 44

64
LÆKN ABLADID
arrested by the steering column and hence
may not have injuries attributable to the wind-
screen, whereas these are likely to predomi-
nate with the front-seat passenger.
The steering wheel impinges upon the chest
and may leave indisputable external evidence
of impact. The injury to the thoracic cage may
be very severe involving the sternum, ribs and
thoracic spine with fatal damage to the heart,
aorta and lungs. In the young, however, fatal
intrathoracic injury may occur in the absence
of any boney injury and with the minimum of
external visible trauma.
The front-seat passenger suffers more fre-
quently from glass injuries, and may have
characteristic impact injuries from the dash-
board upon or below the knees, which may
result in a fracture dislocation of the hip joint.
Secondary injuries may follow ejection
from the vehicle. Some of these ntay be very
severe and may not follow any distinctive rule.
In one case a small open car came out into a
main road and was struck in the rear by a
large motor car travelling at great speed. The
front-seat passenger was ejected and struck a
lamp standard some twenty metres away,
receiving an immediately fatal head injury,
whereas the driver was uninjured.
Specific injuries may be caused by a vehicle
overturning or due to the vehicle catching fire.
The other information learned from the pat-
tern of injuries, and this has important appli-
cation in the field of road safety, are those
injuries which can be related to certain parts
of the cabin such as the steering-wheel,
dashboard, mirrors and internal projections
fromdoor handles and window-winders. Car
occupant restraint systems, such as the seat-
belt and collapsible steering wheel, have been
developed from this information and the
interior of the cabin rid of many projections
which cause their own specific injuries. The
research which is being undertaken in this
field is vast and there is no time to do more
than comment upon it during this lecture.
However, of considerable interest are those
injuries which may be attributed to the restra-
int systems.
It must be emphasized that at above certain
impact forces the restraint system will not
save life — this is apparent. What is important
are the injuries which may be caused by the
restraint systems in non-fatal accidents — or
whether the wearer was killed through wea-
ring a safety belt. When seat belts first
appeared one saw injuries of a serious nature
which could be attributed directly to that
design of belt, but in each case if the belt had
not been worn, death would have been in any
case inevitable. The solitary diagonal belt was
most at fault. With the well adjusted lap and
diagonal belt 1 have not seen severe injuries
which could be attributed to this restraint
system.
The importance of the identification of the
driver has already been stressed. This may be
done from the pattern of injuries as detailed
and from the cabin of the vehicle, but the
pathologist should also look at the clothing.
This I regret is a rather neglected aspect of
the investigation of fatal traffic accidents. The
clothes may be removed in hospital and
handed over to the relatives without any
examination. Study of the footwear may also
suggest a cause for an accident.
For example a lady with 13 cm. heels on her
way home from work in the summer with dry
roads and good visibility failed to stop at a
main intersection and was killed. Not only