To date a great number of biomechanical dynamic load tests on the long bone fractures mechanisms and morphology have been performed using the fragments or whole fresh bone specimens collected from cadavers. However, the latest studies concerning fracture patterns in real world accident casualties (with bone maceration to visualize additional crack fissures) were conducted in the 1970s, i.e. when the vehicle construction and traffic structure significantly differed from that found today. The aim of the present study was to assess the character of diaphyseal fractures of the lower limbs occurring nowadays in vulnerable road users and the possibilities of determining the direction of action of the external force (the direction of impact) on the basis of such fractures. The changes in the construction and shape of bumpers and front contours of modern vehicles only apparently reduced the percentage of flexion fractures since in the majority of cases the process of maceration of bones has disclosed some additional fissures of cracks, which "complemented" the contour of the Messerer's wedge in oblique fractures or even constituted the whole edge in transverse fractures ("phantom wedges"). Therefore, flexion fractures are still valuable biological markers provided that suitable post mortem preparation is carried out. Moreover, the results of the present study may be used to reconstruct the accident circumstances in survival cases as some of the fractures may be found intravitally on high quality X-ray pictures. For the covering abstract see ITRD E141807.
Abstract