In Crashes, Legs Often Take a Hit
Airbags and seat belts have helped more people survive potentially fatal automobile crashes, but they haven’t shielded drivers and passengers from leg and foot injuries.
The vulnerability of feet was illustrated earlier this month, when actor Jason Priestley suffered fractures to both feet, his back and nose, as the car he was driving at the Kentucky Speedway crashed into a wall at 180 mph. He eventually was flown to Methodist Hospital in Indiana, which specializes in injuries common in professional racers.
Although Priestley is expected to make a full recovery, his foot injuries could require a lengthy recuperation.
Race cars have little in common with passenger vehicles--for example, their engines are behind the driver--but people traveling the nation’s highways often suffer similar injuries in a front-end crash.
Automobile designers and federal officials are working to change that. Some new models of cars and trucks have been designed to better protect the lower extremities, and the crash-test dummies used to test automobile safety will be given more realistic thigh bones, knees, Achilles tendons and ankles, said Tim Hurd, a spokesman for the National Highway Traffic Safety Administration. In short, the crash test dummies are getting new legs.
The new part, called the Thor-LX Advanced Lower Extremity, remains experimental, but will better measure how the leg withstands impact.
“Ten years ago, that person in a high-energy crash was dead,” said Dr. Andrew Burgess, an orthopedic surgeon and trauma specialist who’s been working with auto makers and federal officials to make sure cars better protect the legs in automobile accidents.
Today, Burgess said, airbags and seat belts protect the head, chest and abdomen. But the spleen, pelvis and thigh bones are less shielded. Doctors can usually repair those injuries, but many patients are discharged from the hospital with painful lower leg injuries that can interfere with their ability to work and play, leading to depression, addictions, job loss and relationship problems.
The Maryland Shock Trauma Center in Baltimore, which has been focused on lower leg injuries for several years, has found that about one in five drivers admitted to trauma centers after a crash suffer at least one lower leg fracture. The most frequent specific fracture involves the ankle.
“Bad ankle injuries from car crashes most often resemble people falling or jumping from heights,” said Burgess, chief of orthopedic surgery at Shock Trauma until recently going into private practice in Portland, Maine. “Everything pulverizes.”
Researchers have found that women have a higher incidence of foot and ankle fracture in crashes than men. Burgess said that’s because a woman’s smaller foot hangs off the brake pedal, suspended. In a crash, the floor area behind the brake slams into her heel. Men’s larger feet already are in contact with the floor, so their heels aren’t slammed as hard.
Such heel and ankle injuries often don’t heal well because the bones are so damaged.
Legs are injured in two ways. First, when you’re in a moving car that suddenly stops, the excessive force of your body continuing to move forward can break your leg. Even without causing an injury, a crash may apply 60 to 80 times the force of gravity to the legs, said Adrian Lund, chief operating officer of the Insurance Institute for Highway Safety in Arlington, Va. Second, he said, as the passenger compartment gets crushed, your foot might get caught in the brake and gas pedals or your knee can jam into the instrument panel.
Front-seat passengers are subject to the same injuries, except they don’t have the complications of pedals. Back-seat passengers can be subject to leg injuries, most often involving side impact.
In the late 1980s, Mercedes began to pad the floor area behind the brake pedal. Several automakers, including Saab, Volvo and Lexus, added breakaway or energy-absorbing brake pedals.
Several carmakers have since begun creating crush zones for the feet. Some weld extra steel onto the underside of the car to divert energy away from the feet.
Domestic car makers have been catching up. The new features tend to be added with major model changes.
You can learn about a particular model’s safety by checking ratings from the Insurance Institute for Highway Safety. Federal safety agencies test the effects of head-on crashes, but the institute specializes in so-called offset crash tests, in which only about 40% of the front-end on the driver’s side hits the barrier. At 40 mph, these offset crashes are extremely damaging to the passenger compartment, sometimes even more so than the head-on crashes.
Structures at the front of the car begin to crush first, and then the floorboards start to crush toward the driver, Lund said. The institute tests found that in some cars, the passenger compartment was crushing before the front-end.
“We started testing in 1995. Since we’ve been doing offset crash testing and comparing vehicles, we’ve seen tremendous improvements,” Lund said. “Most vehicles we test now are doing a good job of protecting the occupant compartment.”
*
The Insurance Institute for Highway Safety rates crash-worthiness of cars, including the risk of leg injury. For ratings, call (703) 247-1500, write to 1005 N. Glebe Road, Suite 800, Arlington, VA 22201, or go to www.highwaysafety.org.
