Ankle joint injuries as a reconstruction parameter in car-to-pedestrian accidents

The study has assessed the usefulness of ankle joint injuries for deducing about the presumable location of a pedestrian in relation to a motor vehicle at the moment of collision. A statistically significant correlation was found between the direction of impact and the mechanism of ankle joint injuries. Such injuries were found in 113 of 317 pedestrian, fatal victims of road traffic accidents (36%). In the cases of impacts on the medial surface of the lower limb, the injuries associated with the supination mechanism were six times more frequent than the injuries associated with the pronation mechanism, while in the group of impacts on the limbs from the lateral side those connected with the pronation mechanism were four times more frequent. In victims hit from the back, the injuries connected with the plantarflexion mechanism were found almost four times more frequent than the dorsiflexion mechanism and in victims hit from the front in three of the five damaged joints the dorsiflexion component was observed (without any plantarflexion case). Less frequent "pronation injuries" in the limbs hit from the medial side and "supination injuries" in the limbs hit from the lateral side as well as "dorsiflexion injuries" in victims hit from the back predominantly occurred in impacts to the pelvic area, i.e. resulting from collisions with a van or lorry. Injuries of upper ankle joints are, thus, useful for reconstructing the presumable location of the pedestrian in relation to the vehicle at the moment of collision, especially, when the vehicle involved in the accident is known.