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Car Injuries

Foot-ankle injuries have increased in relative importance in recent years. As a basis for future countermeasures, an epidemiology study has been undertaken using Swedish accident data from Folksam Insurance. The database consists of 805 foot-ankle injuries out of 57,949 car occupant injuries reported from 1985 to 1991. The influence of crash location, seating position and occupant age is determined for the frequency, incidence and rate of foot-ankle injury in car crashes.

 

Frontal car crashes produce 76% of the AIS 2-3 foot-ankle injuries with 13% in side impacts and 8% in roll-overs. The rate of AIS 2-3 foot-ankle injury is 24.7 per 1000 occupants injured in all crash locations and is similar irrespective of seating positions. Ankle fractures and sprains both occur at an incidence of 3.7 per 1000 injuries, followed by malleolus fractures at 2.7 and midtarsal fractures at 2.4.

 

The foot-ankle injury incidence and rate are significantly greater (p < 0.01) in near oblique-frontal crashes than for 12 o'clock frontals. For drivers in 11 o'clock and front passengers in 12 o'clock, the incidence is 27.8 per 1000 injuries as compared to 17.5 for drivers and front passengers in 12 o'clock crashes.

 

Occupant age is not as significant as seating position and crash location; however, there are higher incidences for rear occupants > or = 60 years old in oblique frontal crashes. Using the new AAAM Impairment Injury Scale (IIS), 48% of the foot-ankle injuries are rated with residual impairment IIS 1-2. The incidence in near-seated occupants is 1.5 times greater in oblique frontal crashes than in frontals. The incidence for IIS 1-2 impairment in near oblique-frontal crashes is 12.8 per 1000 occupant injuries as compared to 8.3 in frontal crashes.

KNEE INJURIES

 

In the case of lower leg injuries, the knee can be a particular source of trouble depending on the extent of a person’s injuries. Knee injuries are known to be exceptionally painful, if only because the knee joint itself is so complex. As such, the healing process can take a very long time, if at all; more times than not, complete recovery may not even be possible due to complications. Some of the more typical injuries that can involve an accident victim’s knee include the following:

  • Damage to the posterior collateral ligament or PCL with associated pain, swelling and frequent buckling of the knee while walking

  • Dislocation of the knee joint

  • Ruptured tendons

  • Bone fractures

  • Hyperextension of the ligaments surrounding the knee (usually caused by extreme twisting of the joint during impact)

  • Damage to the anterior cruciate ligament(ACL) due to stretching or tearing

THIGH INJURIES

Injuries to a car accident victim’s thigh quite often involve a fracture caused by contact with the vehicle’s dashboard or steering wheel. The force of a traffic accident can literally crush the large bone (femur) that runs from the hip down to the knee. Fractured femurs will quite often need surgery. In many cases, pins are used to hold the broken pieces together so that the entire bone can heal correctly. The success of a well-set femur is crucial in terms the proper hip-thigh-knee alignment; if not addressed quickly, there could be permanent damage and long-term problems with walking.

HIP INJURIES

Injuries to vehicle occupants’ hips are fairly common during front-end traffic collisions. In accidents like these, trauma to the victim’s hips can come in many forms, though all are especially painful. From an injury claim standpoint, it is important to remember that there are multiple treatments and medical procedures that a patient might need to undergo following a hip-related injury; these can be time consuming and expensive. Some of the more common hip injuries include: Dislocation of the hip joint, requiring insertion of surgical plates/screws to insure the bone mends correctly Fractures, which can require full or partial hip replacement typically followed by an extended hospital stay, restricted mobility, and long-term rehabilitation Bruised, fractured or dislocated pelvis, all of which can result in severe pain and an uncomfortable recovery period

ANKLE INJURIES

As one of the important load-bearing parts of the body, the ankle combines flexibility, stability and strength to do its job correctly. During a traffic accident, the force of impact can cause extreme and sudden stress to an occupant’s ankle. In turn, a violent automobile crash can impart terrible damage to this joint.

Since the ankle must support the entire weight of a car accident victim’s body while also being flexible enough to twist and move to maintain balance and ambulation, any injury can be catastrophic to a person’s ability to function on a daily basis. In a car accident, the natural reaction of a driver or passenger is to brace himself with one or both feet; however, in doing so the victim’s ankle can experience a severe compression injury similar in force to landing on hard concrete after falling off a 12-foot-tall ladder.

If sufficient force is imparted to the ankle, a fracture can easily occur, as well as damage to the various ligaments surrounding the joint. The result in many of these cases will usually be extreme swelling and pain. It’s important to mention that in the case of the ankle, it is often considered better to break a bone in the joint than it is to tear a ligament. This is because the healing process itself may be much longer and more difficult for a torn ligament than for a broken bone.

Preventing falls

Falls in the home are very common amongst the elderly. Most falls are preventable and are not a natural part of aeging. Many older people will hide their falls as they fear interference and losing their independence.

However, if they were assisted to take simple steps to help themselves much pain, hospitalisation and injury could be avoided.

We hope that older people, their carers and families, find this guide useful.

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  • A good fastening, good support and a sturdy sole are the most important things to consider when buying shoes and slippers

  • Trim your toenails regularly, a foot file can make this easier. File or cut straight across and not too short and not down at the corners as this can lead to in-growing toenails

  • If you are having problems with your feet you can discuss this with your doctor. You may then be referred for NHS chiropody or podiatry treatment.

  • Falling is not an inevitable part of ageing. Improve strength and balance by joining local exercise classes or other activities; find out more by visiting better.org.uk and selecting your postcode.

When visiting older people in their homes be aware of potential hazards, a simple home safety check can establish the risks.

  • Do they wear old, worn out or loosely fitting slippers?

  • Are there trailing cables, trip hazards or loose mats?

  • Is the lighting adequate especially in hallways and on stairways?

  • Does the older person use a stool to change a light bulb or take down curtains?

  • Do they have banisters or handrails where they need them?

  • Do they need a shower seat or a non-slip bath mat?

  • Does the older person take regular exercise – would they like to?

  • Do they take medications and how often do they review this with their GP or local pharmacist? Older people usually take more than one medication which can increase the risk of falls due to the side effects of drugs. Arrange for them to visit their GP or local pharmacist for a medication review which should ideally be every six months.

  • How often do they have their eye sight tested? Arrange for them to have their eyesight checked regularly. Anyone over 60 is entitled to a free NHS funded eye sight test at their local optician.

  • Do they have a ten year ‘toast proof’ fire alarm? You can request a free Home Fire Safety Check and smoke alarm from the local fire brigade. They will come to the person’s home to advise on exit routes in the event of fire and will fit a free smoke alarm if necessary.

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