Frontal Impact

In a head-on collision, the principal force on the vehicle acts down the axis of the vehicle. On impact, an urestrained occupant moves forward until there is contact with part of the interior. Occupant contact points can be marked by transfer of blood and other tissue from the victim. Interior components are deformed by body contact. The

Fig. 54. Rhabdomyolysis—kidney. (A) Myoglobin casts (arrow). Necrotic renal tubule (arrowhead; H&E, original magnification x200). (B) Immunoperoxidase technique showing positive myoglobin reaction in casts (arrows; original magnification x400). (Courtesy of Dr. M. Moussa, London Health Sciences Centre, London, Ontario, Canada.)

Fig. 54. Rhabdomyolysis—kidney. (A) Myoglobin casts (arrow). Necrotic renal tubule (arrowhead; H&E, original magnification x200). (B) Immunoperoxidase technique showing positive myoglobin reaction in casts (arrows; original magnification x400). (Courtesy of Dr. M. Moussa, London Health Sciences Centre, London, Ontario, Canada.)

occupant's head and face strike the windshield, A-pillar, or front header (Level I or upper-level injuries; see Figs. 20 and 55 and refs. 487-489). Energy is transmitted from the skull to the spinal column, where cervical spine fractures can occur. The instrument panel and steering column are struck by the torso of a passenger or driver, respectively (Level II or middle-level injuries; see Fig. 19; refs. 489 and 490). This can result in considerable deformation of the steering wheel (Fig. 56; ref. 491). The face and anterior neck can also strike the instrument panel or steering wheel (492). Damage to the lower instrument panel on both sides of the steering column is evidence that the driver's knees loaded the dashboard area. In the unrestrained occupant, the force generated by knee contact can fracture the femur and the pelvis (Level III or lower-level injuries [489]). Intrusion at floor level (toe pan) leads to foot and ankle injuries irrespective of restraint usage (Fig. 57; refs. 408, 487, and 493-496). Intrusion and deformation of the occupant compartment increase the possibility of occupant contacts (491,495,497). Occupant contacts can be external (e.g., intruding vehicles, fixed objects).

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