Mechanisms of Aortic Injury in Fatalities Occurring in Motor Vehicle Collisions

    Volume 44, Issue 1 (January 1999)

    ISSN: 0022-1198

    CODEN: JFSOAD

    Page Count: 13


    Nowak, ES
    Investigator, Medical Consultant, and Director, Multi-Disciplinary Accident Research Team, Faculty of Engineering Science, University of Western Ontario, London, Ontario

    Young, JG
    Chief Coroner for Ontario, Ministry of the Solicitor General, Toronto, Ontario

    McClafferty, KJ
    Investigator, Medical Consultant, and Director, Multi-Disciplinary Accident Research Team, Faculty of Engineering Science, University of Western Ontario, London, Ontario

    Shkrum, MJ
    Staff Pathologist, Department of Pathology, London Health Sciences Centre - Victoria Campus, London, Ontario

    Green, RN
    Investigator, Medical Consultant, and Director, Multi-Disciplinary Accident Research Team, Faculty of Engineering Science, University of Western Ontario, London, Ontario

    (Received 18 February 1998; accepted 9 June 1998)

    Abstract

    Case reviews based on autopsy studies have shown that motor vehicle collisions cause between 50 and 90% of traumatic aortic ruptures. Very few studies have analyzed the nature and severity of the collision forces associated with this injury. Our passenger car study (1984–1991) examined 36 collisions in which 39 fatally injured victims sustained aortic trauma. In this injury group, a disproportionate number of heavy truck and roadside fixed-object impacts occurred. Vehicle crash forces were generally severe and were either perpendicular or oblique to the vehicle surface. Intrusion into the occupant compartment was a significant factor in most of these fatal injuries. Occupant contact with vehicle interior surfaces was identified in most cases, and occupant restraints were often ineffective, especially in side collisions. The more elderly victims were seen in the least severe collisions.

    The most frequent site of aortic rupture was at the isthmus. A majority of victims had rib/sternal fractures indicating significant chest compression. Of the various traumatic aortic injury mechanisms proposed in motor vehicle impacts, the favored theories in the literature combine features of rapid deceleration and chest compression. This study supports that predominant impression, concluding that rapid chest deceleration/compression induces torsional and shearing forces that result in transverse laceration and rupture of the aorta, most commonly in the inherently vulnerable isthmus region.


    Paper ID: JFS14410J

    DOI: 10.1520/JFS14410J

    ASTM International
    is a member of CrossRef.

    Author
    Title Mechanisms of Aortic Injury in Fatalities Occurring in Motor Vehicle Collisions
    Symposium , 0000-00-00
    Committee E30