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BACKGROUND: Detailed fatal injury data following fatal motor vehicle crashes (MVC) are necessary to improve occupant safety and promote injury prevention. Autopsy remains the principle source of detailed fatal injury data. However, procedure rates are declining due to a range of technical, ethical and religious concerns. Postmortem computed tomography (PMCT) is a potential alternative or adjunct to autopsy which is increasingly used by forensic researchers. However, there are only limited data regarding the utility of PMCT for analysis of fatal MVC injuries. METHODS: We performed whole body PMCT, autopsy and complete crash reconstruction on 3 subjects fatally injured in MVC in a single county in Michigan. All injuries detected by either PMCT or autopsy were coded using the Abbreviated Injury Scale (AIS). Severe injuries, defined as AIS 3 or higher (AIS 3+), were tallied for each forensic procedure to allow a comparison of relative diagnostic performance.

A method has been developed to identify and document the locations of rib fractures from two-dimensional CT images obtained from occupants of crashes investigated in the Crash Injury Research Engineering Network (CIREN). The location of each rib fracture includes the vertical location by rib number (1 through 12), the lateral location by side of the thorax (inboard and outboard), and the circumferential location by five 36-degree segments relative to the sternum and spine. The latter include anterior, anterior-lateral, lateral, posterior-lateral, and posterior regions. 3D reconstructed images of the whole ribcage created from the 2D CT images using Voxar software are used to help identify fractures and their rib number. A geometric method for consistently locating each fracture circumferentially is described.

Late model passenger cars and light trucks incorporate occupant protection systems with airbags and knee restraints. Knee restraints have been designed principally to meet the unbelted portions of FMVSS 208 that require femur load limits of 10-kN to be met in barrier crashes up to 30 mph, +/- 30 degrees utilizing the 50% male Anthropomorphic Test Device (ATD). In addition, knee restraints provide additional lower-torso restraint for belt-restrained occupants in higher-severity crashes. An analysis of frontal crashes in the University of Michigan Crash Injury Research and Engineering Network (UM CIREN) database was performed to determine the influence of vehicle, crash and occupant parameters on knee, thigh, and hip injuries. The data sample consists of drivers and right front passengers involved in frontal crashes who sustained significant injuries (Abbreviated Injury Scale [AIS] ≥ 3 or two or more AIS ≥ 2) to any body region.