A Severe Ankle and Foot Injury in Frontal Crashes and Its Mechanism
In a frontal automotive crash, the driver's foot is usually stepping on the brake pedal as an instinctive response to avoid a collision. The tensile force generated in the Achilles tendon produces a compressive preload on the tibia. If there is intrusion of the toe board after the crash, an additional external force is applied to the driver's foot. A series of dynamic impact tests using human cadaveric specimens was conducted to investigate the combined effect of muscle preloading and external force. A constant tendon force was applied to the calcaneus while an external impact force was applied to the forefoot by a rigid pendulum. Preloading the tibia significantly increased the tibial axial force and the combination of these forces resulted in five tibial pylon fractures out of sixteen specimens.