Combined chest and abdominal trauma in pedestrians injured during car accidents

Background: Severe injury associated with road traffic injuries and falls from heights is highly global health, social, and economic problem worldwide. The main contingent of victims of concomitant injury (СI) is mostly at working age. Materials and methods: A forensic medical examination was performed in 215 corpses of persons killed in moving car collisions, wherein 173 were males and 42 females. The victims were between 14 and 75 years old. Results: Injuries of two or more parts of the body with fractures of the limb bones (55.8%) and head, chest, and abdominal CI (23.3%) prevail in pedestrians who died in car collisions. CI composed of structural damages of the chest and chest cavity organs in 85.6% of cases. Rib fractures were detected in 57.7% of cases; fractures in the midclavicular and axillary lines predominated in localization. Structural damages of the abdominal cavity organs and tissues are 71.0% of the abdominal CI in pedestrians. In addition, 80.8% of dead pedestrians showed signs of organ and tissue injuries with pronounced hemorrhages in the suspension apparatuses, walls, and parenchyma of organs. Along with hemorrhages, a violation of the anatomical integrity of organs, mainly the liver and spleen, was found in 23.2% of cases. Conclusion: The outlined nature of structural damage of the chest and chest and abdominal cavity organs establish the possibility of their formation in the third phase of car injury — the fall of the injured on the road surface. Traumatic (pleuropulmonary), hemorrhagic shock, and hemorrhagic pneumothorax were the main causes of injuries at the prehospital stage.