Penetrating injury from high-speed motor vehicle collision

Abstract

We present the case history of a post motor vehicle crash victim with lower extremity fractures and decreased blood flow. Emergent Angipgraphy revealed a foreign body which was later operated and removed. The case emphasizes that High-speed motor vehicle accidents commonly lead to penetrating injury from objects within and outside of the vehicle.

CASE HISTORY

A 25-year-old male was airlifted to our institution following a high-speed, head-on motor vehicle collision. He had open left patella and lateral femoral condyle fractures [Figure 1a] with a normal motor and sensory exam, but his foot was cool with sluggish capillary refill (>3 s) and no palpable pulses. He was emergently taken to the operating room for left lower extremity angiography. Angiogram revealed impaired blood flow through the popliteal artery with a foreign object partially occluding the artery [Figure 1b]. The foreign object was removed from the popliteal fossa and found to be a coin [Figure 1c]. The coin had acted as a projectile, passing through the femur [Figure 1d] and bending in half in the process. After coin removal, the patient's vascular exam returned to normal. High-speed motor vehicle accidents commonly lead to penetrating injury from objects within and outside of the vehicle.

Figure 1.

(a) Anteroposterior radiograph of left knee revealing fractures of the patella and lateral femoral condyle (b) Angiogram revealing foreign object on popliteal artery causing impaired blood flow (c) Coin (dime) which acted as a projectile causing fractures of the patella and femoral condyle, and was folded in half due to the forces of the contact with the bone (d) Bone void in lateral femoral condyle due to the path of the coin travelling through the bone