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In a frontal car crash, the drivers foot and ankle may be injured due to loading by the brake pedal. The driver of a vehicle often has time to initiate emergency braking before an impending collision, which places the forefoot or midfoot over the brake pedal. During the crash, the pedal may induce dorsiflexion and axial loading of the ankle due to forward motion of the occupant and rearward intrusion of the pedal relative to the vehicle. In order to investigate the injuries caused by pedal loading, impact tests were conducted on three cadaveric lower limbs. The limbs were braced at the knee, and a pedal positioned beneath the midfoot was driven towards the knee, inducing dorsiflexion and axial loading of the cadaveric limb. Ankle injury was generated in two specimens. Both injured limbs sustained a medial malleolar fracture, and one limb also suffered a talar neck fracture. These results suggest that pedal loading may be an important injury mechanism for fractures of the medial malleolus and talar neck in drivers involved in frontal crashes
Re: Injuries caused by brake pedal loading of the midfoot
I see a lot of Road Traffic Injuries and a straight head on collision is rare. The assumption is correct that the driver's foot is usually hard on the brake but the majority of high speed head-ons are corner to corner and so there rapid spin on the car and a rotational thrust on the foot and ankle in a plane similar to that of the road. This rotation is as great as the trust straight into the pedal. The results are complex breaks that don't fit into any predictable pattern from on RTA to the next.
Motorcycles RTAs are much more predictable. About half will be a crush between the gear box and the bumper of the car with shear injuries due to the speed of the biker.
Put on your red shoes and dance the blues away.