Pathologic features of childhood pedestrian fatalities

A retrospective analysis of 68 cases of fatal childhood pedestrian accident s in South Australia that occurred over a 20-year period from January 1977 to December 1996 was undertaken. The age range was 12 months to 16 years (a verage, 7.6 years), with a male to female ratio of 41:27. The most common s ite of significant injury was the head (91.2%), followed by the abdomen (50 %), chest (47.1%), and neck (38.2%). The most frequently encountered signif icant injury combinations involved the head, chest, and abdomen (14.7%); th e head and chest (11.8%); and the head, neck, and abdomen (11.8%). Injuries were severe, consisting of extensive compound and comminuted skull fractur es, neck fractures, and massive intraparenchymal brain and internal organ d amage with avulsions and fragmentation. Non-life-threatening limb injuries occurred in 88% of cases. A distinct subgroup involved infants and younger children playing in driveways at home who were hit by reversing vehicles. T he injuries were often of such a severe nature that death was instantaneous and with no possibility of successful medical intervention. More deaths oc curred during the winter than summer months.