Relationship between External and Internal Injury in Fatal Road Traffic Accident
Sirin Bussayamanont MD*, Warataporn Sithicharoon MD*, Watit Ruchirawan MD*, Apichai Pangsorn MD*
Affiliation : * Department of Forensic Medicine, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
Background : Road traffic accidents are a major problem, causing death and injury in Thailand.
Objective : To study the relationship between external injury and internal injury which helps to diagnose severe cases caused
by road traffic accidents and provides the information to reduce the chance of misdiagnosis.
Material and Method: The data of age, gender, external injury, the type of injury, internal injury, and the type of internal injury
was gathered from 439 autopsy cases which affected regions of head, neck, chest, abdomen, and extremities. Chi-square and
Binary Logistic Regression were used to analyses the relationship.
Results : The injury that had the greatest relationship with age was internal chest injury (p = 0.002), which was rarely found
in children and was more common in the elderly. Males tended to have more head injuries than females (p = 0.003). The major
cause of death from traffic accidents was head injury. Internal neck injuries depended on the position of the wounds nearby
and the majority of injuries were caused by accelerate-decelerate mechanism. Multiple types of wounds or lacerated wounds
could help to predict internal injury to head (p<0.001, p = 0.001), abdomen (p = 0.001, p = 0.013), and extremities (p<0.001,
p<0.001). Abrasion wounds were the most common wound caused by traffic accident. Internal chest, neck or abdomen
injuries had a relationship with internal injuries in the nearby anatomical regions (p<0.05). The external injury was found to
relate to internal injury (p<0.05). However, the results should be interpreted with caution, because in some cases, in many
regions, external injuries could not be found but internal injuries were present.
Conclusion : External injury was found to be related to internal injury. There was a relationship between gender and head
injury whereby males had a significantly higher number of internal head injuries.
Keywords : Wounds, Traffic injury, Internal injury, External injury
