Working with Neuropsychologists in brain injury cases

September 13, 2014

Neuropsychologists are scientists with advanced training in detecting injuries to the brain and how such injuries affect an injured person.

While most people believe neurologists are the experts of choice in dealing with brain injury, this is seldom the case. Neurologists are helpful in detecting and treating some serious brain injuries, and CT-Scans and MRI's can also be useful, but most of the time the neuropsychologist does the heavy lifting in brain injury cases.

A personal injury lawyer will usually work with a neuropsychologist who will do a neuropsychological assessment.

The lawyer will collect all the clients medical records, past school records and any testing or past IQ tests so that the neuropsychologist can determine the clients baseline
mental status before the injury.

He will then do extensive mental testing of the injured party, which may take between 3 and 15 hours to see exactly what areas of the brain are injured and suggest a plan for rehabilitation.

Brain injuries also called concussions of Traumatic brain injuries can be extremely serious and the aftereffects can be very costly. A brain injury can severely interfere with an injured parties ability to return to work and its important to be seen by a neuropsychologist as quickly as possible, so that the client can have some relief as soon as possible.

If you have suffered a traumatic brain injury (Tbi) also known as a concussion or head injury, please call an experienced brain injury attorney as soon as possible.

Insurance Issues in Dogbite Claims

September 13, 2014

One of the First issues a personal injury lawyer in California looks at in a dogbite case, is the amount of insurance available.

The responsibility for the dogbite may be very clear, but without adequate insurance there usually isn't a good chance for recovery.

The primary source of insurance is usually the Homeowner's Insurance of the owner of the dog. Usually, if someone owns a home, they will have Homeowner's insurance.

The attorney must then obtain and inspect the Homeowners Insurance policy. Recently, some Homeowners policies have started excluding certain breeds of dog, or limited or eliminated coverage if the dog has bit someone before.
Some Homeowners policies exclude all dogbites!

Although pet sitters are typically covered, there may be additional exclusions for business activities.

What if the person who owns the dog is a renter?

In order to hold a renter responsible, the attorney must see if there is Renters Insurance that covers the injury. If there is no renters insurance, it may be possible to go after the Landlord if the Landlord had actual knowledge that the dog was a vicious one.

This requires quick and thorough investigation as soon as the injury occurs.

Sometimes, if a dogbite occurs in an automobile, it may be possible to obtain recovery from that source as well.

Most Homeowners policy have minimal medpay coverage that pays for certain medical bills up to a small limit and that source should also be investigated.

Finally, people can often protect themselves and their family if they shop carefully for a
personal umbrella policy. Some of these policies will provide coverage if the dog owner did not have insurance or was underinsured.

Dog bite injuries often involve the face in young children and later require extensive plastic surgery and psychological treatment.

If you need help finding who sells a personal umbrella policy that covers dog bite injuries, do no hesitate to call me.

I'm Ed Smith from and my firm handles serious dogbite cases throughout the state of California.

Melatonin and Traumatic Brain Injury

September 10, 2014

It's been well documented in medical journals for years that those who suffer brain injury often complain of sleep disturbances. True, loss of sleep after a traumatic brain injury, may in part be due to the associated pain or anxiety following such incidents. However, medical studies clearly indicate that loss of sleep after a traumatic brain injury is often due the brain's inability to properly produce melatonin after severe trauma.

In 2010, the American Academy of Neurology published studies researched by Dr. Rajaratnam, a leading physician studying the links between loss of sleep and brain injury. He reported that the results from the study "suggest that the brain injury may disrupt the brain structures that regulate sleep, including the production of melatonin". Simply put, lack of melatonin production in the brain results in sleep loss.

A study was performed in an Intensive Care Unit in Athens, Greece that treated eight patients consecutively who were admitted to the ICU following a severe head injury. The melatonin levels were charted from blood tests of these patients. Those patients with the greatest head trauma displayed the highest disrupted patterns of melatonin secretions.

Science indicates that the melatonin produced by the body serves to protect the brain and can be a valuable aid in recovery. How? Melatonin shields the brain from neurodegeneration and oxidative stress. Additionally, melatonin encourages the surviving neurons in the brain after trauma to promote regeneration of damaged brain tissue.

Speak with a physician regarding using the use of melatonin. It is possible that a melatonin supplement may be added to your recovery regimen by your physician.

The Law Offices of Edward A. Smith is a personal injury firm located in Sacramento, California that specializes handling severe traumatic brain injury claims. Please contact them for free legal advice at (800) 404-5400. Their website is:

Traumatic Brain Injury Caused by Automobile Accidents

September 10, 2014

Brain trauma can occur during an auto collision when the head hits the windshield or steering wheel. The skull does not have to have been penetrated or fractured for a TBI to occur. The impact involved in an auto collision can cause the soft brain to strike the hard bone of the skull. This occurs because the impact causes the head, which had previously been in motion, to come to an abrupt stop. The brain continues its forward movement, and impacts the interior of the skull. This impact can cause bruising of the brain and/or a brain hemorrhage (bleeding) which in most cases is not visible at the time of injury.

Blunt trauma is another mechanism of injury during a car accident. This occurs when a moving head slams against a hard object such as the windshield. Often, upon impact with the hard object, and open head wound will be visible. This can also occur if the car occupant is ejected at impact.

When head trauma is not visible to the naked eye, diagnostic imaging is necessary to assist in diagnosis. A CT scan (cranial tomography) is a type of imaging study that will reveal brain injuries such as blood clots, active bleeding, contusions, and swelling. In some cases, a magnetic resonance imaging (MRI) scan, which is a different type of imaging, may be required. It is important to note that neither CT nor MRI can detect all types of brain injuries, It is possible to have a severe TBI - even be comatose - and still show normal scan results.

A neuropsychologist is a type of specialist that can evaluate and develop strategies to deal with the effects of TBI. If you have been in an automobile accident and suspect that you may have suffered TBI despite clean scans, you may want to consider consulting a personal injury attorney who can help you find the resources you need to best treat your injuries.

Tips in Handling Children's Brain injury cases

September 10, 2014

When a child suffers a serious fracture in an accident, it's fairly easy for a jury to understand the seriousness of the injury and its consequences.

When a child suffers a brain injury, however, its much more challenging for a jury to understand the nature of the injury of its consequences.

Often a young child is not able to describe with any detail the symptoms he or she is experiencing and their memories may also be affected by their imagination.

A jury cannot See a concussion or most brain injuries (although some can be visualized on CT-Scans or MRI's..most brain injuries are not detected that way) and so to the jury, the child may appear very normal.

A personal injury attorney must use preparation, interviewing and other techniques to fully illustrate the damages a child suffers to the jury.

Extensive interviews with teachers, babysitters, parents and pediatricians can help to establish what the child was like before the accident and how he has changed after.

The attorney should obtain all of the school records and educational testing results from before the accident so they can be given to a neuropsychologist, who is an expert at establishing the nature and extent of brain injuries.

The neuropsychologist will do extensive testing of the child, conduct interviews with clients, teachers and friends, and review the school and medical records so he can establish a baseline of the child's condition before the accident.

The attorney will usually also hire a vocational rehabilitation expert in cases of severe brain injury as that injury will undoubtedly affect the child's future earnings.

Its often difficult to estimate what the earnings loss will be, but courts and vocational experts often consider the child's past school records, the earnings and education of the parents and siblings and Department of Labor statistics to form a reasonable estimate of how much the child was likely to earn over his lifetime both before and after his injury.

An arbitration or mediation not to speak of a courtroom is often threatening to children and a personal injury attorney skilled in brain injury cases, will take the time to bring the child to court beforehand to accustom the child to the judicial process and help make it less threatening.

Besides finding the right experts, its critical to spend time and prepare laywitnesses, such as babysitters, teachers and friends to help explain how the child has changed since his accident.

A brain injury attorney who takes the time to explore the child's life thoroughly, who visits the family home and spends a good deal of time there and who has the expertise to find and work with experienced experts in brain injury cases, will do much to ensure that the child's recovery will be fair and just.

Traumatic Brain Injury and its Effect on Communication and Cognition

September 5, 2014

There are two main types of Traumatic Brain Injury, or TBI:

When a foreign object (such as a bullet) pierces the brain it can cause damage to specific areas of the brain. This type of TBI is known as a Penetrating Injury. Penetrating injuries result in localized damage along the path that the foreign object traveled through the brain. Damage to different areas of the brain will result in different symptomatology.

Another type of TBI is a Closed Head Injury. A closed head injury occurs from a non-penetrating blow to the head. Closed head injuries could occur from, for instance, striking the windshield during a motor vehicle accident.

Traumatic brain injuries can cause a wide variety of symptoms, including headache, dizziness, nausea and/or vomiting, tinnitus - to name a few. Sufferers may also experience problems with communication and cognition, the severity of which varies widely depending upon the area of injury as well as the extent of the damage.


TBI sufferers may find that they have difficulty finding the right words to articulate a thought when speaking or writing. Sometimes it may feel as though comprehending written and oral information is like trying to understand a foreign language. Often, the ability to spell is affected.

In addition to word comprehension, problems with communication can affect a person's social skills following TBI. It may become more difficult to hold a conversation, as the sufferer no longer recognizes the cues that enable banter. This can be as rudimentary as no longer recognizing that they must allow others to speak or finish their thoughts, or it could manifest itself more subtly, such as no longer recognizing tone or sarcasm. Additional difficulties that can affect social interaction and conversation include difficulty following or maintaining the topic, inability to use a proper tone of voice, inability to interpret body language, and being unable to keep up with fast-paced discussion.

Moreover, people affected by TBI may experience unusual emotions, in some cases appearing overly dramatic, and at other times exhibiting a flat affect. The sufferer often is unaware that his or her behavior is out of the ordinary, which can be puzzling and frustrating to family and friends.

Finally, in some cases, adding to the difficulties outlined above, weakness or incoordination of the muscles lips and tongue may affect a victim of TBI. This may result in the sufferer speaking unclearly or being unable to project enough in terms of volume to be heard.


One of the most common symptoms following TBI is difficulty with thinking, or cognition. The cognitive effects manifest in myriad ways. These include attention deficiencies, memory loss, problems with reasoning and executive function, decreased ability to problem-solve, decreased awareness, slowed processing of new information. Many of these cognitive issues can be exacerbated in the presence of auditory or visual distractions.

Fortunately, a skilled health care provider, such as an occupational therapist, can provide tools and exercises to those that suffer from TBI that can minimize the effects of the communication and cognitive problems caused by the traumatic brain injury.

Concussions and Second Impact Syndrome

September 4, 2014

It is not uncommon for accident victims to sustain a concussion. This can occur when the head strikes a window, the steering wheel, or the back of a seat during impact. With time, concussion symptoms may and can resolve.

However, second impact syndrome occurs when the brain has not healed from the initial concussion. If the brain has not healed, a second impact can cause swelling of the brain or hemorrhaging. This in turn can lead to death. Fortunately, second impact syndrome is infrequent. However, it is critical to avoid activities that could cause it to occur.

Most frequently, those who are at higher risk for second impact syndrome are adolescents who participate in sports activities, ride bikes or ATV's, or use a skateboard frequently as a form of transportation.

256px-Jugendfussball_D_Wacker_gegen_MTV.jpgBesides participating in sports activities, adolescents are a higher risk group as their brains are still developing. Dave Ellemberg, a neuropsychologist at the University of Montreal stated regarding adolescents that "the frontal lobe areas of the brain, are growing in spurts and when something is developing rapidly it is even more fragile to injury."

If a child has sustained a concussion outside of school - such as in an auto accident - parents should take appropriate precautions if their children are athletes. Parents, grandparents or guardians should let the coaches and school administrators know if their child has sustained a concussion outside of school or during the summer months. Preventing permanent neurological deficits and second impact syndrome may mean preventing a child athlete from returning to play until they have healed.

The Law Offices of Edward A. Smith specialize in handling claims with serious injuries. If you or your minor child have been involved in a car accident, motorcycle accident, bike accident or were injured in a pedestrian vs. auto incident and need assistance in handling your claim, please contact them for assistance. Their website is:

Photo Attribution: By Usien (Own work) [GFDL ( or CC-BY-SA-3.0-2.5-2.0-1.0 (], via Wikimedia Commons

Is Traumatic Brain Injury Recovery Possible?

September 3, 2014

Automobile accidents account for half of all brain injuries in the U.S. according to Statistics from the Center for Disease Control. A traumatic brain injury occurs when an impact to the head disrupts brain functioning. After a brain injury, the length of recovery varies from person to person and there are many factors that affect the prognosis. Although, the most noticeable improvement happens in the first six months, it is common for a person to steadily improve over a two year period after an injury.

Factors that affect the recovery process include the type and severity of brain injury, the age of person injured, medical history, depth and duration of injured person in a coma.

Recovering from a brain injury is a slow process. In the initial months, it is too soon to determine how long recovery will take. After a year or so one can begin to determine the degree of recovery and resulting impairment, however, every traumatic brain injury (TBI) is different. It is very difficult to determine the outcome of a traumatic brain injury.

The long term effects of traumatic brain injury may include any of the following:

Physical - headaches, blurred vision, nausea, vomiting, difficulty speaking, trouble hearing, loss of balance, dizziness, decreased energy, difficulty walking and using extremities.

Cognitive - memory loss, difficulty concentrating, forgetfulness, difficulty making decisions, difficulty with attention.

Behavioral - easily angered, feeling frustrated, acting out without thinking, difficulty in relationships, sleeping more than usual, isolation.

Often, an injured person with a traumatic brain injury learns to work around and cope with any resulting difficulties.

Recovery from a traumatic brain injury is possible. Devon Spence, a determined 10 year old boy from Johnston, demonstrates that it is possible. Devon sustained a skull fracture and lacerations as a result of an auto accident resulting in a traumatic brain injury.

Truamatic brain injury in children

September 3, 2014

Oftimes, we represent children who have been in an accident and suffer traumatic brain injuries (Tbi injuries).

These injuries are often overshadowed initially by other more visible injuries such as fractures, serious abrasions or internal organ injuries.

Over a period of time, the obvious injuries heal but the parents may notice their child having difficulty with thinking, understanding or remembering things.

In school, attention and behavior problems can suddenly come to the fore.

One of the great difficulties in recovering from these injuries is recognizing that even though everything looks fine and the child appears healthy, the child may be having very real organic brain difficulties.

The type of head injury suffered and the best treatment outcomes are usually diagnosed and treated by a neuropsychologist

Initially, traumatic brain injuries may be missed and most often they are. The typical initial treaters who tend ot be Emergency Room Drs or possible neurologists and not really trained to do the extensive testing that neuropsychologists do.

Those Doctors may have an MRI done or have done a CT Scan but those tests rarely detect most brain injuries.

Once these brain injuries are diagnosed, its important for parents to work with school personnel to devise school programs to help them under the IDEA or Individuals with Disabilities Education Act.

Children with brain injuries have many needs that they may not have had before the accident. An IDEA program for the child can help them get the most of their schooling and sensitive teachers to the very real problems they are having.

Children who suffer a brain injury should be represented by experienced brain injury lawyers who are familiar with those injuries and how to move through them.

Tragic Orland Bus Truck Accident

April 11, 2014

Our hearts go out to the parents and relatives of the High School students tragically killed and seriously injured in a Federal Express vs Tour Bus Accident near Orland on Thursday, April 10th.

The accident occurred when a tour bus was transporting the students from Southern California to Arcata to tour Humboldt State University.

Details are sketchy but it appears the Fed Express truck crossed the grassy center divider and slammed into the bus.

Fed Ex has over 280,000 employees and an enormous fleet of "18 wheeler trucks"

Fed Ex is a leading small package carrier and overnite delivery company. FedEx Drivers get compensated for making ontime delivery and are often in a hurry to get to the next stop,.

Any commercial truck driver in a hurry is necessarily a threat to public safety.

Its unknown at this point what led to the accident, but often factors involved include:

-Vehicle Equipment Failure, including brakes.
-Driver Fatigue or inexperience
-Poorly Loaded Trucks.

In all Trucking Cases, trucking companies immediately have teams investigating and on the scene and it is critical for families of the injured to have a representative who can get an investigator timely to the scene as well.

In a case like this the California Highway Patrol MAIT team will also make an extensive inquiry into causation,

The Law Offices of Edward A. Smith has extensive experience in representing families and individuals suffering severe injuries or death in trucking accidents.

Sacramento Car Accidents: Children on the Road

March 31, 2014

Children_playing_in_Vereda_del_Lago.jpgNo auto accident is more tragic than those involving children. It is incumbent upon everyone to act carefully when traveling to ensure that youngsters are protected from harm, whether that means - using proper child safety seats, slowing down in school zones, and keeping an eye out for kids running into the road.

Unfortunately, children throughout the area continue to be harmed in accidents on or near the roadway. In fact, auto accidents remain one of the leading causes of death for young children and teenagers.

Recovery Following Roadway Accidents

Under the civil law, all those who are harmed by the negligence of others can usually recover for their losses. In general, recovering after an accident requires the harmed person to show that another breached a duty of care (did not act reasonably) and caused the injury. The most hotly contested aspect of these cases is often determining whether a party actually acted unreasonably or did not do what a prudent person would have done in the same situation.

Determining carelessness is different for each case. That is because the vulnerabilities of the party harmed are often taken into account--that includes children. Children are held to a different and more limited standard of care during their encounters with motor vehicles on public streets. Unlike an adult pedestrian who has the duty to exercise ordinary care when encountering traffic or crossing the street, children must simply exercise that degree of care that would reasonably be expected of a child of like age, experience, and intelligence.

Therefore, in determining whether a child's actions amounted to negligence, the jury must first consider the age, mental capacity, and experience of the child. The ultimate question for the jury is whether the particular child, given her individual limitations, showed the level of care that reasonably should be expected of her. Everyone understands that children have yet to develop the maturity and awareness to avoid dangerous situations. That is why conduct that may been deemed reckless if performed by an adult pedestrian would be forgiven in a child.

In most cases, a driver who hits a child on or near the road will be found liable for the harm. For example, even in cases where a child darts out into the road unexpectedly, the driver's own negligence may have contributed to the accident. Perhaps the driver was speeding--speed limits are far lower in neighborhoods and school zones. At other times the driver may have been distracted by looking at a cell phone or otherwise not closely monitoring the road.

Car Accident Recovery

If your child was hurt in an accident on the road, it is critical to secure legal help as soon as possible. If your child has been injured in an accident, please call us for a free consultation. Call Ed at 916-921-6400.

Photo attributed to Wilfredor (Own work) [CC0], via Wikimedia Commons

Inflatable Bicycle Helmet

March 5, 2014

The U.S. National Highway Traffic Safety Administration reported 677 cyclists were killed and 48,000 were injured in motor vehicle traffic crashes in 2011. Wearing a helmet is the most effective means of protecting against a head injury. Unfortunately, fewer than half of cyclists wear them due to their unfashionable look and uncomfortableness. For cyclists who shy away from helmets, a Swedish company invented an air bag collar called the Hovding. The device is worn around the neck and has sensors that can detect a sudden change in speed or movements. If an accident is detected, the collar inflates with helium and forms an airbag protective cover around the head. Unlike most helmets it covers the neck as well as the head.

An Accident Attorney's Advice to his parents on Auto Insurance

February 27, 2014

As a trial lawyer practicing for over 30 years, I've been surprised at how many people over the years are totally confused about what car insurance covers and how much insurance they should carry.

My parents recently asked me about the types and amount of coverage they should have and I'll share with you the advice I gave them.

First, there is no such thing as "Full coverage". Most clients, when I ask them what they carry, say they have this..yet none know what it means. Neither do I.

Here are the main varieties of Auto Insurance in California.


This is insurance that protects you in the event that you are at fault in an accident.
It is usually sold in denominations such as 15/30, 25/50. 100/300 or 300/500.
What this means is that if you have 15/30 coverage, the most that your insurance will pay if you are at fault is $15,000 to one person or $30,000 to everyone that you cause injury to.

Since a night at UC Davis Medical Center can easily cost over $20,000, you are really taking a risk if you have a small sum of bodily injury coverage and you cause a serious injury. Your assets can be totally wiped out if the seriously injured person sues you and obtains a judgment far in excess of your policy.

My advice to most people is to carry a minimum of 50/100 bodily injury insurance no matter how little earnings and assets you may have.

For people in their 20's and 30's that own a home, I'd suggest a minimum of 100/300 insurance. For those of you earning in excess of $75,000 yearly and have been in your home for more than 2-3 years, I'd say a 300/500 policy would be appropriate.

And if you are in the top 10% income or assets wise, I'd buy a 300/500 policy with a UM Umbrella of 1 Million or more.

An umbrella policy will pay the other side if their damages are in excess of your underlying policy. Make sure to ask your agent if he sells a UM Umbrella because you want the additional protection it affords you as I will explain later.

95% of all umbrella policies DO NOT contain UM Protection so make sure to ask.


This coverage protects you if you or anyone in your car is injured by another driver who is at fault up to the amount of coverage you have. I suggest you obtain the same coverages for UM or UIM coverage as I suggested above for Bodily Injury Coverage.

The ways this works is as follows. If you are hit by someone without insurance (As many as 25% of all California drivers), your own uninsured motorist insurance covers you up to your UM limits.

If you are struck by a driver with minimum limits of 15/30 and you have very serious injuries worth say 500,000, you would first collect $15,000 from the other parties insurance and then an additional $485,000 would be available from your own underinsured motorist coverage.


This insurance pays medical bills of yourself or any passengers in your car regardless of who is at fault. I suggest everyone carry a minimum of $10,000 Medpay coverage because it is very cheap.

Even if you have health insurance you should buy Medpay because it protects others in your car who may not have health coverage and it affords everyone to get the best care and not necessarily what may be the substandard care of your health plan,


This will pay for property damage to any cars that are damaged up to the value of the policy. I normally suggest that people carry the sum of collision insurance suggested by their agent but with a good sized deductible if you can afford it.

For most cars, I'd suggest a $500 deductible but if the car is over 7 years old, you can really reduce your premium by selecting a $1000 or $2500 deductible.


Protects you if your car is damaged by a flood, storm, fire or vandalism. I suggest the same limits as the collision coverage,

"Gap Coverage"

This coverage I suggest when people buy new or almost new vehicles. It protects you from the situation which can arise when you drive a new car off the lot. Typically, the value of the car can decline 20% almost as soon as its off the lot.

If you're unlucky enough to have an accident at that time and your car is totalled, the other insurance (Or your own collision coverage) will only pay you the fair market value.

So if you piad $35,000 for a new car and get in a crash the next day, without "Gap coverage", you be out around $7000.

Some of you may worry that the sums of insurance I suggest here will cost you a fortune..but they won't! A 300/500 Bodily injury and UM policy will not cost 10X more than a 30,000/50,000 policy. Not even close.

You will pay a bit more for coverage, but you will be thankful if you are ever in a serious accident.

I gave the above advice to my parents and I give it to you as well.

Anyone having any question at all about auto insurance in California is always welcome to call me.

Knee Injuries in Motor Vehicle Accidents

February 20, 2013

Knee injuries in motor vehicle accidents are often called dashboard knee injuries because the person slips beneath the car restraints and slams their knees on the dashboard. There are many knee injuries that can occur in a dashboard injury. The patient can fracture their patella, the small disc shaped bone that covers the knee structures or can develop chondromalacia or a softening and damage to the cartilage beneath the patella. You'll often feel an achy knee as well as a grinding sensation when you walk with the knee. There can be ruptures of several ligaments within the knee, such as the ACL, MCL, LCL or PCL ligaments. The knee may become unstable and surgery may be necessary.

Common symptoms of knee injuries include a popping sensation in the knee, either at the time of injury or when you bend it later, redness, bruising or swelling of the knee, tingling of the knee, grinding or locking from pieces of cartilage being free floating or ripped within the knee, feeling unstable when you walk, or a deformity of the knee (in severe cases).

The types of injuries you can have with the knee include an anterior cruciate ligament tear or ACL tear. This stabilizes the knee and without an intact ACL you can often not walk and will have pain with the knee at rest that gets worse with motion. These can be isolated or can occur along with a tear in the meniscus. Surgery is usually necessary to repair this sort of injury.

You can also get posterior cruciate ligament tears. It is less common because this is a stronger ligament. It can be damaged during a severe dashboard injury or by falling on a knee that is flexed. A PCL injury is rarely isolated and is often coexisting with other injuries to the knee. It is the result of severe trauma.

A medial collateral ligament is the ligament most damaged in just about any knee injury, including motor vehicle accidents. It can be sprained, strained or torn. You can feel tearing or a ripping sensation, followed by swelling and bruising along the medial border of the knee. This type of injury is common in sports injuries as well as motor vehicle accidents.

The knee can become strained or sprained in a motor vehicle accident. It happens when the ligaments get stretched but not torn. All of the above ligaments can be strained or sprained, leading to pain, difficulty walking and a period of disability when it comes to walking on the knee.

It is estimated that about ten percent of all bodily injuries in a motor vehicle accident occur to the knee. Most of these injuries were not serious and represented sprains or strains. Most were as a result of frontal impact injuries and were associated with lacerations of the knee. Knee fractures usually happen as a result of high speed impacts and ligamentous tears occur in about 20 out of every 1000 motor vehicle injuries. Women are more likely to experience a contusion to the knee when compared to men. There has been little variation in knee injuries in spite of changes in the lap or three point restraining system.

If you were involved in a motor vehicle accident and need assistance, please call (916) 921-6400 for free, friendly advice.

Lower Extremity Injuries in Motor Vehicle Accidents

February 14, 2013

The good news is that restraints in motor vehicles have become optimized so people have a lesser incidence of upper body damage. Little attention has been paid to lower extremity injuries, however, in part because they do not cause mortality in general and they carry low injury scores. They do, though, cause a great deal of disability in those who suffer them. Not only is there a great psychological burden from lower extremity injuries but there is a longstanding possible disability. Other, unrelated injuries and factors like depression influence how the patient does long term.

A patient can sustain a foot injury from slamming the foot into the seat or footboard ahead of them. Foot injuries may or may not need to be casted but certainly they impair the ability of the patient to get around. It can mean days or weeks off the job until the individual can bear weight. Fortunately there are few long term disabilities from foot fractures.

Fibular_artery.pngTib/fib fractures are very common. These are fractures of the tibia and fibula, and can come from pressure pushing up from force on the bottom of the foot. It can also come from a direct force on the tibial and fibular area. Because the tibia is so close to the skin, an open or "compound" fracture can occur, leading to infection and poor healing. Tibial/fibular fractures can be healed through surgery that uses rods and plates to hold the bony segments together. It can also heal secondarily, with the body casted so that the bones knit together over time. A person with a tib/fib fracture can heal perfectly over 4-6 months of time or they can heal badly with one leg shorter than the other or an abnormal gait.

Femur fractures happen more often in children than in adults. It happens usually when forces below the femur put pressure on the femur and fracture it. It can fracture in the mid-shaft, leading to severe bony instability of the lower leg. The femur fracture is usually healed with rods placed surgically within the marrow of the femur. A person can walk much sooner with surgical correction of their femur fracture. It is rare to have the femur heal secondarily.

High on the femur is the hip. Hip fractures can involve fractures to the proximal femur or fractures to the ball of the ball and joint socket. In theory, a hip fracture can involve a fracture to the acetabulum or "socket" alone but then it is caused an acetabular fracture. Fractures of the hip come from forces directed upward from the foot at the time of the motor vehicle accident. There are many different types of hip fractures, depending on where the hip happens to break. These fractures need to be treated surgically, usually be removing the damaged hip and replacing it with an artificial hip and socket. In some cases, plates and rods are used to repair the hip.

Pelvic fractures carry some morbidity and mortality. They involve the bone within the pelvic region that rings the bladder and reproductive organs. There is generally a lot of bleeding with pelvic fractures that can cause shock to occur.

Lower extremity fractures are serious consequences of motor vehicle accidents. When they are associated with other types of trauma, they can be especially debilitating.

(Portrait attributed to Mikael Häggström via WikiMedia).

If you have a lower extremity fracture caused by a motor vehicle collision and need assistance, please call our office for free friendly advice at: (916) 921-6400.