[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Forensic medicine](https://durgical.com/en/forensic-medicine/) › [Mechanical injuries](https://durgical.com/en/forensic-medicine/areas/injuries/) › Road traffic injuries: pedestrians, drivers and riders # Road traffic injuries: pedestrians, drivers and riders - Topic Road traffic injuries follow patterns set by the person's role: pedestrian, driver, passenger or motorcyclist, and help reconstruct the event. Updated Nov 5, 2026 ## Key points - Pedestrian: primary impact on the legs (bumper), secondary impact with bonnet and windscreen (head), secondary injuries from the ground. - Measure the height of leg injuries from the heel: it is compared with the bumper height. - Run-over: abrasions with the tyre tread pattern and flaying of the skin. - Occupants: seat-belt marks, steering-wheel and dashboard injuries; their side helps place the person in the vehicle. - Motorcyclist: a correctly worn helmet greatly cuts the risk of death and brain injury. ## What it is Road crashes kill about 1.16 million people a year worldwide and are the leading cause of death between ages 5 and 29, according to WHO; more than half of those killed are pedestrians, cyclists and motorcyclists. For the doctor, injuries follow patterns set by the person's role. In a pedestrian struck by a car there are primary impact injuries (bumper, at leg height), secondary impact injuries (bonnet and windscreen, often the head) and secondary injuries (from the ground); the person may also be run over. In occupants, the steering wheel, dashboard and seat belt matter; in motorcyclists, the helmet and the head. ## Key facts - Primary impact injuries in pedestrians cluster in the lower limbs; secondary impact injuries in the head and neck. - A small external injury may hide serious internal injury: there are no "minor" injuries after a crash. - Seat belts can reduce the risk of death for vehicle occupants by up to half (WHO). - Alcohol and other substances are tested in drivers and pedestrians when the law or the case requires. - A fall from height and a pedestrian impact can give similar injuries: the scene and the pattern help tell them apart. ## Step by step - Treat and rule out internal injury; observe the patient even if they seem stable. - Ask and record the role (pedestrian, driver, passenger, motorcyclist), helmet or seat-belt use and the type of vehicle. - Describe each injury with its location; on the legs, measure the height from the heel. - Look for patterned injuries: tyre tread, seat belt, steering wheel, vehicle grille. - Keep clothing and debris (glass, paint) with chain of custody. - Take samples for alcohol and other substances when requested, with chain of custody. ## Next step: what to do and document - Do not discharge early after a crash in which someone in the same vehicle was badly hurt or killed: observe and rule out internal injury. - Record the person's role in the crash, helmet or seat-belt use and the time of care. - Describe and photograph patterned injuries and measure the height of leg injuries from the heel. - Keep clothing, paint or glass debris and biological samples with chain of custody when the authority requests them. - Write the record and reports with precise descriptions: they are often used in criminal and insurance proceedings. ## Test yourself Think of the answer, then tap the question to see it. ## Where are primary impact injuries found in a pedestrian struck by a car? In the lower limbs, from the bumper; secondary impact injuries (bonnet, windscreen) often involve the head. ## Why is the height of leg injuries measured from the heel? To compare it with the height of the vehicle's bumper and help reconstruct the impact. ## What pattern does a wheel passing over the body leave? Abrasions reproducing the tyre tread, often with flaying of the skin and crush injuries. ## By how much does a seat belt reduce the risk of death for occupants, according to WHO? By up to about half. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/forensic-medicine/road-traffic-injuries-pedestrians-drivers-and-riders/) ## Elsewhere in DurgiPedia - [Mechanical and electrical injury: abrasion, contusion, laceration, wounds](https://durgical.com/en/general-pathology/mechanical-and-electrical-injury-abrasion-contusion-laceration-wounds/) ## Connections ## Related 5 - [Classifying mechanical injuries](https://durgical.com/en/forensic-medicine/classifying-mechanical-injuries/) - [Abrasions](https://durgical.com/en/forensic-medicine/abrasions/) - [Bruises and haematomas: recognising them, and why colour cannot date them](https://durgical.com/en/forensic-medicine/bruises-and-haematomas-recognising-them-and-why-colour-cannot-date-them/) - [Alcohol in forensic medicine: blood levels and their limits](https://durgical.com/en/forensic-medicine/alcohol-in-forensic-medicine-blood-levels-and-their-limits/) - [Chain of custody (cadena de custodia) in the hospital or rural post](https://durgical.com/en/forensic-medicine/chain-of-custody-in-the-hospital-or-rural-post/) ## Related conditions 5 - [Major trauma (polytrauma): ATLS primary survey](https://durgical.com/en/conditions/major-trauma-atls-primary-survey/) - [Traumatic brain injury](https://durgical.com/en/conditions/traumatic-brain-injury/) - [Pelvic fracture](https://durgical.com/en/conditions/pelvic-fracture/) - [Tibial shaft fracture](https://durgical.com/en/conditions/tibial-shaft-fracture/) - [Blunt abdominal trauma](https://durgical.com/en/conditions/blunt-abdominal-trauma/) [← All of forensic medicine](https://durgical.com/en/forensic-medicine/) Educational content on forensic and legal medicine; not legal advice and no substitute for the technical guides of Colombia's National Institute of Legal Medicine and Forensic Sciences. Laws change: each page links the official text and says when it was last checked. For a real case, follow the guide in force and ask the competent authority. Sources: [Road traffic injuries (fact sheet)](https://www.who.int/news-room/fact-sheets/detail/road-traffic-injuries) (World Health Organization, 2026); [Pattern and distribution of pedestrian injuries in fatal road traffic accidental cases in Dharan, Nepal](https://pmc.ncbi.nlm.nih.gov/articles/PMC4121907/) (Journal of Natural Science, Biology and Medicine (PMC), 2014); [Distinguishing injury patterns in fatal falls from heights versus pedestrian impacts: an autopsy study](https://pmc.ncbi.nlm.nih.gov/articles/PMC12325525/) (Forensic Science, Medicine and Pathology (PMC), 2025); [Trauma Forensics in Blunt and Sharp Force Injuries](https://pmc.ncbi.nlm.nih.gov/articles/PMC9802595/) (Journal of the West African College of Surgeons (PMC), 2022). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/forensic-medicine/road-traffic-injuries-pedestrians-drivers-and-riders/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/forensic-medicine/road-traffic-injuries-pedestrians-drivers-and-riders/