Waddle's Triad in Pedestrians Struck by Automobiles

 

Typical elements:

(1) The pedestrian is struck from the side, often while crossing the street.

(2) The point of contact is the car bumper striking the patient in the legs, below the center of gravity.

Findings in the Triad	Correlate
fracture of tibia, fibula and/or femur	direct impact of bumper with lower extremities
injury to thorax and/or abdomen	impact when the pedestrian lands on the hood or windshield of the vehicle
craniofacial injuries	impact of pedestrian when thrown off the car and landing on pavement or curb

 

Associated injuries:

(1) A fixed hood ornament may impale the patient.

(2) Children may be run over and have compression injuries.

(3) Adults may suffer lateral compression pelvic fractures.

 

Modifiers:

(1) speed of vehicle

(2) height of the bumper or point of contact

(3) whether vehicle was braking or attempting to swerve

(4) road conditions (ice, oil or other reason to loose traction)

(5) height of the pedestrian

(6) rotational position of the pedestrian

(7) direct vs glancing contact