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    When It Comes to Feet, Cars 'Auto' Be Redesigned

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    U.S. podiatrist Sutpal Singh, DPM, of Apple Valley and Barstow, Calif., says he sees accident-related foot, ankle, and leg injuries at least a couple times a year.

    Though the German researchers conclude that the actual structure of the automobile's foot compartment is not stable enough to protect feet in an accident, Singh has a different impression of what causes the injury. Here's how it can happen, he says:

    "You are driving straight ahead and slam on the breaks, and all the pressure is on your foot because your leg and knee are extended," he says. "Your foot is on the ground and the impact of the front of the car and the end of the other car compresses on your foot and ankle, potentially resulting in a compression fracture or a dislocation," he says.

    "Imagine taking your fist and hitting against the wall. That's what you are doing essentially," he says.

    "Once they have a severe ankle fracture, they usually have pain for quite a long time," Singh tells WebMD. "If the cartilage is damaged, they will develop arthritis, but if it's a minor fracture, then they usually do pretty well."

    Cary M. Golub, DPM, a podiatrist in private practice in Long Beach, N.Y., agrees with Singh. "Injury to the foot is caused when you try to brace yourself by pressing your foot into the brake as impact occurs, " he says. "It can occur to a passenger when their foot compresses against the floor as they brace themselves in an accident."

    In the new study, foot and ankle injuries among drivers and front seat passengers were similar. Richter writes, "the pedals, steering wheel, or asymmetric design of the dashboard do not influence the injury incidence, mechanism, or severity." Rather the abrupt change in velocity and "the extent of foot compartment [damage] correlated with the [extent of injury]."

    "These injuries are sudden and painful and can result in dislocation between two parts of the foot and may need surgery," Golub says.

    "Ankle fractures are very common because as you are bracing yourself, the retrograde force of the foot against the pedal or brake causes impact at the ankle joints," he says.

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