Current design guidelines for the front end of motor vehicles aim to reduce tibial fractures but this may be at the expense of an increased risk of injury to the knee itself . The purpose of this study was to describe the type of knee injuries and group characteristics of those sustaining them with a view to initiating a more detailed research project in injuries to the lower limb.

The medical records of all patients aged 16 years and over presenting to the Accident & Emergency (A& E) Department at University Hospital Nottingham with a knee injury sustained in a road traffic accident between April 1992 and December 1998 were identified and reviewed.

In a total of 374 patients, 178 sustained significant knee injuries, requiring admission to hospital. 78% of these sustained a fracture, with fracture of the tibial plateau being most common. 22% of patients sustained ligamentous injury. Almost 50% of patients received operative treatment during the first month after injury.

Current legislation may be responsible for placing pedestrians at more risk from knee injuries. An understanding of the mechanism of knee injury compared with tibial fracture is important and recommendations for prevention of injury can then be instituted.