Marshall's Triad
Definition
The three-part injury pattern from steering-wheel impact in frontal car crashes: rib fracture, sternal fracture and ruptured thoracic viscus. A diagnostic finding for unrestrained driver impact.
- Injury pattern
- Rib fracture, sternal fracture, ruptured thoracic viscus
- Mechanism
- Steering-wheel impact in frontal collision
- Population at risk
- Unrestrained drivers
Common questions
Why does Marshall's triad specifically point to an unrestrained driver rather than a passenger?+
The pattern reflects direct chest impact against the steering wheel, a structure only the driver's seating position is exposed to, so its presence indicates the person was behind the wheel at impact and was not held back by a seatbelt or airbag that would otherwise distribute or reduce that force.
Does the presence of all three injuries in Marshall's triad confirm the driver was alive at impact?+
The pattern indicates the mechanism of injury, blunt steering-wheel impact, but establishing whether the injuries were sustained ante-mortem or post-mortem still requires standard vitality markers such as haemorrhage and tissue reaction at the injury sites, examined separately.
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