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Description of road traffic related knee injuries in published investigations is very heterogeneous. The purpose of this study was to estimate the risk of knee injuries in real world car impacts in Germany focusing vulnerable road users (pedestrians, bicyclists and motorcyclists) and restrained car drivers. The accident research unit analyses technical and medical data collected shortly after the accident at scene. Two different periods (years 1985-1993 and 1995-2003) were compared focusing on knee injuries (Abbreviated Injury Scale (AISKnee) 2/3). In order to determine the influences type of collision, direction and speed as well as the injury pattern and different injury scores (AIS, MAIS, ISS) were examined. 1.794 pedestrians, 742 motorcyclists, 2.728 bicyclists and 1.116 car drivers were extracted. 2% had serious ligamentous or bony injuries in relation to all injured. The risk of injury is higher for twowheelers than for pedestrians, but knee injury severity is higher for the latter group. Overall the current knee injury risk is low and significant reduced comparing both time periods (27%, p<0,0001). Severe injuries (AISKnee 2/3) were below 1%). Improved aerodynamic design of car fronts reduced the risk for severe knee injuries significantly (p=0,0015). Highest risk of injury is for motorcycle followed by pedestrians, respectively. Knee protectors could prevent injuries by reducing local forces. The classically described dashboard injury was rarely identified. The overall injury risk for knee injuries in road traffic is lower than estimated and reduced comparing both periods. The aerodynamic shape of current cars compared to older types reduced the incidence and severity of knee injuries. Further modification and optimization of the interior and exterior design could be a proper measurement. Classic described injury mechanisms were rarely identified. It seems that the AIS is still underestimating extremity injuries and their long term results.
Although ATV accidents account for numerous deaths in the US and Australia, the role in traffic accidents and hospital admissions in Germany is unknown. At a level I trauma centre, hospital and crash charts were analysed for medical and technical parameters of ATV accidents. ATV drivers were 0.1% of emergency trauma patients. The mean total hospital stayrnwas 15 days; there were 1.5 stays per patients with 2.0 surgical procedures needed. One patient died, only two recovered fully. 14 cases of ATV accidents out of 18990 (0.1%) were documented within 10 years. The mean impact velocity was 35 km/h. Car collisions were predominant. The upper extremity was the predominant injured region (AIS 0.7), Mean maximum AIS was 1.4. ATV accidents in Germany are rare but pose high risk for severe injuries. Possible reasons are low active and passive security, limited experience and risky driving behaviour. Preventive measures are discussed.rn
The purpose of this study was to analyse the actual injury situation of bicyclists regarding accidents involving more than one bicyclist. Bicyclists were included in a medical and technical analysis to create a basis for preventive measures and discovered repeating accident patterns and circumstances such as daytime, environment, helmet use rate. Technical and medical data were collected at the scene, shortly after accident. The population was compared focusing on bicycle versus bicycle accidents. Technical analysis included speed at crash, type of collision, impact angle, environment, used lane and relative velocity. Medical analysis included injury pattern and severity (AIS, ISS). Included were 578 injured bicyclists in 289 accidents from years 1999 to 2008, 61 percent were male (n=350) and 39 percent female (n=228). Sixty-seven percent ranged between 18 to 64 years of age, twelve percent each between 13 to 17 years of age and older than 65 years, eight percent between 6 to 12 years and one percent between 2 to 5 years.. Crashes took place in urban areas in 92 percent, in rural areas in 8 percent. Weather conditions were dry lanes in 97 percent and wet conditions in 3 percent. Eighty-three percent of all accidents happened during daytime, ten percent during night, and seven percent during dawn. The helmet use rate was only 7,5 percent in all involved bicyclists. The mean Maximum Abbreviated injury scale, Injury severity score was 1,31. Bicyclists are still minimally- or unprotected road users. The helmet use rate is unsatisfactorily low. The incidence of bicycle to bicycle crashes is high. Most of these accidents take place in urban areas. The level and pattern of injuries is moderate. Most of the more severe injuries occur to the head and could have been avoided by frequent helmet use.
The national accident statistics demonstrate that the situation of passenger car side impacts is dominated by car to car accidents. Car side to pole impacts are relatively infrequent events. However the importance of car side to pole impacts is significantly increasing with fatal and seriously injured occupants. For the present study the German in-depth database GIDAS (German In-Depth-Accident Study) and the UK based database CCIS (Co-operative Crash Injury Study) were used. Two approaches were undertaken to better understand the scenario of car to pole impacts. The first part is a statistical analysis of passenger car side to pole impacts to describe the characteristics and their importance relevant to other types of impact and to get further knowledge about the main factors influencing the accident outcome. The second part contains a case by case review on passenger cars first registered 1998 onwards to further investigate this type of impact including regression analysis to assess the relationship between injury severity and pole impact relevant factors.
Although the statistics show a decreasing rate of child injuries and fatalities in German road accidents more efforts can be made to protect children in cars e.g. by developing appropriate child restraint systems. An important part in of this work can be achieved with the help of crash tests using child dummies. However these crash tests cannot completely reflect the situation of real world crashes as factors like children moving out of the optimal position or children incorrectly fastened by their parents are difficult to predict. Therefore this study gives an overview over the current accident and injury situation of child occupants in cars in German road accidents.
Since its beginning in 1999, the German In-Depth Accident Study (GIDAS) evolved into the presumably leading representative road traffic accident investigation in Europe, based on the work started in Hanover in 1973. The detailed and comprehensive description of traffic accidents forms an essential basis for vehicle safety research. Due to the ongoing extension of demands of researchers, there is a continuous progress in the techniques and systematic of accident investigation within GIDAS. This paper presents some of the most important developments over the last years. Primary vehicle safety systems are expected to have a significant and increasing influence on reducing accidents. GIDAS therefore began to include and collect active safety parameters as new variables from the year 2005 onwards. This will facilitate to assess the impact of present and future active safety measures. A new system to analyse causation factors of traffic accidents, called ACASS, was implemented in GIDAS in the year 2008. The whole process of data handling was optimised. Since 2005 the on-scene data acquisition is completely conducted with mobile tablet PCs. Comprehensive plausibility checks assure a high data quality. Multi-language codebooks are automatically generated from the database structure itself and interfaces ensure the connection to various database management systems. Members of the consortium can download database and codebook, and synchronize half a terabyte of photographic documentation through a secured online access. With the introduction of the AIS 2005 in the year 2006, some medical categorizations have been revised. To ensure the correct assignment of AIS codes to specific injuries an application based on a diagnostic dictionary was developed. Furthermore a coding tool for the AO classification was introduced. All these enhancements enable GIDAS to be up to date for future research questions.
This study aimed to identify the occurrence, type and mechanisms of the traumatic injuries of the vulnerable road users in vehicle collisions, and to determine the effects of human, engineering, and environment factors on traffic accidents and injuries. The pedestrian accident cases were collected in the years 2000 to 2005 from Changsha Wujing hospital China and Accident Research Unit at Medical University Hannover in Germany. A statistic analysis was carried out using the collected accident data. The results from analysis of Changsha data were compared with results from analysis of GIDAS data Hannover. The injury severities were determined using AIS code and ISS values. The results were presented in terms of cause of injuries, injury distributions, injury patterns, injury severity. The factors influenced the injury outcomes were proposed and discussed for the vehicle transport environment and road users. The results were discussed with regard to accident data collection, accident sampling and injury distributions etc. In the urban area of Changsha, motorcycles and passenger cars are most frequently involved in vehicle pedestrian accidents. Head and lower extremities injuries are the predominant types of pedestrian injuries. The pedestrian accidents were identified as vital issue in urban traffic safety and therefore a high priority should be given to this road user group in research of safe urban transportation. In Hannover area, cars are most frequently involved in traffic accidents, injured pedestrians are involved in road traffic of Germany in 13% of all causalities only in 2005 and have nearly the same number as motorcyclists, but the half of bicyclists.
Injury severity of e.g. pedestrians or bikers after crashes with cars that are reversing is almost unknown. However, crash victims of these injuries can frequently be seen in emergency departments and account for a large amount of patients every year. The objective of this study is to analyze injury severity of patients that were crashed into by reversing cars. The Hannover Medical School local accident research unit prospectively documented 43,000 road traffic accidents including 234 crashes involving reversing cars. Injury severity including the abbreviated injury scale (AIS) and the maximum abbreviated injury scale (MAIS) was analyzed as well as the location of the accident. As a result 234 accidents were included into this study. Pedestrians were injured in 141 crashes followed by 70 accidents involving bikers. The mean age of all crash victims was 57 -± 23 years. Most injuries took place on straight stretches (n = 81) as well as parking areas (n = 59), entries (n = 36) or crossroads (n = 24). The AIS of the lower extremities was highest followed by the upper extremities. The AIS of the neck was lowest. The mean MAIS was 1.3 -± 0.6. The paper concludes that the lower extremities show the highest risk to become injured during accidents with reversing cars. However, the risk of severe injuries is likely low.
Novice drivers are at high risk for crash involvement. We performed an analysis of causations, injury patterns and distributions of novice drivers in cars and on motorcycles in road traffic as a basis for proper measurements. Method Data of accident and hospital records of novice drivers (licence < 2 years) were analysed focusing the following parameters: injury type, localisation and mechanism, Abbreviated Injury Scale (AIS), maximum AIS (MAIS), delta-v, collision speed and other technical parameters and have been compared to those of experienced drivers. In 18352 accidents in the area of Hannover (years1985"2004), 2602 novice drivers and 18214 experienced drivers were recorded having an accident. Novice car drivers were more often and severe injured than experienced and on motorcycles the experienced riders were at higher risk. Novice drivers of both groups sustained more often extremity injuries. 4.5 % novice car drivers were not restraint compared to 3.7 % of the experienced drivers and 6.1 % novice motorcycle drivers did not wear a proper helmet (versus 6.5 %). Severe injuries sustained at a rate of 20 % at collision speeds below 30 km/h and in 80% at collision speeds above 50 km/h. Novice car drivers drove significant older cars. The risk profile of novice drivers is similar to those of drivers older than 65 years. Structural protection and special lectures like skidding courses could be proper remedial action next to harder punishment of violations.
Side impacts, both nearside and farside, have been indicated by research to be responsible for a large proportion of serious injuries from road crashes. This study aimed to compare and contrast the characteristics of nearside and farside crashes in Australia, Germany and the U.S., using the ANCIS, GIDAS and NASS/CDS in-depth-databases, in order to establish the impact and injury severity associated with these crashes, and the types of injuries sustained. The analyses revealed some interesting similarities, as well as differences, between both nearside and farside crashes, and the emergent trends between the three investigated countries. More specifically, it was indicated that whilst the severity of injury sustained in nearside crashes was slightly greater overall than that found for farside crashes, careful consideration of struck and nonstruck side occupants must be made when considering aspects such as vehicle design and occupant protection.