Sonstige
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.
Ruptures and dissections of the thoracic and abdominal aortic vessel caused by traffic accidents are rare but potentially life-threatening injuries. They can occur by blunt trauma via seat belt or dashboard injury. The study aimed at evaluating the overall mortality, morbidity, neurological disorders, and differences in operative procedures of open repair and stenting. It shows that, with a change and improvement in diagnostic tools and surgical approach, mortality and morbidity of blunt aortic injuries were significantly reduced. Still an immediate life-threatening injury early diagnosis via multiple-slice and scans and surgical repair with minimally invasive stents showed excellent short-time results for selected patients.
This study aims to analyze spine injuries in motor vehicle accidents. Between 1985 and 2004 the Hannover accident research unit documented 18353 accidents. We identified 161 front passengers (0.53%) with cervical spine injuries, 84 (0.28%) with thoracic and 95 (0.31%) with lumbar injuries. Technical and medical data was reviewed. Patients" records were retrieved. X-rays were evaluated and fractures were classified according to the Magerl classification. 68% and 57% of thoracic and lumbar fractures occurred in accidents with multiple impacts. Delta-v was 50, 40 and 40 kph in passengers with cervical, thoracic and lumbar spine, resp. Passengers with spinal fractures frequently showed numerous concomitant injuries, e.g. additional vertebral fractures. The influence of seat belts and airbags is discussed. Patient work-up has to include a thorough investigation for additional injuries.
Introduction: Spine injuries pose a considerable risk to life and quality of life. The total number of road deaths in developed countries has markedly decreased, e.g. in Germany from over 20000 in 1970 to less than 4000 in 2010, but little is known how this is reflected in the burden of spine fractures of motor vehicle users. In this study, we aimed to show the actual incidence of spine injuries among drivers and front passengers and elucidate possible dependencies between crash mechanisms and types of injuries.