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.
This study aimed at prediction of long bone fractures and assessment of lower extremity injury mechanisms in real world passenger car to pedestrian collision. For this purpose, two pedestrian accident cases with detail recorded lower limb injuries were reconstructed via combining MBS (Multi-body system) and FE (Finite element) methods. The code of PC Crash was used to determine the boundary conditions before collision, and then MBS models were used to reproduce the pedestrian kinematics and injuries during crash. Furthermore, a validated lower limb FE model was chosen to conduct reconstruction of injuries and prediction of long bone fracture via physical parameters of von Mises stress and bending moment. The injury outcomes from simulations were compared with hospital recorded injury data and the same long bone fracture patterns and positions can be observed. Moreover, the calculated long bone fracture tolerance corresponded to the outcome from cadaver tests. The result shows that FE model is capable to reproduce the dynamic injury process and is an effective tool to predict the risk of long bone fractures.
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
An approach to the standardization of accident and injury registration systems (STAIRS) in Europe
(1998)
STAIRS is a European Commission funded study whose aim is to produce a set of guidelines for a harmonised, crash injury database. The need to evaluate the effectiveness of the forthcoming European Union front and side impact directives has emphasised the need for real world crash injury data-sets that can be representative of the crash population throughout Europe. STAIRS will provide a methodology to achieve this. The ultimate aim of STAIRS is to produce a set of data collection tools which will aid decision making on vehicle crashworthiness as well as providing a means to evaluate the effectiveness of safety regulations. This paper will disseminate the up-to-date findings of the group as they try to harmonise their methods. The stage has been reached where studies into the diverse methods of the UK, French and German systems of crash injury investigation have been undertaken. An assessment has already been made of the relationships between the three current systems in order to define the areas of agreement and divergence. The conclusions reached stated that there were many areas that are already closely related and that the differences were only at the detailed level. With the emphasis on secondary safety and injury causation, core data sets were decided upon, taking into account: vehicle description, collision configuration, structural response of vehicles, restraint and airbag performance, child restraint performance, Euro NCAP, pedestrian and vehicle occupant kinematics, injury description and causation. Each variable was studied objectively, the important elements isolated and developed into a form that all partners were agreeable on. A glossary of terms is being developed as the project progresses which includes ISO standards and other definitions from the associated CAREPLUS project, which addresses the comparability of national data sets. A major consideration of the group was the data collection method to be employed. The strengths and weaknesses of each study were investigated to obtain a clear idea of which aspects offered the best way forward. The quality of this information and transference into a common format, as well as the necessary error checking systems to be employed have just been completed and are described. In tandem with this area of study the problem of the statistical relationship of each sample to the national population is also being investigated. The study proposes a mechanism to use a sample of crash injury data to represent the national and international crash injury problem
Still correlated with high mortality rates in traffic accidents traumatic aortic ruptures were frequently detected in unprotected car occupants in the early years. This biomechanical analysis investigates the different kinds of injury mechanisms leading to traumatic aortic injuries in todays traffic accidents and how the way of traffic participation affects the frequency of those injuries over the years. Based on GIDAS reported traffic accidents from 1973 to 2014 are analyzed. Results show that traumatic aortic injuries are mainly observed in high-speed accidents with high body deceleration and direct load force to the chest. Mostly chest compression is responsible for the load direction to the cardiac vessels. The main observed load vector is from caudal-ventral and from ventral solely, but also force impact from left and right side and in roll-over events with chest compression lead to traumatic aortic injuries. Classically, the injury appeares at the junction between the well-fixed aortic arch and the pars decendens following a kind of a scoop mechanism, a few cases with a hyperflexion mechanism are also described. In our analysis the deceleration effect alone never led to an aortic rupture. Comparing the past 40 years aortic injuries shift from unprotected car occupants to today's unprotected vulnerable road users like pedestrians, cyclists and motorcyclists. Still the accident characteristics are linked with chest compression force under high speed impact, no seatbelt and direct body impact.
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.
[Introduction:] A large number of road users involved in road traffic crashes recover from their injuries, but some of them never recover fully and suffer from some kind of permanent disability. In addition to loss of life or reduced quality of life, road accidents carry many and diverse consequences to the survivors such as legal implications, economic burden, job absences, need of care from a third person, home and vehicle adaptations as well as psychological consequences. Within an EU funded project MOVE/C4/SUB/2011-294/SI2.628846 (REHABIL AID) these consequences were analyzed more detailed.
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.