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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.
To elucidate the risk of pedestrians, bicycle and motorbike users, data of two accident research units from 1999 to 2014 were analysed in regard to demographic data, collision details, preclinical and clinical data using SPSS. 14.295 injured vulnerable road users were included. 92 out of 3610 pedestrians ("P", 2.5%), 90 out of 8307 bicyclists ("B", 1.1%) and 115 out of 4094 motorcycle users ("M", 2.8%) were diagnosed with spinal fractures. Thoracic fractures were most frequent ahead of lumbar and cervical fractures. Car collisions were most frequent mechanism (68, 62 and 36%). MAIS was 3.8, 2.8 and 3.2 for P, B and A with ISS 32, 16 and 23. AIS-head was 2.2, 1.3 and 1.5). Vulnerable road users are at significant risk for spine fractures. These are often associated with severe additional injuries, e.g. the head and a very high overall trauma severity (polytrauma).
The bicyclist accidents were analyzed to get better understanding of the occurrences and frequency of the accidents, injury distributions, as well as correlation of injury severity/outcomes with engineering and human factors in two different countries of China and Germany. The accident cases that occurred from 2001 to 2006 were collected from IVAC database in Changsha and GIDAS database in Hannover. Based on specified sampling criteria, 1,570 bicyclist cases were selected from IVAC database in Changsha, and 1806 cases were collected from Hannover, documented in GIDAS database. Statistical analyses were carried out by using these selected data. The results from the statistical analysis are presented and discussed in this study.
The incidence and treatment of sternal fractures among traffic accidents are of increasing importance to ensure best possible outcomes. Analysis of technical indicators of the collision, preclinical and clinical data of patients with sterna fractures from 1985-2004 among 42,055 injured patients were assessed by an Accident Research Unit. Two time groups were categorized: 1985-1994 (A) vs. 1995-2004 (B). 267/42,055 patients (0.64%) suffered a sterna fracture. Regarding the vehicle type, the majority occurred after car accidents in 0.81% (251/31,183 pts), followed by 0.19% (5/2,633pts) driving motorbike, and 0.11% (4/3,258pts) driving a truck. 91% wore a safety belt. Only 13% of all passengers suffering a sternal fracture had an airbag on board (33/255 car/trucks), with an airbag malfunction in 18%. The steering column was deformed in 39%, the steering wheel in 36%. Cars in the recent years were significantly older (7.67-±5 years (B) vs. 5.88-±5 years (A), p=0.003). Cervical spine injuries are frequent (23% vs. 22%), followed by multiple rib fractures (14% vs. 12%) and lung injuries (12% vs. 11%). We found 9/146 (6%) and 3/121 patients (3%) with heart contusion among the 267 sternal fractures. MAIS was 2.56-±1.3 vs. 2.62-±1.3 (A vs. B, p=0.349). 18% of patients were polytraumatized, with 11.2% dying at the scene, 2.3% in the hospital. Sternal fractures occur most often in old cars to seat-belted drivers often without any airbag. Severe multiple rib fractures and lung contusion are concomitant injuries in more than 10% each indicating the severity of the crash. Over a twentyyear period, the injury severity encountered was not different with 18% polytrauma patients suffering sternal fractures.
The "Seven Steps Method" is an analysis and classification system, which describes the human participation factors and their causes in the temporal sequence (from the perceptibility to concrete action errors) taking into consideration the logical sequence of individual basic functions. By means of the "seven steps" it is possible to describe the relevant human causes of accidents from persons involved in the accident in an economic way with a sufficient degree of exactitude, because the causes can be further differentiated in their value (e.g. diversion as external diversion with regard to impact due to surroundings) and their sub values (e.g. external diversion with regard to impact due to surroundings in the shape of a "capture" of the perception by a prominent object of the traffic environment). Theoretically it is possible that one or more causing moments can be assigned to a person involved in an accident in each of the "seven steps"; however it is also possible to sufficiently clarify the cause in only one level (examples for this are described). In the practice of accident investigation at the site of the accident, the sequence chart is also relevant. With its assistance the questioning of the people involved in an accident can be accomplished in a structured way by assigning a set of questions to each step.
Bicyclists are minimally or unprotected road users. Their vulnerability results in a high injury risk despite their relatively low own speed. However, the actual injury situation of bicyclists has not been investigated very well so far. The purpose of this study was to analyze the actual injury situation of bicyclists in Germany to create a basis for effective preventive measures. Technical and medical data were prospectively collected shortly after the accident at the accident scenes and medical institutions providing care for the injured. Data of injured bicyclists from 1985 to 2003 were analyzed for the following parameters: collision opponent, collision type, collision speed (km/h), Abbreviated Injury Scale (AIS), Maximum AIS (MAIS), incidence of polytrauma (Injury Severity Score >16), incidence of death (death before end of first hospital stay). 4,264 injured bicyclists were included. 55% were male and 45% female. The age was grouped to preschool age in 0.9%, 6 to 12 years in 10.8%, 13 to 17 years in 10.4%, 18 to 64 years in 64.7%, and over 64 years in 13.2%. The MAIS was 1 in 78.8%, 2 in 17.0%, 3 in 3.0%, 4 in 0.6%, 5 in 0.4%, and 6 in 0.2%. The incidence of polytrauma was 0.9%, and the incidence of death was 0.5%. The incidence of injuries to different body regions was as follows: head, 47.8%; neck, 5.2%, thorax, 21%; upper extremities, 46.3%; abdomen, 5.8%; pelvis, 11.5%, lower extremities, 62.1%. The accident location was urban in 95.2%, and rural in 4.8%. The accidents happened during daylight in 82.4%, during night in 12.2%, and during dawn/dusk in 5.3%. The road situation was as follows: straight, 27.3%; bend, 3.0%; junction, 32.0%; crossing, 26.4%; gate, 5.9%; others, 5.4%. The collision opponents were cars in 65.8%, trucks in 7.2%, bicycles in 7.4%, standing objects in 8.8%, multiple objects in 4.3%, and others in 6.5%. The collision speed was grouped <31 in 77.9%, 31-50 in 4.9%, 51-70 in 3.7%, and >70 in 1.5%. The helmet use rate was 1.5%. 68% of the registered head injuries were located in the effective helmet protection area. In bicyclists, head and extremities are at high risk for injuries. The helmet use rate is unsatisfactorily low. Remarkably, two thirds of the head injuries could have been prevented by helmets. Accidents are concentrated to crossings, junctions and gates. A significant lower mean injury severity was observed in victims using separate bicycle lanes. These results do strongly support the extension or addition of bicycle lanes and their consequent use. However, the lanes are frequently interrupted at crossings and junctions. This emphasizes also the important endangering of bicyclists coming from crossings, junctions and gates, i.e. all situations in which contact of bicyclists to motorized vehicles is possible. Redesigning junctions and bicycle traffic lanes to minimize the possibility of this dangerous contact would be preventive measures. A more consequent helmet use and use and an extension of bicycle paths for a better separation of bicyclists and motorized vehicle would be simple but very effective preventive measures.
This study is aimed to investigate the correlations of impact conditions and dynamic responses with the injuries and injury severity of child pedestrians by accident reconstruction. For this purpose, the pedestrian accident cases were selected from Sweden and Germany with detailed information about injuries, accident cars, and accident environment. The selected accident cases were reconstructed using mathematical models of pedestrian and passenger car. The pedestrian models were generated based on the height, weight, and age of the pedestrian involved in accidents. The car models were built up based on the corresponding accident car. The impact speeds in simulations were defined based on the reported data. The calculated physical quantities were analyzed to find the correlation with injury outcomes registered in the accident database. The reconstruction approaches are discussed in terms of data collection, estimating vehicle impact speeds, pedestrian moving speeds and initial posture, secondary ground impact, validity of the mathematical models, as well as impact biomechanics.
Introduction: The method of causation analysis applied under the German accident survey GIDAS, which is based on Accident Causation Analysis System (ACAS) focuses on an on-scene data collection of predominantly directly event-related causation factors which were crucial in the accident emergence as situational resulting events and influences. The paradigm underlying this method refers to the findings of the psychological traffic accident research that most causally relevant features of the system components human, infrastructure and vehicle technology are found directly in the situation shortly before the accident. This justifies the survey method which is conducted directly at the accident (on-scene), shortly after the accident occurrence (in-time) with the detection of human-related causes (in-depth). Human aspects of the situation analysis that interact and influence the risk situations shortly before the collision are reported as errors, lapses, mistakes and failures in ACAS in specific categories and subcategories. Thus methodically ACAS is designed primarily for the collection of accident features on the level of operational action, which certainly leads to valid findings and behavioral causes of accidents. The enhancement by means of Moderating Conditions concerns the pre-crash phase in different levels: strategical, tactical and operational.