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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.
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).
With an ever rising human life expectancy the share of elderly people in society is constantly rising. This leads to the fact that at the same rate the share of people with age related diseases such as dementia and poor eyesight taking part in traffic will rise and therefore traffic accidents caused by this group of people due to the disease will play an ever greater role. This Situation will be among the future challenges of road safety work. At present this study displays specific characteristics of accidents caused by elderly car drivers (aged 65 or higher) based on the analysis of the German In-Depth Accident Study GIDAS. Herein almost 1000 elderly car drivers were identified as accident participants in the years 2008 to 2011. The focus of this study lies on identifying special types of accidents which are caused by elderly drivers and on characterizing these types with the information gathered on scene and by interviewing the participants. The main evidence analyzed is the knowledge about the accident locality, the trajectories of the participants as well as the reasons for the occurrence of the accidents. Furthermore personal information such as the personal condition before the accident and driving purposes is used to identify patterns of contributing circumstances for accidents caused by elderly traffic participants.
In Germany averagely two million traffic accidents happen each year and emergency medical services are called to more than 400 000 patients. Even though this number is decreasing continuously (due to improvements in the fields of vehicle safety, road construction, and accident prevention) every case is yet a challenge for the rescuers and requires improvements in emergency medicine as well. Especially during diagnostics right at the accident scene, there are only limited instruments available to gain the necessary knowledge of the injuries suffered, to come to essential decisions about treatment or transport. To provide an additional diagnostic aid by scouting and estimating the situation, a software-tool calculating the likeliness of the most frequent severe injuries (AIS 3-6) of front occupants in passenger cars has been developed to deliver this necessary information about particular accident scenarios. To achieve this, logistic likelihood functions have been calculated in a multivariate regression analysis analysing all AIS 3+ injuries in the GIDAS database of the years 1999-2006 that happened more than four times
In most of developed countries, the progress made in passive safety during the last three decades allowed to drastically reduce the number of killed and severely injured especially for occupants of passenger cars. This reduction is mainly observed for frontal impacts for which the AIS3+ injuries has been reduced about 52% for drivers and 38% for front passengers. The stiffening of the cars' structure coupled with the generalization of airbags and the improvement of the seatbelt restraint (load limiter, pretension, etc.) allowed to protect vital body regions such as head, neck and thorax. However, the abdomen did not take advantage with so much success of this progress. The objective of this study is to draw up an inventory on the abdominal injuries of the belted car occupants involved in frontal impact, to present adapted counter-measures and to assess their potential effectiveness. In the first part the stakes corresponding to the abdominal injuries will be defined according to types of impact, seat location, occupants' age and type of injured organs. Then, we shall focus on the abdominal injury risk curves for adults involved in frontal impact and on the comparisons of the average risks according to the seat location. In the second part we will list counter-measures and we shall calculate their effectiveness. The method of case control will be used in order to estimate odds ratio, comparing two samples, given by occupants having or not having the studied safety system. For this study, two type of data sources are used: national road injured accident census and retrospective in-depth accident data collection. Abdominal injuries are mainly observed in frontal impact (52%). Fatal or severe abdominal occupant- injuries are observed at least in 27% of cases, ranking this body region as the most injured just after the thorax (51%). In spite of a twice lower occupation rate in the back seats compared to the front seats, the number of persons sustaining abdominal injuries at the rear place is higher than in the front place. In recent cars, the risk of having a serious or fatal abdominal injury in a frontal impact is 1.6% for the driver, 3.6% for the front passenger and 6.3% for the rear occupants. The most frequently hurt organs are the small intestine (17%), the spleen (16%) and the liver (13%). The most common countermeasures have a good efficiency in the reduction of the abdominal injuries for the adults: the stiffness of the structure of the seats allows decreasing the abdominal injury risk from 54% (driver) to 60% (front occupant), the seatbelt pretensioners decrease also this risk from 90% (driver) to 83% (front passenger).
While cyclists and pedestrians are known to be at significant risk for severe injuries when exposed to road traffic accidents (RTAs) involving trucks, little is known about RTA injury risk for truck drivers. The objective of this study is to analyze the injury severity in truck drivers following RTAs. Between 1999 and 2008 the Hannover Medical School Accident Research Unit prospectively documented 43,000 RTAs involving 582 trucks. Injury severity including the abbreviated injury scale (AIS) and the maximum abbreviated injury scale (MAIS) were analyzed. Technical parameters (e.g. delta-v, direction of impact), the location of accident, and its dependency on the road type were also taken into consideration. The results show that the safety of truck drivers is assured by their vehicles, the consequence being that the risk of becoming injured is likely to be low. However, the legs especially are at high risk for severe injuries during RTAs. This probability increases in the instance of a collision with another truck. Nevertheless, in RTAs involving trucks and regular passenger vehicles, the other party is in higher risk of injury.
Powered Two Wheeler (Motorcycle) crashes are overrepresented in EU, England, and United States casualty statistics for both fatal and serious injuries. While regional geographic differences are evident for motorcycle size, type, and engine displacement, the casualty statistics consistently indicate significantly higher injury rates for all motorcycle riders when compared to car occupants. Accident analysis and reconstruction of these motorcycle crashes is a necessary process to gain further understanding of potential injury mitigation strategies. This paper focuses on the analysis of the rider post impact trajectory in the immediate moments following a crash. The rider and motorcycle, while loosely coupled by seating position leading up to a crash, quickly decouple as the crash forces develop. As a result, the rider moves relative to the motorcycle and relative to the collision partner. This movement, or trajectory, is primarily influenced by the type and configuration of the impact, the type and configuration of the motorcycle and collision partner, and the speeds involved. Understanding the rider's post impact trajectory will assist in the development of injury mitigation strategies. Both the free flight trajectory of the rider and the rider's trajectory as influenced by interaction with the motorcycle and collision partner are examined. Rider trajectories in full scale crash testing and real world motorcycle crashes are both studied and presented. The resulting physical evidence that can be observed by an accident analyst is discussed. The application of projectile motion physics is analyzed and the necessary input parameters, such as initial launch angle, are studied. This study will assist in understanding the post-impact dynamics of a motorcyclist, and will provide useful information to analysts evaluating real world crashes.
The number of road accidents in Portugal has decreased significantly in the last decades, however, this tendency is not similar in all types of transportation. In the most recent years and by European standards, Portugal is still one of the leading countries concerning the number of fatalities in Powered Two Wheelers (PTW) accidents. To this effect, the in-depth investigation of PTW accidents is crucial and so, a thorough statistical analysis concerning the main factors influencing PTW riders injury severity accidents was undertaken regarding the 2007-2010 period in the National Road Safety Authority (ANSR) injured riders database using the software SPSS. In addition, to determine the importance of absent factors in the database analysis, such as velocity, a set of 53 real accidents involving PTW were also investigated and computationally reconstructed using the software PC-Crash. Lateral collisions between a motorcycle, its rider and the side of three different passenger cars were also simulated, varying the motorcycle impact angle and velocity in order to estimate the PTW deformation energy and the rider- injuries, as this accident configuration stands out in terms of frequency and even severity. The results of this detailed study are presented.
The number of injuries sustained by car occupants involving the head, thorax, spine, pelvis and the upper limbs have been reduced significantly during recent years. This is probably due to better safety features in the cars, especially the availability and usage of safety belts, airbags etc. Therefore one can notice clinically a relative increase in survivors of severe frontal crashes, but many of them have injuries to the lower extremities. To verify this, we analyzed the foot and ankle injuries of front seat passengers.
The share of high-tensile steel in car bodies has increased over the last years. While occupant safety has generally benefited from this measure, there is a potential risk that, as a result, rescue time may increase considerably. In more than 60% of all car occupant fatalities a technical rescue has been necessary. These are in particular those cases where occupants die immediately at the accident scene. Therefore, in these cases "rescue time" is a very sensitive parameter. In addition to the general analysis of the need of technical rescue and the actual rescue time depending on model years, the injury pattern of occupants requiring technical rescue will be analysed to provide advice for rescue teams. Furthermore, a detailed analysis of rescue measures for the most popular car models depending on the safety cell design is given.