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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.
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
Pedestrian accidents are one of the major concerns related with road accidents around the world. Portugal has one of the highest rates of pedestrian fatalities in Europe. In this paper an overview conditions were the pedestrian accidents occurred in Portugal is presented. In the last years, a project related with the pedestrian accidents has run in Portugal for the period 2004-2006 where 603 people died, 2097 have been severely injured and about 17000 slightly injured. Within this project all the pedestrian accidents in this period have been analysed providing global information about a wide range of aspects, since location, driver and pedestrian characteristics, weather and road conditions, among others. In addition, 50 in-depth accidents have been investigated and the data collected according the Pendant methodology. For this in-depth methodology detailed information about the accident has been collected, including injuries, vehicle damage, road conditions and road user- behaviour and actions. An accident reconstruction has been carried for each case including the determination of the speeds and driver actions, and the analysis of the contributing factors for the accident. Depending of the accident complexity, different methodologies have been used to analyse these accident, from the classical analytical equations such as Simms and Woods, to the use of detailed computational pedestrian models as those included in the commercial software- PC-Crash-® or Madymo-®. Also one of the goals of our investigation is the development of multibody models and methodologies for the reconstruction of pedestrian accidents. Some of these tools integrated in the commercial software Cosmos Motion-® are presented. The advantages of the different approaches are compared and discussed for some of the accidents investigated. With these tools the impact speed can be determined from the projection distance with analytical tools or PC-Crash-®, but more complex tools should be used to determine speed from the injuries, what is especially important for fatal accidents. The influence of the vehicle geometry and stiffness characteristics is another aspect analysed, where the influence of the vehicle stiffness has been determined using a combined multibody-finite elements approach within the software Madymo-®.
The purpose of this work is to investigate the association between the injuries in motorcycle accident and the main accident configurations. The data were provided by a multicentric case-control study MAIDS regarding the risk of crash and injuries of motorcyclists. Chi-square test was used to evaluate the relationship between the variables and a logistic regression was performed to evaluate the association of injury severity with some variables supposed to be predictive factors. Lesive patterns characterized by internal haemorrhages are mainly associated with fronto-lateral crashes, above all in urban areas. Lacerations or abrasions, mainly reported in torso and lower extremities, are mostly associated with single crashes or accidents in queue also for crashes occurred to low speed (< 50 km/h). The severity of injuries is highly associated with impact speed, regardless of the crash configuration. Fractures and haemorrhages play an important role in determining the severity of injuries. The upper extremities are the most frequently traumatised anatomic areas.
In the course of the EUROPEAN PROJECT TRACE all fatally injured pedestrians autopsied at the Institute for Legal Medicine in Munich in 2004 had been analysed by using the "Human Functional Failure (HFF) analysis" method. It was possible to apply this method although some restrictions have to be taken into account. The results derived from this analysis comprise first the failures the pedestrians (most often "impairment of sensorimotor and cognitive abilities") and the opponents (most often " Non-detection in visibility constraints conditions") faced in the accident, second the conflicts and tasks (pedestrian crossing the street conflicting with a vehicle from the side (which was going ahead on a straight road), the degree of accident involvement (pedestrians often the primary active part), and further the contributing factors to the accident (pedestrians most often "alcohol (> 0.05% BAC)", opponents most often "visibility constraints").
A change emerges in hospital landscape due to health political measures, which in consequence also influences the pre-clinical medical care of emergencies. The main focus of this study was to gather information about emergency medical care after traffic accidents on the basis of data of Bavarian emergency medical services. In Bavaria, in 2006 it was necessary to call an emergency doctor in the case of 14.261 traffic accidents. Predominantly the patients were provided by land-based life saving appliances, air rescue services were only applied in 19.1 % of the cases. 47.6 % of patients being involved in a traffic accident were transported into a primary health care hospital. A prehospital interval of more than 60 minutes was calculated in 20 % of emergency care. 96.2 % of the patients were transported to hospitals of tertiary or maximum supply by air rescue services. The life saving appliances" readiness for action is however restricted to daylight. A further limitation appeared for routine office hours in hospitals: Only 36.7 % of accidents occurred in this time frame. An increase of hospitalizations in clinics of maximum supply appeared from 2002 until 2006 while simultaneously the prehospital period was extended. To assure a sufficient medical care of seriously injured persons further on, a fulltime and area-wide expostulation of efficient facilities is necessary. For this purpose it is necessary to establish regional trauma networks as well as emergency medical service at night time. Beyond that, a cost efficient compensation of the structural, personnel and logistic expenses has to be assured.
The aim of this study is to investigate the differences in car occupant injury severity recorded in AIS 2005 compared to AIS 1990 and to outline the likely effects on future data analysis findings. Occupant injury data in the UK Cooperative Crash Injury Study Database (CCIS) were coded for the period February 2006 to November 2007 using both AIS 1990 and AIS 2005. Data for 1,994 occupants with over 6000 coded injuries were reviewed at the AIS and MAIS level of severities and body regions to determine changes between the two coding methodologies. Overall there was an apparent general trend for fewer injuries to be coded at the AIS 4+ severity and more injuries to be coded at the AIS 2 severity. When these injury trends were reviewed in more detail it was found that the body regions which contributed the most to these changes in severity were the head, thorax and extremities. This is one of the first studies to examine the implications for large databases when changing to an updated method for coding injuries.
The following paper presents the nature and mechanism of injuries sustained in frontal impacts, focusing on car to car impacts. It was found that the body regions most frequently sustaining severe to fatal injuries were the legs and the thorax. The nature and mechanism of the injury sustained was investigated only for the thorax injuries, due to their potentially life threatening nature. The analysis revealed that the most frequent cause of the injury recorded was the seatbelt for low severity injuries and the front structure of the vehicle for higher severity injuries. An analysis of the effect of load limiter technology in the restraint system showed that the proportion of occupants who sustained "no thorax injury" did not increase when a load limiter was fitted to the restraint system. However, a decrease in the "organ" and "organ and skeletal" injuries was observed in the load limiter sample. Sample size and variation mean that these findings are not conclusive.
It is well known that motorcycle riding is fascinating but quite more dangerous than for example car driving. In 2006, 5,091 persons were killed as victims of crashes occurring on public roads in Germany. 52% (2,683) were car occupants, 16% (793) motorcycle riders, 14% (711) pedestrians, 10% (486) bicycle riders, 5% (235) commercial vehicle occupants, 2% (107) riders of smaller powered two-wheelers, called "Mofa, Moped and Mokick". This shows that motorcycle riders recently are the second largest group of killed traffic participants in Germany. Latest information coming from the Federal Statistics predict for the year 2007 the figure of 4,958 killed road victims in total. This would be again a successful reduction (-133 killed persons or "2.6% compared to the year 2006). But the news coming from the Federal Statistics during the year 2007 and at the begin of 2008 did not always tell the same positive story. It is questioned whether the positive trend of substantially reduced figures of killed road user year by year will longer continue for Germany. That means it could be impossible to reach the ambitious target, set by the European Commission, to cut in half the figure of killed road users until the year 2010 " compared to the figure for the year 2001. It was reported that the group of 45 to 49 years old traffic participants (all traffic modes) is conspicuous with an increase of 30% up to 297 killed road users in total from January to August 2007. This increase can be ascribed in particular by an increase of killed motorcycle riders within this age group. Due to mild weather conditions in Germany in 2007 the season for motorcycle riding began relatively early and this may be a main reason for the increase of the figure of killed motorcycle riders by 16% from January to August 2007. With this background the accident occurrence of motorcycles became more and more essential. As part of the actual discussion about historical trends, recent emphases, causes and relevant structures of the events of motorcycle crashes it is evident, to have latest and carefully updated figures coming from both the Federal Statistics and In-depth studies. The paper will give a contribution to this using the German Federal Statistics and in-depth studies, for example GIDAS. Additional data coming from the DEKRA Motorcycle Accident Database as well as from literature are considered, too. The paper will help to describe the current situation of the accident involvement of motorcycles in Germany.
While many medical studies have dealt with the incidence, nature and treatment of polytrauma the injury-causing accident mechanisms are rarely discussed in detail, mostly due to the lack of documentation of the technical aspects. The present prospective study was started in late 2007 and collects data from traffic accidents with most severely injured in six south- German counties and two larger cities for the duration of one year. It is aimed at identifying and documenting all polytrauma cases (ISS ≥ 16) caused by traffic accidents and their crash circumstances. The data collection is based on an interdisciplinary concept to include both the police, emergency dispatch centers, hospitals and fire departments in the region and is completely anonymous. Potentially relevant cases where an emergency physician was called to the scene of a traffic accident are provided by the dispatch center. All three hospitals in the region suited for the treatment of polytraumatised patients record injuries, major diagnostic and surgery data. Data and images from the accident scene are provided by the police and by fire departments. The latter provide information which is usually not available from the police, like deployed airbags, vehicle extrication measures and detailed views of car interiors. The main objective of the study is to determine the structure of road users who sustain a polytrauma, their crash opponents and the injury patterns found in relation to the collision configuration and the protection by seat belts, air bags and other devices. With detailed documentation of vehicle damage and extrication measures the study is also intended to support the development of injury predictors for pre-hospital treatment and provide field data regarding further improvement of technical rescue.