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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.
Real world accident reconstruction with the Total Human Model for Safety (THUMS) in Pam-Crash
(2013)
Further improvement of vehicle safety needs detailed analysis of real world accidents. According to GIDAS (German In-Depth Accident Study) most car to car front accidents occur at mid-crash severity. In this range thoracic injuries already occur. In this study a real world frontal crash with mid-crash severity out of the AARU database was reconstructed. The selected car to car accident was reconstructed by AARU by means of pc-crash software in order to get the initial dynamic accident conditions. These initial conditions were used to reconstruct the complete accident in more detail using FE models for the car structure and the occupants. Occupant simulations were performed with FE HIII-dummy models and the THUMS using Pam-Crash code. An initial THUMS validation was performed in order to verify the model-´s biofidelity by means of table-top test simulations. THUMS bone stiffness values were modified to match the real word occupant age. A comparison between driver and passenger restraint system loading was done, as well as an injury prediction comparison between the HIII-dummy model and THUMS response for both cases. Detailed comparison between the HIII-dummy models and THUMS regarding thoracic loading are discussed.
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.
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.
During the last 5 years, the number of cars fitted with side airbags has dramatically increased. They are now standard equipment, even on many smaller cars or less luxurious vehicles. While some side airbags offer thoracic protection alone, there are those that combine thoracic and head protection (of which most deploy from the seat). Other systems employ separate airbags for head and thorax protection, which are designed to be effective noticeably in a crash against a pole. This paper proposes an evaluation of the effectiveness of side airbags in preventing thoracic injuries to passenger car occupants involved in side crashes. First, the target population (who can take benefit of side airbag deployment and in what circumstances) is defined. Side airbags can be especially effective in cases of impacts on the door with intrusion at a certain impact speed. Then, an example case of a side impact with side airbag deployment is given were side airbag deployment is thought to have had a positive effect on injury outcome. A further case is presented where the impact configuration is likely to have reduced the effect of side airbag deployment on injury outcome. Finally, the estimation of side airbag effectiveness (in terms of additional occupant protection brought exclusively by the airbag) is proposed by comparing injury risk sustained by occupants in (more or less) similar cars (fitted or non fitted with airbags) because, during these years, car structure, and side airbag conception have considerably evolved. In-depth accident data from France, the UK and Germany has been collected. Out of 2,035 side impact accident cases available in the databases, we selected 435 occupants of passenger cars (built from 1998 onwards) involved in an injury accident between year 1998 and year 2004 for EES (Energy Equivalent Speed) values between 20km/h and 50km/h. The occupants, belted or not, were sat on the struck side, whatever the obstacle and type of accidents (intersection, loss of control, etc.). For multiple impact crashes, the side impact is assumed to be the more severe one. Passenger cars were fitted with (96) or without (339) side airbags. Most of the potential risk explanatory variables were correctly and reliably reported in the databases (velocity " impact zone " impact angle " occupant characteristics, etc.). The analysis compared injury risks for different levels of EES and different types of side airbags. A logistic regression model was also computed with injury variables (such as thoracic AIS 2+ or AIS 3+) as the dependant variable and other variables (including airbag type and EES) as explanatory injury risk factors. Results revealed statistically non-significant reductions in thoracic AIS 2+ and AIS 3+ injury risk in side airbag equipped cars in the impact violence range selected (odds ratio between 0.84 and 0.98 depending on types of airbags). The results are discussed. The non-significance is assumed to be due to a low number of cases. Statistical analysis for head injuries was not possible due to the low number of accident cases with passenger cars fitted with head airbags in the databases. Moreover, the discrepancies between the data coming from different countries (especially calculation of EES) might have introduced instability in the analysis.