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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.
Pedestrian and cyclist are the most vulnerable road users in traffic crashes. One important aspect of this study was the comparable analysis of the exact impact configuration and the resulting injury patterns of pedestrians and cyclists in view of epidemiology. The secondary aim was assessment of head injury risks and kinematics of adult pedestrian and cyclists in primary and secondary impacts and to correlate the injuries related to physical parameters like HIC value, 3ms linear acceleration, and discuss the technical parameter with injuries observed in real-world accidents based documented real accidents of GIDAS and explains the head injuries by simulated load and impact conditions based on PC-Crash and MADYMO. A subsample of n=402 pedestrians and n=940 bicyclists from GIDAS database, Germany was used for preselection, from which 22 pedestrian and 18 cyclist accidents were selected for reconstruction by initially using PC-Crash to calculate impact conditions, such as vehicle impact velocity, vehicle kinematic sequence and throw out distance. The impact conditions then were employed to identify the initial conditions in simulation of MADYMO reconstruction. The results show that cyclists always suffer lower injury outcomes for the same accident severity. Differences in HIC, head relative impact velocity, 3ms linear contiguous acceleration, maximum angular velocity and acceleration, contact force, throwing distance and head contact timing are shown. The differences of landing conditions in secondary impacts of pedestrians and cyclists are also identified. Injury risk curves were generated by logistic regression model for each predicting physical parameters.
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.
Injury severity of e.g. pedestrians or bikers after crashes with cars that are reversing is almost unknown. However, crash victims of these injuries can frequently be seen in emergency departments and account for a large amount of patients every year. The objective of this study is to analyze injury severity of patients that were crashed into by reversing cars. The Hannover Medical School local accident research unit prospectively documented 43,000 road traffic accidents including 234 crashes involving reversing cars. Injury severity including the abbreviated injury scale (AIS) and the maximum abbreviated injury scale (MAIS) was analyzed as well as the location of the accident. As a result 234 accidents were included into this study. Pedestrians were injured in 141 crashes followed by 70 accidents involving bikers. The mean age of all crash victims was 57 -± 23 years. Most injuries took place on straight stretches (n = 81) as well as parking areas (n = 59), entries (n = 36) or crossroads (n = 24). The AIS of the lower extremities was highest followed by the upper extremities. The AIS of the neck was lowest. The mean MAIS was 1.3 -± 0.6. The paper concludes that the lower extremities show the highest risk to become injured during accidents with reversing cars. However, the risk of severe injuries is likely low.
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.
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.
Novice drivers are at high risk for crash involvement. We performed an analysis of causations, injury patterns and distributions of novice drivers in cars and on motorcycles in road traffic as a basis for proper measurements. Method Data of accident and hospital records of novice drivers (licence < 2 years) were analysed focusing the following parameters: injury type, localisation and mechanism, Abbreviated Injury Scale (AIS), maximum AIS (MAIS), delta-v, collision speed and other technical parameters and have been compared to those of experienced drivers. In 18352 accidents in the area of Hannover (years1985"2004), 2602 novice drivers and 18214 experienced drivers were recorded having an accident. Novice car drivers were more often and severe injured than experienced and on motorcycles the experienced riders were at higher risk. Novice drivers of both groups sustained more often extremity injuries. 4.5 % novice car drivers were not restraint compared to 3.7 % of the experienced drivers and 6.1 % novice motorcycle drivers did not wear a proper helmet (versus 6.5 %). Severe injuries sustained at a rate of 20 % at collision speeds below 30 km/h and in 80% at collision speeds above 50 km/h. Novice car drivers drove significant older cars. The risk profile of novice drivers is similar to those of drivers older than 65 years. Structural protection and special lectures like skidding courses could be proper remedial action next to harder punishment of violations.
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.
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.
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.