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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.
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 the context of this study, different data sources for accident research were examined regarding their possible data access and evaluated concerning the individual quality and extent of the data. Analyses of accidents require detailed and comprehensive information in particular concerning vehicle damages, injury patterns and descriptions of the accident sequence. The police documentation supplies the basic accident statistics and is amended in the context of the forensic treatment by further information, e.g. by medical and technical appraisals and witness questionings. As a new approach to the data acquisition for the analysis of fatal traffic accidents, the information was made usable which was collected by the police and by the investigations of the public prosecutor. The best strategy for obtaining reliable, extensive and complete data consists of combining the information from these two sources: the very complete, but elementary statistic data of the Niedersächsisches Landesamt für Statistik (Lower Saxony State Authority of Statistics), based on the police documentation as well as the very extensive accident information resulting from the investigation documentation of the public prosecutor after conclusion of the procedure, the so-called Court Records. Of all 715 fatal traffic accidents, which happened in the year 2003 in the German State of Lower Saxony, 238 cases were selected by means of a statistically coincidental selective procedure based on a statistically representative manner (every third accident). These cases cover the investigation documents of the 11 responsible public prosecutor- offices, which were requested and evaluated while preserving the data security. Of the 238 cases 202 cases were available, which were individually coded and stored in a data base using 160 variables. Thus a data base of a sample of representative data for fatal accidents in Lower Saxony was set up. The data base contains extensive information concerning general accident data (35 variables), concerning road and road surface data (30 variables), concerning vehicle-specific data (68 variables) as well as concerning personal and injury data (27 variables).
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.
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.