The interaction of

Chong, Mark<sup>1</sup>; Sochor, Mark<sup>2</sup>; Ipaktchi, Kyros<sup>2</sup>; Brede, Chris<sup>2</sup>; Poster, Craig<sup>2</sup>; Wang, Stewart<sup>3</sup>

Affiliations

¹Birmingham Accident Research Center, University of Birmingham, United Kingdom

²University Hospital Michigan CIREN Center, Ann Arbor, Michigan

³Department of Surgery, University of Michigan Program for Injury Research and Education, University of Michigan, Ann Arbor, Michigan

Abstract and keywords

Background: To advance occupant protection through the improvement of safety countermeasures, it is necessary to understand the factors that affect human injury tolerance. This study investigated the effect of ‘occupant factors' i.e. age, gender, height, weight, and body mass index (BMI) on the pattern of lower extremity injury after motor vehicle crashes (MVCs). The second objective was to identify factor(s) (including restraint systems and Δ V) that influence the severity of fractures (open versus close fractures) within the lower extremity area. The outcome of this study may have implications toward secondary prevention in MVCs.

Methods: One-hundred and thirty-seven front-seat occupants involved in MVCs with frontal impact admitted to the University of Michigan trauma center as part of the Crash Injury Research and Engineering Network (CIREN) project were evaluated. Injuries were classified according to location (knee, thigh, hip [KTH]; lower leg [LL], foot and ankle [FA]). All the relevant variables mentioned above were analyzed.

Results: KTH fractures were the most common region (49.5%) affected, followed by fractures to the FA (38.4%) and LL region (12.1%). Female occupants, being generally shorter than their male counterpart, sustained a significantly higher percentage of FA fractures (44% vs. 29.5%, p < 0.05). Male occupants sustained more KTH fractures (58.3% vs. 44%, p < 0.05). Results demonstrated that there were significantly higher percentages of ‘open' fractures in the below knee area (FA [53.8%], LL [24.4%], and KTH [21.8%]; p < 0.05). Of all those variables tested (age, gender, height, weight, BMI, restraint systems, and Δ V), occupant's height had a significant effect on the severity of fractures sustained.

Conclusion: The interactive effect observed for height and gender on the pattern of lower extremity fracture is principally related to the body habitus and that gender may be a ‘proxy' variable. The ‘human factor' plays a vital role in influencing the pattern of injury in a MVC. This study strongly supports the fact that occupants with dissimilar body habitus interact differently with the interior cabin of the vehicle, thus, the performance of the active and passive safety systems.

Keywords: Lower extremity fractures, Motor vehicle crashes, Trauma, USA, Occupant factors

Links

DOI: 10.1097/01.ta.0000222577.43192.a6

PubMed: 17414354

WoS: 000244877300034

History

Received: 2005-06-30

Accepted: 2006-03-24

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Cited By (5)

Year	Entry
2023	Bangert LG, Collins CJ, Riexinger LE. Do females have a higher risk of suffering distal tibia fractures in frontal car crashes? In: Proceedings of the 2023 International IRCOBI Conference on the Biomechanics of Injury. September 13-165, 2023; Cambridge, United Kingdom.244-253.
2011	Holcombe S, Kohoyda-Inglis C, Wang L, Goulet JA, Wang SC, Kent RW. Patterns of acetabular femoral head coverage. Stapp Car Crash J. 2011;55:479-490.
2010	Lee J, Conroy C, Coimbra R, Tominaga GT, Hoyt DB. Injury patterns in frontal crashes: the association between knee–thigh–hip (KTH) and serious intra-abdominal injury. Accid Anal Prev. January 2010;42(1):50-55.
2024	Leledakis A. Heterogeneity in Car Occupant Safety: Using Numerical Simulations to Address Real-World Safety [PhD thesis]. Götenburg, Sweden: Chalmers University of Technology; 2024.
2015	Klein KF. Use of Parametric Finite Element Models to Investigate Effects of Occupant Characteristics on Lower-Extremity Injuries in Frontal Crashes [PhD thesis]. University of Michigan; 2015.