Objective: A prospective study of the interaction between airbag (AB) and seat-belt (Bt) protection versus vehicular compartment (VC) intrusion effects on injury patterns in motor vehicle crash (MVC) trauma patients.
Methods: Two hundred MVC patients, nonejected drivers or front seat passengers wth multiple trauma or severe lower extremity (LE) trauma admitted to two Level I trauma centers.
Results: In frontal crashes, airbags (AB) more than Bt reduced Glasgow Coma Scale severity in brain injury, face fracture, shock, and the need for MVC extrication (all p <0.05). Frontal AB also had a protective effect on LE fractures (41% vs. 66%, p <0.01), but had no significant protective effect on pelvic fractures. When AB protection was present, it prevented brain and face fracture injuries caused by impact contacts and reduced the incidence of these injuries resulting from VC intrusions (p <0.05). Thoracoabdominal injuries resulting from steering wheel intrusion showed AB protection against intrusions of twice the magnitude of those seen in non-AB vehicles (p <0.05). In frontal MVCs, AB reduced LE fracture contact injuries but did not prevent LE fractures resulting from intrusions of instrument panel, toepan, or floor pedal structures. In lateral MVCs, Bt did not protect against brain, face, thorax, or pelvic injuries.
Conclusion: Safety measures beyond frontal airbags must address frontal crash LE injuries induced by steering wheel, instrument panel, and toepan passenger compartment structure intrusions. Lateral crash injuries may profit from side AB supplemental restraint protection.
|1995||Viano DC. Restraint effectiveness, availability and use in fatal crashes: implications to injury control. J Trauma. April 1995;38(4):538-546.|
|1974||Teasdale G, Jennett B. Assessment of coma and impaired consciousness: a practical scale. Lancet. July 13, 1974;2(7872):81-84.|
|1995||Dalmotas DJ, German A, Hendrick BE, Hurley RM. Airbag deployments: the Canadian experience. J Trauma. April 1995;38(4):476-481.|
|1994||Evans L. Safety-belt effectiveness: the influence of crash severity and selective recruitment. In: 38th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). September 21-23, 1994; Lyon, France.25-42.|
|1995||Burgess AR, Dischinger PC, O'Quinn TD, Schmidhauser CB. Lower extremity injuries in drivers of airbag-equipped automobiles: clinical and crash reconstruction correlations. J Trauma. April 1995;38(4):509-516.|
|1995||Lund AK, Ferguson SA. Driver fatalities in 1985-1993 cars with airbags. J Trauma. April 1995;38(4):469-475.|
|1993||Zador PL, Ciccone MA. Automobile driver fatalities in frontal impacts: air bags compared with manual belts. Am J Public Health. May 1993;83(5):661-666.|
|1989||Siegel JH, Dalal SA, Burgess AR, Young JWR. Pattern of organ injuries in pelvic fracture: impact force implications for survival and death in motor vehicle injuries. In: 33rd Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 2-4, 1989; Baltimore, MD.353-366.|
|1993||Siegel JH, Mason-Gonzalez S, Dischinger P, Cushing B, Read K, Robinson R, Smialek J, Heatfield B, Hill W, Bents F, Jackson J, Livingston D, Clark CC. Safety belt restraints and compartment intrusions in frontal and lateral motor vehicle crashes: mechanisms of injuries, complications, and acute care costs. J Trauma. May 1993;34(5):736-759.|
|1999||Dischinger PC, Ho SM, Kufera JA. The epidemiology of traumatic brain injury: a statewide study of hospitalized Maryland drivers. In: 43rd Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). September 20-21, 1999; Barcelon, Spain.71-88.|
|2000||Ferrando J, Plasència A, Ricart I, Canaleta X, Seguí-Gómez M. Motor-vehicle injury patterns in emergency-department patients in a south-european urban setting. In: 44th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 2-4, 2000; Chicago, IL.|
|2001||Durbin DR, Elliott M, Arbogast KB, Anderko RL, Winston FK. The effect of seating position on risk of injury for children in side impact collisions. In: 45th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). September 24-26, 2001; San Antonio, TX.|
|2002||Read KM, Burgess AR, Dischinger PC, Kufera JA, Kerns TJ, Ho SM, Burch C. Psychosocial and physical factors associated with lower extremity injury. In: 46th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). September 30–October 2, 2002; Tempe, AZ.|
|2002||Siegel JH, Smith JA, Tenenbaum N, McCammon L, Siddiqi SQ, Presswalla F, Pierre-Louis P, Williams W, Zaretski L, Hutchins K, Perez L, Shaikh J, Natarajan G. Deceleration energy and change in velocity on impact: key factors in fatal versus potentially survivable motor vehicle crash (MVC) aortic injuries (AI): the role of associated injuries as determinants of outcome. In: 46th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). September 30–October 2, 2002; Tempe, AZ.|
|2003||Dischinger P, Read K, Kerns T, Ho S, Kufera J, Burch C, Jawed N, Burges A, Bents F. Causes and outcomes of mild traumatic brain injury: an analysis of CIREN data. In: 47th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). September 22-24, 2003; Lisbon, Portugal.577-589.|
|1996||Dischinger PC, Ho SM, Kerns TJ, Brennan P. Patterns of injury in frontal collisions with and without airbags. In: Proceedings of the 1996 International IRCOBI Conference on the Biomechanics of Impact. September 11-13, 1996; Dublin, Ireland.311-319.|
|2016||Yoganandan N, Chirvi S, Pintar FA, Uppal H, Schlick M, Banerjee A, Voo L, Merkle A, Kleinberger M. Foot–ankle fractures and injury probability curves from post-mortem human surrogate tests. Annals Biomed Eng. October 2016;44(10):2937-2947.|
|2001||Seipel RC, Pintar FA, Yoganandan N, Boynton MD. Biomechanics of calcaneal fractures: a model for the motor vehicle. Clin Orthop Relat Res. July 2001;388:218-224.|
|2014||Matar HE, Atkinson HD, Toh EM, Akimau PI, Davies MB. Surgical interventions for treating tarsometatarsal (Lisfranc) fracture dislocations. Cochrane Database Sys Rev. 2014;(7):CD011235.|
|2001||Richter M, Wippermann B, Krettek C, Schratt HE, Hufner T, Thermann H. Fractures and fracture dislocations of the midfoot: occurrence, causes and long-term results. Foot Ankle Int. 2001;22(5):392-398.|
|2002||Richter M, Thermann H, Huefner T, Schmidt U, Kretter C. Aetiology, treatment and outcome in Lisfranc joint dislocations and fracture dislocations. Foot Ankle Surg. 2002;8(1):21-32.|
|2002||Richter M, Wippermann B, Thermann H, Schroeder G, Otte D, Troeger HD, Krettek C. Plantar impact causing midfoot fractures result in higher forces in Chopart's joint than in the ankle joint. J Orthop Res. 2002;20(2):222-232.|
|2001||Richter M, Thermann H, Wippermann B, Otte D, Schratt H-E, Tscherne H. Foot fractures in restrained front seat car occupants: a long-term study over twenty-three years. J Orthop Trauma. May 2001;15(4):287-293.|
|2004||Howard A, Rothman L, McKeag AM, Pazmino-Canizares J, Monk B, Comeau JL, Mills D, Blazeski SB, Hale I, German A. Children in side-impact motor vehicle crashes: seating positions and injury mechanisms. J Trauma. June 2004;56(6):1276-1285.|
|2004||Read KM, Kufera JA, Dischinger PC, Kerns TJ, Ho SM, Burgess AR, Burch CA. Life-altering outcomes after lower extremity injury sustained in motor vehicle crashes. J Trauma. October 2004;57(4):815-823.|
|2000||Funk JR. The Effect of Active Muscle Tension on the Axial Impact Tolerance of the Human Foot/ankle Complex [PhD thesis]. Charlottesville, VA: University of Virginia; August 2000.|
|2008||Thor CP. Characteristics of Thoracic Organ Injuries in Frontal Crashes [Master's thesis]. Virginia Polytechnic Institute and State University; December 10, 2008.|