Technical parameters and mechanisms for knee joint injuries to belted car drivers in road traffic accidents

Otte, Dietmar; Haasper, Carl

Affiliations

¹Accident Research Unit, Hanover Medical School, Germany

²Trauma Department, Hanover Medical School, Germany

Abstract and keywords

This paper describes the risk of the knee joint injury for belted car drivers in traffic accidents. The situation for knee injuries has been influenced by the changing of interior design of vehicles, including the dashboard and restraint systems like seatbelts, pretensioners and airbags over recent decades. An analysis of real world accidents was carried out by ARU-MUH (Accident Research Unit at Medical University Hannover) utilizing accident data gathered under the in-depth-investigation methodology practiced by the GIDAS (German-In-Depth-Accident-Study) multi-disciplinary research team. GIDAS document accidents on-the-spot, using a sampling process to ensure that results are representative for the German traffic accident situation.

Accident documentations from 1985 to 2003 are used for this study. Two different groups of accident data were compared: the years 1985 to 1993 (n=536 people with knee injury rated AIS1, n=81 people with knee injury rated AIS2+, n= 7260 injured people without knee injury), and 1995 to 2003 (n=451 people with knee injury rated AIS1, n=48 people with knee injury rated AIS2+, n= 9372 injured people without knee injury). The study describes the frequencies of knee injuries on soft tissue knee lesions rated AIS1 and injuries to ligaments and fractures rated AIS2+. In addition, knee injury risks are evaluated by comparing results with the group of drivers without knee injury. The study shows that there is, nowadays, a low risk of severe knee injuries rated AIS 2+ for seat-belted car drivers (0.4% of all injured drivers, documented years 1995 to 2003). It can be pointed out comparing the results with previous studies, that knee injury risk for belted drivers in German car accidents is much lower than that expected from investigations in other countries. The classical dashboard injury that could be seen in the past, very often involving fractures of the acetabulum plus patella plus rupture of rear cruciate ligament can no longer be seen in accidents today. A fracture of the patella could be established in the current accident sample for only 0.1% of all injured belted car drivers. Patella fractures are an indicator of axial load, observed in 43% of the AIS2+ knee injury cases (n=44). The number of patella fractures is directly proportional to delta-v and intrusion. A femur fracture was found in 25 %, and a fracture of the acetabulum was found in 5 % of the knee injured cases. Ruptures of the cruciate ligaments are observed relatively seldom (7.5% of AIS2+ knee injured occupants). These results express a good level of passive safety in cars today.

Keywords: Knee injury; Knee fracture; Occupant safety; bony and ligament injuries of knee

Cited Works (6)

Year	Entry
2004	Dischinger PC, Read KM, Kufera JA, Kerns TJ, Burch CA, Jawed N, Ho SM, Burgess AR. Consequences and costs of lower extremity injuries. In: 48th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). September 13-15, 2004; Key Biscayne, FL.339-353.
2005	Otte D, Haasper C. Technical parameters and mechanisms for the injury risk of the knee joint of vulnerable road users impacted by cars in road traffic accidents. In: Proceedings of the 2005 International IRCOBI Conference on the Biomechanics of Impact. September 21-23, 2005; Prague, Czech Republic.281-297.
1995	Thomas P, Charles J, Fay P. Lower limb injuries: the effect of intrusion, crash severity and the pedals on injury risk and injury type in frontal collisions. In: Proceedings of the 39th Stapp Car Crash Conference. November 8-10, 1995; San Diego, CA. Warrendale, PA: Society of Automotive Engineers:265-280. SAE 952728.
1998	The Abbreviated Injury Scale-1990 Revision, Update 1998. Des Plaines, IL: Association for the Advancement of Automotive Medicine (AAAM); 1998.
2003	Kuppa S, Fessahaie O. An overview of knee-thigh-hip injuries in frontal crashes in the United States. In: Proceedings of the 18th International Technical Conference on the Enhanced Safety of Vehicles (ESV). May 19-22, 2003; Nagoya, Japan.
2003	Otte D, Krettek C, Brunner H, Zwipp H. Scientific approach and methodology of a new in-depth-investigation study in germany so called GIDAS. In: Proceedings of the 18th International Technical Conference on the Enhanced Safety of Vehicles (ESV). May 19-22, 2003; Nagoya, Japan.

Cited By (2)

Year	Entry
2006	Lanz C, Walz FH, Muser MH, Schmitt K-U, Otte D. Incidence and injury mechanisms of tibia head fractures among. In: Proceedings of the 2006 International IRCOBI Conference on the Biomechanics of Impact. September 20-22, 2006; Madrid, Spain.289-302.
2007	Otte D, Haasper C. Characteristics on fractures of tibia and fibula in car impacts to pedestrians: influences of car bumper height and shape. In: Proceedings of the 2007 International IRCOBI Conference on the Biomechanics of Impact. September 19-21, 2007; Maastricht, The Netherlands.71-81.