Thoracic Injuries in Frontal Car Crashes: Risk Assessment Using a Finite Element Human Body Model

Accident data show that there is a clear need to improve the protection to occupantsí thorax in frontal car crashes. For this purpose, models that can predict the risk of injuries and assess the occupant protection offered by different restraint systems are needed. Two types of models are usually applied to accomplish this, mechanical models, also known as anthropomorphic test devices (ATDs), and numerical models, of ATDs and of the human body. Numerical models of the human body based on the finite element method (FE- HBM) offer a more detailed representation of humans than ATDs. On the other hand, there is no clear consensus on the injury criteria and thresholds to predict thoracic injuries using FE-HBMs. The general aim of this thesis is to contribute to the reduction in number and severity of thoracic injuries in frontal car crashes by utilising an FE-HBM.

To reach this aim, the FE-HBM Total HUman Model for Safety version 3.0 (THUMS v3.0) was improved by comparing its kinematic and thoracic stiffness responses to tests with Post Mortem Human Subjects (PMHSs). Thoracic injury criteria at the global, structural and material levels were calculated with the modified THUMS in simulations of PMHS tests. Injury risk curves, with and without age adjustment, were constructed by applying the survival analysis method to matched pairs of injury criteria calculated with the modified THUMS and the injury outcome of the PMHS test. The injury risk curves that best approximated the test data were selected. Then, the risks predicted by the modified THUMS and the selected curves were compared to the risks predicted by an injury risk curve constructed based on real-world crash data. Different configurations of the modified THUMS were simulated and the results of the changes in the thoracic stiffness and coupling were applied to support the design update of the thorax of an existing ATD.

The contributions of this thesis include: modified THUMS, with an enhanced biofidelity in frontal car crashes compared to THUMS v3.0; injury risk curves for the modified THUMS to predict the risk of two or more fractured ribs in frontal car crashes; and recommendations to improve the design of an existing ATD thorax.

Keywords: Thoracic injury criteria; rib fracture; finite element; human body model; survival analysis; real-world crash data

Year	Entry
2003	Ruan J, El-Jawahri R, Chai L, Barbat S, Prasad P. Prediction and analysis of human thoracic impact responses and injuries in cadaver impacts using a full human body finite element model. Stapp Car Crash J. 2003;47:299-321. SAE 2003-22-0014.
2005	Charpail E, Trosseille X, Petit P, Laporte S, Lavaste F, Vallancien G. Characterization of PMHS ribs: a new test methodology. Stapp Car Crash J. 2005;49:183-198. SAE 2005-22-0009.
1991	Horsch JD, Melvin JW, Viano DC, Mertz HJ. Thoracic injury assessment of belt restraint systems based on Hybrid III chest compression. In: Proceedings of the 35th Stapp Car Crash Conference. November 18-20, 1991; San Diego, CA. Warrendale, PA: Society of Automotive Engineers:85-108. SAE 912895.
2002	Oshita F, Omori K, Nakahira Y, Miki K. Development of a finite element model of the human body. In: 7th International LS-DYNA Users Conference. May 19-21, 2002; Detroit, MI.3-37–3-48.
2007	Kleiven S. Predictors for traumatic brain injuries evaluated through accident reconstructions. Stapp Car Crash J. 2007;51:81-114. SAE 2007-22-0003.
1999	Nusholtz G, Mosier R. Consistent threshold estimate for doubly censored biomechanical data. In: Proceedings of the SAE International Congress & Exposition. March 1-4, 1999; Detroit, MI. Warrendale, PA: Society of Automotive Engineers. SAE 1999-01-0714.
2014	Davidsson J, Carroll J, Hynd D, Lecuyer E, Song E, Trosseille X, Eggers A, Sunnevang C, Praxl N, Martinez L, Lemmen P, Been B. Development of injury risk functions for use with the THORAX demonstrator: an updated THOR. In: Proceedings of the 2014 International IRCOBI Conference on the Biomechanics of Injury. September 10-12, 2014; Berlin, Germany.359-376.
2010	Kent RW, Forman JL, Bostrom O. Is there really a “cushion effect”? a biomechanical investigation of crash injury mechanisms in the obese. Obesity. 2010;18(4):749-753.
2009	Shaw G, Parent D, Purtsezov S, Lessley D, Kerrigan J, Shin J, Crandall J, Zama Y, Ejima S, Kamiji K, Yasuki T. Frontal impact PMHS sled tests for FE torso model development. In: Proceedings of the 2009 International IRCOBI Conference on the Biomechanics of Impact. September 9-11, 2009; York, UK.341-356.
2008	Trosseille X, Baudrit P, Leport T, Vallancien G. Rib cage strain pattern as a function of chest loading configuration. Stapp Car Crash J. 2008;52:205-231. SAE 2008-22-0009.
2010	Carroll J, Adolph T, Chauvel C, Labrousse M, Trosseille X, Pastor C, Eggers A, Smith S, Hynd D. Overview of serious thorax injuries in european frontal car crash accidents and implications for crash test dummy development. In: Proceedings of the 2010 International IRCOBI Conference on the Biomechanics of Impact. September 15-17, 2010; Hannover, Germany.217-234.
2005	Kent R, Lee S-H, Darvish K, Wang S, Poster CS, Lange AW, Brede C, Lange D, Matsuoka F. Structural and material changes in the aging thorax and their role in crash protection for older occupants. Stapp Car Crash J. November 2005;49:231-249. SAE 2005-22-0011.
2005	Kent R, Murakami D, Kobayashi S. Frontal thoracic response to dynamic loading: the role of superficial tissues, viscera, and the rib cage. In: Proceedings of the 2005 International IRCOBI Conference on the Biomechanics of Impact. September 21-23, 2005; Prague, Czech Republic.355-365.
2009	Ito O, Dokko Y, Ohashi K. Development of adult and elderly FE thorax skeletal models. In: Proceedings of the SAE World Congress & Exhibition. April 20-23, 2009; Detroit, MI. Warrendale, PA: Society of Automotive Engineers. SAE 2009-01-0381.
2009	Kindig MM. Tolerance to Failure and Geometric Influences on the Stiffness of Human Ribs Under Anterior-Posterior Loading [Master's thesis]. Charlottesville, VA: University of Virginia; December 2009.
1999	Eppinger R, Sun E, Bandak F, Haffner M, Khaewpong N, Maltese M, Kuppa S, Nguyen T, Takhounts E, Tannous R, Zhang A, Saul R. Development of Improved Injury Criteria for the Assessment of Advanced Automotive Restraint Systems - II. Washington, DC: National Highway Traffic Safety Administration (NHTSA); November 1999.
1998	Zioupos P, Currey JD. Changes in the stiffness, strength, and toughness of human cortical bone with age. Bone. January 1998;22(1):57-66.
2013	Vavalle NA, Moreno DP, Rhyne AC, Stitzel JD, Gayzik FS. Lateral impact validation of a geometrically accurate full body finite element model for blunt injury prediction. Ann Biomed Eng. 2013;41(3):497-512.
2010	Li Z, Kindig MW, Subit D, Kent RW. Influence of mesh density, cortical thickness and material properties on human rib fracture prediction. Med Eng Phys. November 2010;32(9):998-1008.
1978	Foret-Bruno JY, Hartemann F, Thomas C, Fayon A, Tarrière C, Got C, Patel A. Correlation between thoracic lesions and force values measured at the shoulder of 92 belted occupants involved in real accidents. In: Proceedings of the 22nd Stapp Car Crash Conference. October 24-26, 1978; Ann Arobor, MI. Warrendale, PA: Society of Automotive Engineers:271-292. SAE 780892.
2009	Vezin P, Berthet F. Structural characterization of human rib cage behavior under dynamic loading. Stapp Car Crash J. 2009;53:93-125. SAE 2009-22-0004.
1974	Neathery RF. Analysis of chest impact response data and scaled performance recommendations. In: Proceedings of the 18th Stapp Car Crash Conference. December 4-5, 1974; Ann Arbor, MI. Warrendale, PA: Society of Automotive Engineers:459-493. SAE 741188.
2011	Song E, Lecuyer E, Trosseille X. Development of injury criteria for frontal impact using a human body FE model. In: Proceedings of the 22nd International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 13-16, 2011; Washington, DC.
1982	Mertz HJ, Weber DA. Interpretations of the impact responses of a 3-year-old child dummy relative to child injury potential. In: Proceedings of the 9th International Technical Conference on Experimental Safety Vehicles (ESV). November 1-4, 1982; Kyoto, Japan.368-376.
2009	Song E, Trosseille X, Baudrit P. Evaluation of thoracic deflection as an injury criterion for side impact using a finite elements thorax model. Stapp Car Crash J. 2009;53:155-191. SAE 2009-22-0006.
2009	Shigeta K, Kitagawa Y, Yasuki T. Development of next generation human FE model capable of organ injury prediction. In: Proceedings of the 21st International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 15-18, 2009; Stuttgart, Germany.
2005	Duma S, Stitzel J, Kemper A, McNally C, Kennedy E, Matsuoka F. Non-censored rib fracture data from dynamic belt loading tests on the human cadaver thorax. In: Proceedings of the 19th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 6-9, 2005; Washington, DC.
2006	Turner CH. Bone strength: current concepts. Annals NY Acad Sci. 2006;1068(1):429-446.
1977	Foster JK, Kortge JO, Wolanin MJ. Hybrid III: a biomechanically-based crash test dummy. In: Proceedings of the 21st Stapp Car Crash Conference. October 19-21, 1977; New Orleans, LA. Warrendale, PA: Society of Automotive Engineers:975-1014. SAE 770938.
2012	Petitjean A, Trosseille X, Praxl N, Hynd D, Irwin A. Injury risk curves for the WorldSID 50th male dummy. Stapp Car Crash J. October 2012;56:323-347.
2001	Kuppa S, Wang J, Haffner M, Eppinger R. Lower extremity injuries and associated injury criteria. In: Proceedings of the 17th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 4-7, 2001; Amsterdam, The Netherlands.
1978	Carter DR, Spengler DM. Mechanical properties and composition of cortical bone. Clin Orthop Relat Res. September 1978;135:192-217.
2009	Bean JD, Kahane CJ, Mynatt M, Rudd RW, Rush CJ, Wiacek C. Fatalities in Frontal Crashes Despite Seat Belts and Air Bags: Review of All CDS Cases: Model and Calendar Years 2000-2007: 122 Fatalities. Washington, DC: National Highway Traffic Safety Administration; September 2009. NHTSA Technical Report DOT HS 811 202.
2006	Kimpara H, Iwamoto M, Watanabe I, Miki K, Lee JB, Yang KH, King AI. Effect of assumed stiffness and mass density on the impact response of the human chest using a three-dimensional FE model of the human body. J Biomech Eng. October 2006;128(5):772-776.
2013	Vavalle NA, Jelen BC, Moreno DP, Stitzel JD, Gayzik FS. An evaluation of objective rating methods for full-body finite element model comparison to PMHS tests. Traffic Inj Prev. November 22, 2013;14(suppl 1):S87-S94.
1994	Bouquet R, Ramet M, Bermond F, Cesari D. Thoracic and pelvis human response to impact. In: Proceedings of the 14th International Technical Conference on the Enhanced Safety of Vehicles (ESV). May 23-26, 1994; Munich, Germany.100-109.
2011	Li Z, Hu J, Reed MP, Rupp JD, Hoff CN, Zhang J, Cheng B. Development, validation, and application of a parametric pediatric head finite element model for impact simulations. Ann Biomed Eng. December 2011;39(12):2984-2997.
1974	Akaike H. A new look at the statistical model identification. IEEE Trans Automat Contr. December 1974;19(6):716-723.
1990	The Abbreviated Injury Scale-1990 Revision. Des Plaines, IL: Association for the Advancement of Automotive Medicine (AAAM); 1990.
2004	Kent R, Lessley D, Sherwood C. Thoracic response to dynamic, non-impact loading from a hub, distributed belt, diagonal belt, and double diagonal belts. Stapp Car Crash J. 2004;48:495-519. SAE 2004-22-0022.
2013	Lemmen P, Been B, Carroll J, Hynd D, Davidsson J, Martinez L, García A, Vezin P, Eggers A. An advanced thorax-shoulder design for the THOR dummy. In: Proceedings of the 23rd International Technical Conference on the Enhanced Safety of Vehicles (ESV). May 27-30, 2013; Seoul, South Korea.
2013	Kitagawa Y, Yasuki T. Correlation among seatbelt load, chest deflection, rib fracture and internal organ strain in frontal collisions with human body finite element models. In: Proceedings of the 2013 International IRCOBI Conference on the Biomechanics of Injury. September 11-13, 2013; Gothenburg, Sweden.282-316.
2014	Golman AJ, Danelson KA, Miller LE, Stitzel JD. Injury prediction in a side impact crash using human body model simulation. Accid Anal Prev. March 2014;64:1-8.
2002	Kent RW. Dynamic Response of the Thorax: Restraint-Specific Hard Tissue Injury Prediction [PhD thesis]. Charlottesville, VA: University of Virginia; January 2002.
2005	Vezin P, Verriest JP. Development of a set of numerical human models for safety. In: Proceedings of the 19th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 6-9, 2005; Washington, DC.
1996	Mertz HJ, Prasad P, Nusholtz G. Head injury risk assessment for forehead impacts. In: Proceedings of the SAE International Congress & Exposition. February 26–March 1, 1996; Detroit, MI. Warrendale, PA: Society of Automotive Engineers. SAE 960099.
2004	Kennedy EA, Hurst WJ, Stitzel JD, Cormier JM, Hansen GA, Smith EP, Duma SM. Lateral and posterior dynamic bending of the mid-shaft femur: fracture risk curves for the adult population. Stapp Car Crash J. 2004;48:27-51. SAE 2004-22-0002.
2009	Shaw G, Parent D, Purtsezov S, Lessley D, Crandall J, Kent R, Guillemot H, Ridella SA, Takhounts E, Martin P. Impact response of restrained PMHS in frontal sled tests: skeletal deformation patterns under seat belt loading. Stapp Car Crash J. 2009;53:1-48. SAE 2009-22-0001.
2005	Wismans J, Happee R, van Dommelen JAW. Computational human body models. In: Gilchrist MD, ed. IUTAM Symposium on Impact Biomechanics: From Fundamental Insights to Applications. Dordrecht, The Netherlands: Springer; 2005:417-429. Solid Mechanics and Its Applications; vol 124.
2011	Pipkorn B, Kent R. Validation of a human body thorax model and its use for force, energy and strain analysis in various loading conditions. In: Proceedings of the 2011 International IRCOBI Conference on the Biomechanics of Injury. September 14-16, 2011; Krakow, Poland.210-223.
1991	Mertz HJ, Horsch JD, Horn G, Lowne RW. Hybrid III sternal deflection associated with thoracic injury severities of occupants restrained with force-limiting shoulder belts. In: Proceedings of the SAE International Congress & Exposition. February 25–March 1, 1991; Detroit, MI. Warrendale, PA: Society of Automotive Engineers:105-119. SAE 910812.
2001	Haffner M, Eppinger R, Rangarajan N, Shams T, Artis M, Beach D. Foundations and elements of the NHTSA Thor ALPHA ATD design. In: Proceedings of the 17th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 4-7, 2001; Amsterdam, The Netherlands.
1970	Nahum AM, Gadd CW, Schneider DC, Kroell CK. Deflection of the human thorax under sternal impact. 1970. SAE 700400.
2004	Kent RW, Funk JR. Data censoring and parametric distribution assignment in the development of injury risk functions from biochemical data. In: Proceedings of the SAE World Congress & Exhibition. March 8-11, 2004; Detroit, MI. Warrendale, PA: Society of Automotive Engineers. SAE 2004-01-0317.
2011	Petitjean A, Trosseille X. Statistical simulations to evaluate the methods of the construction of injury risk curves. Stapp Car Crash J. 2011;55:411-440.
2007	Cuerden R, Cookson R, Massie P, Edwards M. A review of the European 40% offset frontal impact test configuration. In: Proceedings of the 20th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 18-21, 2007; Lyon, France.
2005	Kent R, Henary B, Matsuoka F. On the fatal crash experience of older drivers. In: 49th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). September 12-14, 2005; Boston, MA.371-391.
2008	Cormier JM. The influence of body mass index on thoracic injuries in frontal impacts. Accid Anal Prev. March 2008;40(2):610-615.
2005	Tamura A, Watanabe I, Miki K. Elderly human thoracic FE model development and validation. In: Proceedings of the 19th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 6-9, 2005; Washington, DC.
2009	Rudd RW, Bean J, Cuentas C, Kahane CJ, Mynatt M, Wiacek C. A study of the factors affecting fatalities of air bag and belt-restrained occupants in frontal crashes. In: Proceedings of the 21st International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 15-18, 2009; Stuttgart, Germany.
2012	Gayzik FS, Moreno DP, Vavalle NA, Rhyne AC, Stitzel JD. Development of a full human body finite element model for blunt injury prediction utilizing a multi-modality medical imaging protocol. In: 12th International LS-DYNA Users Conference. 2012; Detroit, MI.
2000	Crandall J, Kent R, Patrie J, Fertile J, Martin P. Rib fracture patterns and radiologic detection: a restraint-based comparison. In: 44th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 2-4, 2000; Chicago, IL.
2007	Kemper AR, McNally C, Pullins CA, Freeman LJ, Duma SM, Rouhana SW. The biomechanics of human ribs: material and structural properties from dynamic tension and bending tests. Stapp Car Crash J. 2007;51:235-273. SAE 2007-22-0011.
2002	Iwamoto M, Kisanuki Y, Watanabe I, Furusu K, Miki K, Hasegawa J. Development of a finite element model of the total human model for safety (THUMS) and application to injury reconstruction. In: Proceedings of the 2002 International IRCOBI Conference on the Biomechanics of Impact. September 18-20, 2002; Munich, Germany.
2006	Murakami D, Kobayashi S, Torigaki T, Kent R. Finite element analysis of hard and soft tissue contributions to thoracic response: sensitivity analysis of fluctuations in boundary conditions. Stapp Car Crash J. 2006;50:169-189. SAE 2006-22-0008.
2012	Stigson H, Kullgren A, Rosén E. Injury risk functions in frontal impacts using data from crash pulse recorders. In: 56th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 14-17, 2012; Seattle, WA.267-276.
2011	Bose D, Segui-Gomez M, Crandall JR. Vulnerability of female drivers involved in motor vehicle crashes: an analysis of US population at risk. Am J Public Health. December 2011;101(12):2368-2373.
1974	Kroell CK, Schneider DC, Nahum AM. Impact tolerance and response of the human thorax II. In: Proceedings of the 18th Stapp Car Crash Conference. December 4-5, 1974; Ann Arbor, MI. Warrendale, PA: Society of Automotive Engineers:383-457. SAE 741187.
2008	Gayzik FS, Yu MM, Danelson KA, Slice DE, Stitzel JD. Quantification of age-related shape change of the human rib cage through geometric morphometrics. J Biomech. 2008;41(7):1545-1554.
2002	Petitjean A, Lebarbe M, Potier P, Trosseille X, Lassau J-P. Laboratory reconstructions of real world frontal crash configurations using the Hybrid III and THOR dummies and PMHS. Stapp Car Crash J. 2002;46:27-54. SAE 2002-22-0002.
1993	Hertz E. A note on the head injury criterion (HIC) as a predictor of the risk of skull fracture. In: 37th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). November 4-6, 1993; San Antonio, TX.303-312.
2012	Forman JL, Kent RW, Mroz K, Pipkorn B, Bostrom O, Segui-Gomez M. Predicting rib fracture risk with whole-body finite element models: development and preliminary evaluation of a probabilistic analytical framework. In: 56th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 14-17, 2012; Seattle, WA.109-124.
2005	Kemper AR, McNally C, Kennedy EA, Manoogian SJ, Rath AL, Ng TP, Stitzel JD, Smith EP, Duma SM, Matsuoka F. Material properties of human rib cortical bone from dynamic tension coupon testing. Stapp Car Crash J. 2005;49:199-230. SAE 2005-22-0010.

Year

Entry

2003

Ruan J, El-Jawahri R, Chai L, Barbat S, Prasad P. Prediction and analysis of human thoracic impact responses and injuries in cadaver impacts using a full human body finite element model. Stapp Car Crash J. 2003;47:299-321. SAE 2003-22-0014.

2005

Charpail E, Trosseille X, Petit P, Laporte S, Lavaste F, Vallancien G. Characterization of PMHS ribs: a new test methodology. Stapp Car Crash J. 2005;49:183-198. SAE 2005-22-0009.

1991

Horsch JD, Melvin JW, Viano DC, Mertz HJ. Thoracic injury assessment of belt restraint systems based on Hybrid III chest compression. In: Proceedings of the 35th Stapp Car Crash Conference. November 18-20, 1991; San Diego, CA. Warrendale, PA: Society of Automotive Engineers:85-108. SAE 912895.

2002

Oshita F, Omori K, Nakahira Y, Miki K. Development of a finite element model of the human body. In: 7th International LS-DYNA Users Conference. May 19-21, 2002; Detroit, MI.3-37–3-48.

2007

Kleiven S. Predictors for traumatic brain injuries evaluated through accident reconstructions. Stapp Car Crash J. 2007;51:81-114. SAE 2007-22-0003.

1999

Nusholtz G, Mosier R. Consistent threshold estimate for doubly censored biomechanical data. In: Proceedings of the SAE International Congress & Exposition. March 1-4, 1999; Detroit, MI. Warrendale, PA: Society of Automotive Engineers. SAE 1999-01-0714.

2014

Davidsson J, Carroll J, Hynd D, Lecuyer E, Song E, Trosseille X, Eggers A, Sunnevang C, Praxl N, Martinez L, Lemmen P, Been B. Development of injury risk functions for use with the THORAX demonstrator: an updated THOR. In: Proceedings of the 2014 International IRCOBI Conference on the Biomechanics of Injury. September 10-12, 2014; Berlin, Germany.359-376.

2010

Kent RW, Forman JL, Bostrom O. Is there really a “cushion effect”? a biomechanical investigation of crash injury mechanisms in the obese. Obesity. 2010;18(4):749-753.

2009

Shaw G, Parent D, Purtsezov S, Lessley D, Kerrigan J, Shin J, Crandall J, Zama Y, Ejima S, Kamiji K, Yasuki T. Frontal impact PMHS sled tests for FE torso model development. In: Proceedings of the 2009 International IRCOBI Conference on the Biomechanics of Impact. September 9-11, 2009; York, UK.341-356.

2008

Trosseille X, Baudrit P, Leport T, Vallancien G. Rib cage strain pattern as a function of chest loading configuration. Stapp Car Crash J. 2008;52:205-231. SAE 2008-22-0009.

2010

Carroll J, Adolph T, Chauvel C, Labrousse M, Trosseille X, Pastor C, Eggers A, Smith S, Hynd D. Overview of serious thorax injuries in european frontal car crash accidents and implications for crash test dummy development. In: Proceedings of the 2010 International IRCOBI Conference on the Biomechanics of Impact. September 15-17, 2010; Hannover, Germany.217-234.

2005

Kent R, Lee S-H, Darvish K, Wang S, Poster CS, Lange AW, Brede C, Lange D, Matsuoka F. Structural and material changes in the aging thorax and their role in crash protection for older occupants. Stapp Car Crash J. November 2005;49:231-249. SAE 2005-22-0011.

2005

Kent R, Murakami D, Kobayashi S. Frontal thoracic response to dynamic loading: the role of superficial tissues, viscera, and the rib cage. In: Proceedings of the 2005 International IRCOBI Conference on the Biomechanics of Impact. September 21-23, 2005; Prague, Czech Republic.355-365.

2009

Ito O, Dokko Y, Ohashi K. Development of adult and elderly FE thorax skeletal models. In: Proceedings of the SAE World Congress & Exhibition. April 20-23, 2009; Detroit, MI. Warrendale, PA: Society of Automotive Engineers. SAE 2009-01-0381.

2009

Kindig MM. Tolerance to Failure and Geometric Influences on the Stiffness of Human Ribs Under Anterior-Posterior Loading [Master's thesis]. Charlottesville, VA: University of Virginia; December 2009.

1999

Eppinger R, Sun E, Bandak F, Haffner M, Khaewpong N, Maltese M, Kuppa S, Nguyen T, Takhounts E, Tannous R, Zhang A, Saul R. Development of Improved Injury Criteria for the Assessment of Advanced Automotive Restraint Systems - II. Washington, DC: National Highway Traffic Safety Administration (NHTSA); November 1999.

1998

Zioupos P, Currey JD. Changes in the stiffness, strength, and toughness of human cortical bone with age. Bone. January 1998;22(1):57-66.

2013

Vavalle NA, Moreno DP, Rhyne AC, Stitzel JD, Gayzik FS. Lateral impact validation of a geometrically accurate full body finite element model for blunt injury prediction. Ann Biomed Eng. 2013;41(3):497-512.

2010

Li Z, Kindig MW, Subit D, Kent RW. Influence of mesh density, cortical thickness and material properties on human rib fracture prediction. Med Eng Phys. November 2010;32(9):998-1008.

1978

Foret-Bruno JY, Hartemann F, Thomas C, Fayon A, Tarrière C, Got C, Patel A. Correlation between thoracic lesions and force values measured at the shoulder of 92 belted occupants involved in real accidents. In: Proceedings of the 22nd Stapp Car Crash Conference. October 24-26, 1978; Ann Arobor, MI. Warrendale, PA: Society of Automotive Engineers:271-292. SAE 780892.

2009

Vezin P, Berthet F. Structural characterization of human rib cage behavior under dynamic loading. Stapp Car Crash J. 2009;53:93-125. SAE 2009-22-0004.

1974

Neathery RF. Analysis of chest impact response data and scaled performance recommendations. In: Proceedings of the 18th Stapp Car Crash Conference. December 4-5, 1974; Ann Arbor, MI. Warrendale, PA: Society of Automotive Engineers:459-493. SAE 741188.

2011

Song E, Lecuyer E, Trosseille X. Development of injury criteria for frontal impact using a human body FE model. In: Proceedings of the 22nd International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 13-16, 2011; Washington, DC.

1982

Mertz HJ, Weber DA. Interpretations of the impact responses of a 3-year-old child dummy relative to child injury potential. In: Proceedings of the 9th International Technical Conference on Experimental Safety Vehicles (ESV). November 1-4, 1982; Kyoto, Japan.368-376.

2009

Song E, Trosseille X, Baudrit P. Evaluation of thoracic deflection as an injury criterion for side impact using a finite elements thorax model. Stapp Car Crash J. 2009;53:155-191. SAE 2009-22-0006.

2009

Shigeta K, Kitagawa Y, Yasuki T. Development of next generation human FE model capable of organ injury prediction. In: Proceedings of the 21st International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 15-18, 2009; Stuttgart, Germany.

2005

Duma S, Stitzel J, Kemper A, McNally C, Kennedy E, Matsuoka F. Non-censored rib fracture data from dynamic belt loading tests on the human cadaver thorax. In: Proceedings of the 19th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 6-9, 2005; Washington, DC.

2006

Turner CH. Bone strength: current concepts. Annals NY Acad Sci. 2006;1068(1):429-446.

1977

Foster JK, Kortge JO, Wolanin MJ. Hybrid III: a biomechanically-based crash test dummy. In: Proceedings of the 21st Stapp Car Crash Conference. October 19-21, 1977; New Orleans, LA. Warrendale, PA: Society of Automotive Engineers:975-1014. SAE 770938.

2012

Petitjean A, Trosseille X, Praxl N, Hynd D, Irwin A. Injury risk curves for the WorldSID 50th male dummy. Stapp Car Crash J. October 2012;56:323-347.

2001

Kuppa S, Wang J, Haffner M, Eppinger R. Lower extremity injuries and associated injury criteria. In: Proceedings of the 17th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 4-7, 2001; Amsterdam, The Netherlands.

1978

Carter DR, Spengler DM. Mechanical properties and composition of cortical bone. Clin Orthop Relat Res. September 1978;135:192-217.

2009

Bean JD, Kahane CJ, Mynatt M, Rudd RW, Rush CJ, Wiacek C. Fatalities in Frontal Crashes Despite Seat Belts and Air Bags: Review of All CDS Cases: Model and Calendar Years 2000-2007: 122 Fatalities. Washington, DC: National Highway Traffic Safety Administration; September 2009. NHTSA Technical Report DOT HS 811 202.

2006

Kimpara H, Iwamoto M, Watanabe I, Miki K, Lee JB, Yang KH, King AI. Effect of assumed stiffness and mass density on the impact response of the human chest using a three-dimensional FE model of the human body. J Biomech Eng. October 2006;128(5):772-776.

2013

Vavalle NA, Jelen BC, Moreno DP, Stitzel JD, Gayzik FS. An evaluation of objective rating methods for full-body finite element model comparison to PMHS tests. Traffic Inj Prev. November 22, 2013;14(suppl 1):S87-S94.

1994

Bouquet R, Ramet M, Bermond F, Cesari D. Thoracic and pelvis human response to impact. In: Proceedings of the 14th International Technical Conference on the Enhanced Safety of Vehicles (ESV). May 23-26, 1994; Munich, Germany.100-109.

2011

Li Z, Hu J, Reed MP, Rupp JD, Hoff CN, Zhang J, Cheng B. Development, validation, and application of a parametric pediatric head finite element model for impact simulations. Ann Biomed Eng. December 2011;39(12):2984-2997.

1974

Akaike H. A new look at the statistical model identification. IEEE Trans Automat Contr. December 1974;19(6):716-723.

1990

The Abbreviated Injury Scale-1990 Revision. Des Plaines, IL: Association for the Advancement of Automotive Medicine (AAAM); 1990.

2004

Kent R, Lessley D, Sherwood C. Thoracic response to dynamic, non-impact loading from a hub, distributed belt, diagonal belt, and double diagonal belts. Stapp Car Crash J. 2004;48:495-519. SAE 2004-22-0022.

2013

Lemmen P, Been B, Carroll J, Hynd D, Davidsson J, Martinez L, García A, Vezin P, Eggers A. An advanced thorax-shoulder design for the THOR dummy. In: Proceedings of the 23rd International Technical Conference on the Enhanced Safety of Vehicles (ESV). May 27-30, 2013; Seoul, South Korea.

2013

Kitagawa Y, Yasuki T. Correlation among seatbelt load, chest deflection, rib fracture and internal organ strain in frontal collisions with human body finite element models. In: Proceedings of the 2013 International IRCOBI Conference on the Biomechanics of Injury. September 11-13, 2013; Gothenburg, Sweden.282-316.

2014

Golman AJ, Danelson KA, Miller LE, Stitzel JD. Injury prediction in a side impact crash using human body model simulation. Accid Anal Prev. March 2014;64:1-8.

2002

Kent RW. Dynamic Response of the Thorax: Restraint-Specific Hard Tissue Injury Prediction [PhD thesis]. Charlottesville, VA: University of Virginia; January 2002.

2005

Vezin P, Verriest JP. Development of a set of numerical human models for safety. In: Proceedings of the 19th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 6-9, 2005; Washington, DC.

1996

Mertz HJ, Prasad P, Nusholtz G. Head injury risk assessment for forehead impacts. In: Proceedings of the SAE International Congress & Exposition. February 26–March 1, 1996; Detroit, MI. Warrendale, PA: Society of Automotive Engineers. SAE 960099.

2004

Kennedy EA, Hurst WJ, Stitzel JD, Cormier JM, Hansen GA, Smith EP, Duma SM. Lateral and posterior dynamic bending of the mid-shaft femur: fracture risk curves for the adult population. Stapp Car Crash J. 2004;48:27-51. SAE 2004-22-0002.

2009

Shaw G, Parent D, Purtsezov S, Lessley D, Crandall J, Kent R, Guillemot H, Ridella SA, Takhounts E, Martin P. Impact response of restrained PMHS in frontal sled tests: skeletal deformation patterns under seat belt loading. Stapp Car Crash J. 2009;53:1-48. SAE 2009-22-0001.

2005

Wismans J, Happee R, van Dommelen JAW. Computational human body models. In: Gilchrist MD, ed. IUTAM Symposium on Impact Biomechanics: From Fundamental Insights to Applications. Dordrecht, The Netherlands: Springer; 2005:417-429. Solid Mechanics and Its Applications; vol 124.

2011

Pipkorn B, Kent R. Validation of a human body thorax model and its use for force, energy and strain analysis in various loading conditions. In: Proceedings of the 2011 International IRCOBI Conference on the Biomechanics of Injury. September 14-16, 2011; Krakow, Poland.210-223.

1991

Mertz HJ, Horsch JD, Horn G, Lowne RW. Hybrid III sternal deflection associated with thoracic injury severities of occupants restrained with force-limiting shoulder belts. In: Proceedings of the SAE International Congress & Exposition. February 25–March 1, 1991; Detroit, MI. Warrendale, PA: Society of Automotive Engineers:105-119. SAE 910812.

2001

Haffner M, Eppinger R, Rangarajan N, Shams T, Artis M, Beach D. Foundations and elements of the NHTSA Thor ALPHA ATD design. In: Proceedings of the 17th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 4-7, 2001; Amsterdam, The Netherlands.

1970

Nahum AM, Gadd CW, Schneider DC, Kroell CK. Deflection of the human thorax under sternal impact. 1970. SAE 700400.

2004

Kent RW, Funk JR. Data censoring and parametric distribution assignment in the development of injury risk functions from biochemical data. In: Proceedings of the SAE World Congress & Exhibition. March 8-11, 2004; Detroit, MI. Warrendale, PA: Society of Automotive Engineers. SAE 2004-01-0317.

2011

Petitjean A, Trosseille X. Statistical simulations to evaluate the methods of the construction of injury risk curves. Stapp Car Crash J. 2011;55:411-440.

2007

Cuerden R, Cookson R, Massie P, Edwards M. A review of the European 40% offset frontal impact test configuration. In: Proceedings of the 20th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 18-21, 2007; Lyon, France.

2005

Kent R, Henary B, Matsuoka F. On the fatal crash experience of older drivers. In: 49th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). September 12-14, 2005; Boston, MA.371-391.

2008

Cormier JM. The influence of body mass index on thoracic injuries in frontal impacts. Accid Anal Prev. March 2008;40(2):610-615.

2005

Tamura A, Watanabe I, Miki K. Elderly human thoracic FE model development and validation. In: Proceedings of the 19th International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 6-9, 2005; Washington, DC.

2009

Rudd RW, Bean J, Cuentas C, Kahane CJ, Mynatt M, Wiacek C. A study of the factors affecting fatalities of air bag and belt-restrained occupants in frontal crashes. In: Proceedings of the 21st International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 15-18, 2009; Stuttgart, Germany.

2012

Gayzik FS, Moreno DP, Vavalle NA, Rhyne AC, Stitzel JD. Development of a full human body finite element model for blunt injury prediction utilizing a multi-modality medical imaging protocol. In: 12th International LS-DYNA Users Conference. 2012; Detroit, MI.

2000

Crandall J, Kent R, Patrie J, Fertile J, Martin P. Rib fracture patterns and radiologic detection: a restraint-based comparison. In: 44th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 2-4, 2000; Chicago, IL.

2007

Kemper AR, McNally C, Pullins CA, Freeman LJ, Duma SM, Rouhana SW. The biomechanics of human ribs: material and structural properties from dynamic tension and bending tests. Stapp Car Crash J. 2007;51:235-273. SAE 2007-22-0011.

2002

Iwamoto M, Kisanuki Y, Watanabe I, Furusu K, Miki K, Hasegawa J. Development of a finite element model of the total human model for safety (THUMS) and application to injury reconstruction. In: Proceedings of the 2002 International IRCOBI Conference on the Biomechanics of Impact. September 18-20, 2002; Munich, Germany.

2006

Murakami D, Kobayashi S, Torigaki T, Kent R. Finite element analysis of hard and soft tissue contributions to thoracic response: sensitivity analysis of fluctuations in boundary conditions. Stapp Car Crash J. 2006;50:169-189. SAE 2006-22-0008.

2012

Stigson H, Kullgren A, Rosén E. Injury risk functions in frontal impacts using data from crash pulse recorders. In: 56th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 14-17, 2012; Seattle, WA.267-276.

2011

Bose D, Segui-Gomez M, Crandall JR. Vulnerability of female drivers involved in motor vehicle crashes: an analysis of US population at risk. Am J Public Health. December 2011;101(12):2368-2373.

1974

Kroell CK, Schneider DC, Nahum AM. Impact tolerance and response of the human thorax II. In: Proceedings of the 18th Stapp Car Crash Conference. December 4-5, 1974; Ann Arbor, MI. Warrendale, PA: Society of Automotive Engineers:383-457. SAE 741187.

2008

Gayzik FS, Yu MM, Danelson KA, Slice DE, Stitzel JD. Quantification of age-related shape change of the human rib cage through geometric morphometrics. J Biomech. 2008;41(7):1545-1554.

2002

Petitjean A, Lebarbe M, Potier P, Trosseille X, Lassau J-P. Laboratory reconstructions of real world frontal crash configurations using the Hybrid III and THOR dummies and PMHS. Stapp Car Crash J. 2002;46:27-54. SAE 2002-22-0002.

1993

Hertz E. A note on the head injury criterion (HIC) as a predictor of the risk of skull fracture. In: 37th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). November 4-6, 1993; San Antonio, TX.303-312.

2012

Forman JL, Kent RW, Mroz K, Pipkorn B, Bostrom O, Segui-Gomez M. Predicting rib fracture risk with whole-body finite element models: development and preliminary evaluation of a probabilistic analytical framework. In: 56th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 14-17, 2012; Seattle, WA.109-124.

2005

Kemper AR, McNally C, Kennedy EA, Manoogian SJ, Rath AL, Ng TP, Stitzel JD, Smith EP, Duma SM, Matsuoka F. Material properties of human rib cortical bone from dynamic tension coupon testing. Stapp Car Crash J. 2005;49:199-230. SAE 2005-22-0010.

Year	Entry
2016	Antona‐Makoshi J, Yamamoto Y, Kato R, Kunitomi S, Konosu A, Dokko Y, Yasuki T, Takamiya T. Effect of seatbelt and airbag loads on thoracic injury risk in frontal crashes considering average and small body sizes and age‐dependent thoracic fragility. In: Proceedings of the 2016 International IRCOBI Conference on the Biomechanics of Injury. September 14-16, 2016; Malaga, Spain.904-930.
2019	Pipkorn B, Iraeus J, Björklund M, Bunketorp O, Jakobsson L. Multi-scale validation of a rib fracture prediction method for human body models. In: Proceedings of the 2019 International IRCOBI Conference on the Biomechanics of Injury. September 11-13, 2019; Florence, Italy.175-192.

Year

Entry

2016

Antona‐Makoshi J, Yamamoto Y, Kato R, Kunitomi S, Konosu A, Dokko Y, Yasuki T, Takamiya T. Effect of seatbelt and airbag loads on thoracic injury risk in frontal crashes considering average and small body sizes and age‐dependent thoracic fragility. In: Proceedings of the 2016 International IRCOBI Conference on the Biomechanics of Injury. September 14-16, 2016; Malaga, Spain.904-930.

2019

Pipkorn B, Iraeus J, Björklund M, Bunketorp O, Jakobsson L. Multi-scale validation of a rib fracture prediction method for human body models. In: Proceedings of the 2019 International IRCOBI Conference on the Biomechanics of Injury. September 11-13, 2019; Florence, Italy.175-192.