Injury patterns in frontal crashes: the association between knee-thigh-hip (KTH) and serious intra-abdominal injury.

Safety belts protect occupants in frontal impacts by reducing occupant deceleration and preventing the occupant from hitting interior vehicle components likely to cause injury. However, occupants moving forward during the impact may contact the safety belt webbing across their chest and abdomen. We hypothesized that if the occupant loaded their knee-thigh-hip (KTH) region with enough force to result in injury to this region-it might prevent compression (and injury) of their abdomen by the safety belt. Crash Injury Research and Engineering Network (CIREN) data were used to test the association between KTH and intra-abdominal injury related to safety belts. Odds ratios with 95% confidence limits (CL) and logistic regression models were used to assess statistical significance. Analyses were based on 706 CIREN adult, front seat occupants using their safety belt and injured in frontal crashes. Occupants with KTH injury were four times less likely (adjusted odds ratio=0.25, 95% CL 0.10, 0.62) to have concomitant serious intra-abdominal injury caused by the safety belt. Although safety belts save lives and prevent serious injury, some occupants may sustain serious intra-abdominal injury when the abdomen is loaded by the safety belt during a frontal impact. These results may be useful to motor vehicle manufacturers and others who design and test motor vehicle safety systems.

[1]  W. Haddon,et al.  The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. , 1974, The Journal of trauma.

[2]  Sheldon L. Stucki,et al.  Comparison of Measured Velocity Change in Frontal Crash Tests to NASS Computed Velocity Change , 1998 .

[3]  Kaye Sullivan,et al.  Derivation and theoretical assessment of a set of biomechanics-based, AIS2+ risk equations for the knee-thigh-hip complex. , 2006, Stapp car crash journal.

[4]  F. Lewis,et al.  Current Therapy of Trauma , 1983 .

[5]  Dot Hs,et al.  Lives Saved by the Federal Motor Vehicle Safety Standards and Other Vehicle Safety Technologies, 1960-2002 , 2004 .

[6]  I. Munshi,et al.  A unique pattern of injury secondary to seatbelt-related blunt abdominal trauma. , 2004, The Journal of emergency medicine.

[7]  H. Eid,et al.  Biomechanics of road traffic collision injuries: a clinician's perspective. , 2007, Singapore medical journal.

[8]  Patrick J. Atkinson,et al.  The influence of impact interface on human knee injury: Implications for instrument panel design and the lower extremity injury criterion , 1997 .

[9]  M. Bhandari,et al.  Organ injuries associated with femoral fractures: implications for severity of injury in motor vehicle collisions. , 1999, The Journal of trauma.

[10]  J. E. Kelley,et al.  Injuries in Pediatric Patients with Seatbelt Contusions , 2003, The American surgeon.

[11]  Craig S. Poster,et al.  The interaction of 'occupant factors' on the lower extremity fractures in frontal collision of motor vehicle crashes based on a level I trauma center. , 2007, The Journal of trauma.

[12]  S Lemeshow,et al.  The importance of assessing the fit of logistic regression models: a case study. , 1991, American journal of public health.

[13]  R. Gonzalez,et al.  Screening for abdominal injury prior to emergent extra-abdominal trauma surgery: a prospective study. , 2004, The Journal of trauma.

[14]  Shashi Kuppa,et al.  An overview of knee-thigh-hip injuries in frontal crashes in the United States , 2003 .

[15]  Hampton C. Gabler,et al.  Crash Severity: A Comparison of Event Data Recorder Measurements with Accident Reconstruction Estimates , 2004 .

[16]  Matthew P Reed,et al.  The tolerance of the human hip to dynamic knee loading. , 2002, Stapp car crash journal.

[17]  M. Sise,et al.  The impact of safety belt use on liver injuries in motor vehicle crashes: the importance of motor vehicle safety systems. , 2007, The Journal of trauma.

[18]  John D. States,et al.  Accident Investigation and Impairment Study of Lower Extremity Injury , 1993 .

[19]  A. R. Frisancho.  Physical Status: The Use and Interpretation of Anthropometry , 1996, The American Journal of Clinical Nutrition.

[20]  Jonathan D Rupp,et al.  Injuries to the hip joint in frontal motor-vehicle crashes: biomechanical and real-world perspectives. , 2004, The Orthopedic clinics of North America.

[21]  D. Huelke,et al.  Lower Extremity Injuries in Frontal Crashes: Injuries, Locations, AIS and Contacts , 1991 .

[22]  Bryan C. Baker,et al.  Effects of seat belt load limiters on driver fatalities in frontal crashes of passenger cars , 2007 .