Description of road traffic related knee injuries in published investigations is very heterogeneous. The purpose of this study was to estimate the risk of knee injuries in real world car impacts in Germany focusing vulnerable road users (pedestrians, bicyclists and motorcyclists) and restrained car drivers. The accident research unit analyses technical and medical data collected shortly after the accident at scene. Two different periods (years 1985-1993 and 1995-2003) were compared focusing on knee injuries (Abbreviated Injury Scale (AISKnee) 2/3). In order to determine the influences type of collision, direction and speed as well as the injury pattern and different injury scores (AIS, MAIS, ISS) were examined. 1.794 pedestrians, 742 motorcyclists, 2.728 bicyclists and 1.116 car drivers were extracted. 2% had serious ligamentous or bony injuries in relation to all injured. The risk of injury is higher for twowheelers than for pedestrians, but knee injury severity is higher for the latter group. Overall the current knee injury risk is low and significant reduced comparing both time periods (27%, p<0,0001). Severe injuries (AISKnee 2/3) were below 1%). Improved aerodynamic design of car fronts reduced the risk for severe knee injuries significantly (p=0,0015). Highest risk of injury is for motorcycle followed by pedestrians, respectively. Knee protectors could prevent injuries by reducing local forces. The classically described dashboard injury was rarely identified. The overall injury risk for knee injuries in road traffic is lower than estimated and reduced comparing both periods. The aerodynamic shape of current cars compared to older types reduced the incidence and severity of knee injuries. Further modification and optimization of the interior and exterior design could be a proper measurement. Classic described injury mechanisms were rarely identified. It seems that the AIS is still underestimating extremity injuries and their long term results.
Es wurden Unfälle, die im Rahmen des Forschungsprojektes "Erhebungen am Unfallort" dokumentiert wurden, hinsichtlich der Häufigkeit und der Charakteristik von Pkw-Mehrfachkollisionen analysiert. Beschrieben wurden bei einer vergleichenden Gegenüberstellung von Einfach- und Mehrfachkollisionen die Besonderheiten, die die Mehrfachkollisionen prägen, und zwar im Vorfeld des Unfallgeschehens wie auch im Unfallgeschehen selbst. Mit allen beobachteten Unterschieden der Merkmalsausprägungen ist eine Steigerung der Ausgangsgeschwindigkeit, also der Geschwindigkeit, die vor dem Unfallgeschehen gefahren wurde, verbunden. Die Entstehungswahrscheinlichkeit von Mehrfachkollisionen steigt mit der Zunahme der Fahrgeschwindigkeiten. Geschlechtsspezifische Unterschiede sind lediglich für die Wahl der Ausgangsgeschwindigkeiten vor dem Unfallereignis von Bedeutung. Keine Rolle spielen Fahrzeugeigenschaften bei der Entstehung von Mehrfachkollisionen. Bei Mehrfachkollisionen wurde häufig beobachtet, dass Pkw seitlich mit Objekten am Straßenrand (Leitplanke, Bäume etc.) zusammenstoßen. Bei Seitenkollisionen treten überdurchschnittlich schwere Fahrzeugdeformationen sowie schwere Verletzungen am Kopf, im Thoraxbereich und an den oberen Extremitäten auf. Die Rekonstruktion von Mehrfachkollisionen wird durch ein oftmals komplexes Spuren- und Deformationsbild erschwert. Hilfreich erweisen sich fotogrammetrische Verfahren wie Stereoaufnahmen und Draufsichtfotografie.
Still correlated with high mortality rates in traffic accidents traumatic aortic ruptures were frequently detected in unprotected car occupants in the early years. This biomechanical analysis investigates the different kinds of injury mechanisms leading to traumatic aortic injuries in todays traffic accidents and how the way of traffic participation affects the frequency of those injuries over the years. Based on GIDAS reported traffic accidents from 1973 to 2014 are analyzed. Results show that traumatic aortic injuries are mainly observed in high-speed accidents with high body deceleration and direct load force to the chest. Mostly chest compression is responsible for the load direction to the cardiac vessels. The main observed load vector is from caudal-ventral and from ventral solely, but also force impact from left and right side and in roll-over events with chest compression lead to traumatic aortic injuries. Classically, the injury appeares at the junction between the well-fixed aortic arch and the pars decendens following a kind of a scoop mechanism, a few cases with a hyperflexion mechanism are also described. In our analysis the deceleration effect alone never led to an aortic rupture. Comparing the past 40 years aortic injuries shift from unprotected car occupants to today's unprotected vulnerable road users like pedestrians, cyclists and motorcyclists. Still the accident characteristics are linked with chest compression force under high speed impact, no seatbelt and direct body impact.
Pedestrian and cyclist are the most vulnerable road users in traffic crashes. One important aspect of this study was the comparable analysis of the exact impact configuration and the resulting injury patterns of pedestrians and cyclists in view of epidemiology. The secondary aim was assessment of head injury risks and kinematics of adult pedestrian and cyclists in primary and secondary impacts and to correlate the injuries related to physical parameters like HIC value, 3ms linear acceleration, and discuss the technical parameter with injuries observed in real-world accidents based documented real accidents of GIDAS and explains the head injuries by simulated load and impact conditions based on PC-Crash and MADYMO. A subsample of n=402 pedestrians and n=940 bicyclists from GIDAS database, Germany was used for preselection, from which 22 pedestrian and 18 cyclist accidents were selected for reconstruction by initially using PC-Crash to calculate impact conditions, such as vehicle impact velocity, vehicle kinematic sequence and throw out distance. The impact conditions then were employed to identify the initial conditions in simulation of MADYMO reconstruction. The results show that cyclists always suffer lower injury outcomes for the same accident severity. Differences in HIC, head relative impact velocity, 3ms linear contiguous acceleration, maximum angular velocity and acceleration, contact force, throwing distance and head contact timing are shown. The differences of landing conditions in secondary impacts of pedestrians and cyclists are also identified. Injury risk curves were generated by logistic regression model for each predicting physical parameters.