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Upper Extremity Fractures in Restrained Front-Seat Occupants

2000; Lippincott Williams & Wilkins; Volume: 48; Issue: 5 Linguagem: Inglês

10.1097/00005373-200005000-00015

1529-8809

Martinus Richter, Dietmar Otte, D. Ing, Kaneschka Jahanyar, Cand Med, M. Blauth,

Trauma and Emergency Care Studies

The aim of our study was to analyze the injury mechanism of upper extremity fractures in car crashes, to create a basis for developing prophylactic devices.During 1985-1995, 3,260 restrained car drivers (1,228 front-seat passengers) were injured in 9,380 crashes involving cars. A total of 179 drivers (5.5%) (front-seat passengers: n = 53, 4.3%) sustained fractures of the arm. The hand (25%), wrist (23%), and forearm (23%) were affected most often, and the elbow (9%), upper arm (10%), and shoulder (10%) were seldom affected. No considerable differences of the injury mechanism were found comparing drivers with front-seat passengers. Fractures were mainly caused by head-on collisions (n = 119, 51%) or multiple collisions (n = 78, 34%). In 73% of the crashes (n = 166), delta-v exceeded 30 km/h (18.6 mph). A lower Delta-v resulted mainly in fractures affecting the shoulder and wrist.Because more than half of the upper extremity fractures resulted from a direct impact to the hand, arm, or both, modifications to improve the energy absorption by padding dashboard and inner door or by additional airbags are promising.