Citation

Ivancic PC. J. Orthop. Sports Phys. Ther. 2016; 46(10): 826-833.

Affiliation

Biomechanics Research Laboratory, Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT.

Copyright

(Copyright © 2016, Orthopaedic Section and Sports Physical Therapy Section of the American Physical Therapy Association)

DOI

10.2519/jospt.2016.6716

PMID

27594659

Abstract

Synopsis Head and spinal injuries commonly occur during motor vehicle crashes (MVCs). The goal of this clinical commentary is to discuss real-life versus simulated MVCs and present clinical, biomechanical, and epidemiological evidence of MVC-related injury mechanisms. We also address how this knowledge helps guide and inform design of injury mitigation devices and could assist clinical decision making. Evidence indicates that there exists no universal injury tolerance applicable to the entire population of MVC occupants. Occupant injuries are dependent upon a number of factors, including: occupant characteristics (age, height, weight, sex, bone mineral density, and pre-existing medical and musculoskeletal conditions); pre-MVC factors (awareness of the impending crash, occupant position, usage of and position of the seatbelt and head restraint, and vehicle specifications); and MVC-related factors (crash orientation, vehicle dynamics, type of active or passive safety systems, and occupant kinematic response). Injuries resulting from a MVC occur due to blunt impact and/or inertial loading. An S-shaped curvature of the cervical spine and associated injurious strains have been documented during rear, frontal, and side impact MVCs. Injury mechanism data and quantification of spinal instability help guide and inform emergent and subsequent conservative or surgical care when: choosing optimal patient position during transport, determining which injuries may be treated conservatively, performing reduction, choosing optimal positioning intraoperatively, and determining if bracing should be worn prior to and/or following surgery. Continued improvement of traditional injury mitigation systems, such as seats, seatbelts, airbags, and head restraints, together with research of newer collision avoidance technologies will lead to safer motor vehicles and ultimately more effective injury-management strategies. J Orthop Sports Phys Ther, Epub 3 Sep 2016. doi:10.2519/jospt.2016.6716.

Language: en