Miettinen T, Lindgren K A, Airaksinen O, Leino E
Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Finland.
Clin Exp Rheumatol. 2002 May-Jun;20(3):399-402.
The aim of the study was to define how many whiplash injuries occur in Finland in traffic accidents and the degree of severity of these injuries using the whiplash-associated disorders (WAD) classification presented by the Quebec Task Force, and to define possible long-term health effects caused by whiplash injury as well as the duration of whiplash-associated sick-leaves.
This was a prospective one-year-follow-up study. Fourteen insurance companies paving compensations for traffic accidents in Finland sent the accident reports and medical certificates of all neck injuries attributable to traffic accidents to the research team. The material was collected from neck injuries that had occurred in traffic accidents during the year 1998.
The majority of those suffering a whiplash injury were women. On the basis of the WAD classification, most whiplash injuries were mild, belonging to grades WAD I and II. At one year from the accident nearly 10% considered that their health had been impaired significantly as a result of their neck injury. Over 10% of those questioned had been on sick-leave for over a month but only 1.5% had been on sick-leave associated with the injury for more than 6 months. The most common symptom after one year was neck pain or neck pain combined with headache and symptoms in the upper extremities. No major changes related to the seasons of the year were found.
The number of reported neck injuries in proportion to all traffic accidents involving physical injuries is small, even in proportion to rear-end collisions. In a considerable proportion of collision patients, whiplash injury does result in significant impairment which can last as long as a year after the accident. The WAD classification predicts the duration of work disability and the long-term health damage caused by the injury. Since the appearance of symptoms and the individual need for rehabilitation due to impaired functional capacity do not depend solely on the tissue damage and biomechanical forces involved in the collision, in the future it will be important to determine which factors are responsible for the differences in coping after a collision.
本研究旨在利用魁北克工作组提出的挥鞭样相关疾病（WAD）分类法，确定芬兰交通事故中发生的挥鞭样损伤数量及其严重程度，并确定挥鞭样损伤可能造成的长期健康影响以及与挥鞭样损伤相关的病假时长。
这是一项为期一年的前瞻性随访研究。芬兰为交通事故提供赔偿的14家保险公司将所有因交通事故导致的颈部损伤的事故报告和医疗证明发送给了研究团队。该材料收集自1998年期间在交通事故中发生的颈部损伤。
大多数遭受挥鞭样损伤的是女性。根据WAD分类法，大多数挥鞭样损伤为轻度，属于WAD I级和II级。事故发生一年后，近10%的人认为其健康因颈部损伤而受到显著损害。超过10%的受访者病假超过一个月，但只有1.5%的人因该损伤病假超过6个月。一年后最常见的症状是颈部疼痛或颈部疼痛伴头痛及上肢症状。未发现与一年中的季节有重大关联。
与所有涉及身体损伤的交通事故相比，报告的颈部损伤数量较少，即使与追尾碰撞相比也是如此。在相当一部分碰撞患者中，挥鞭样损伤确实会导致严重损害，这种损害在事故发生后可持续长达一年。WAD分类法可预测工作残疾的时长以及损伤造成的长期健康损害。由于症状的出现以及因功能能力受损而产生的个体康复需求并非仅取决于碰撞中涉及的组织损伤和生物力学力，未来确定哪些因素导致碰撞后应对差异将很重要。
