Bennett Tellen D, Kaufman Robert, Schiff Melissa, Mock Charles, Quan Linda
Department of Pediatrics, University of Washington, Seattle, Washington, USA.
J Trauma. 2006 Sep;61(3):592-7. doi: 10.1097/01.ta.0000195792.26837.99.
The mechanism, crash characteristics, and spectrum of lower extremity injuries in children restrained in forward-facing car seats during front and rear impacts have not been described.
We identified in two databases children who sustained lower extremity injuries while restrained in forward-facing car seats. To identify the mechanism, we analyzed crash reconstructions from three frontal-impact cases from the Crash Injury Research and Engineering Network. To further describe the crash and injury characteristics we evaluated children between 1 and 4 years of age with lower extremity injuries from front or rear impacts in the National Automotive Sampling System (NASS) Crashworthiness Data System (CDS) database.
Crash reconstruction data demonstrated that the likely mechanism of lower extremity injury was contact between the legs and the front seatbacks. In the CDS database, we identified 15 children with lower extremity injuries in a forward-facing child seat, usually (13 out of 15) placed in the rear seat, incurred in frontal impacts (11 out of 15). Several (5 out of 15) children were in unbelted or improperly secured forward-facing car seats. Injury Severity Scores varied widely (5-50).
Children in forward-facing car seats involved in severe front or rear crashes may incur a range of lower extremity injury from impact with the car interior component in front of them. Crash scene photography can provide useful information about anatomic sites at risk for injury and alert emergency department providers to possible subtle injury.
对于在正面和 rear 碰撞中使用前向式儿童安全座椅的儿童，其下肢损伤的机制、碰撞特征及损伤谱尚未见描述。
我们在两个数据库中识别出在使用前向式儿童安全座椅时遭受下肢损伤的儿童。为确定机制，我们分析了来自碰撞损伤研究与工程网络的三起正面碰撞案例的碰撞重建情况。为进一步描述碰撞和损伤特征，我们在国家汽车抽样系统（NASS）碰撞worthiness数据系统（CDS）数据库中评估了1至4岁因正面或 rear 碰撞而下肢受伤的儿童。
碰撞重建数据表明，下肢损伤的可能机制是腿部与前排座椅靠背的接触。在CDS数据库中，我们识别出15名在使用前向式儿童安全座椅时下肢受伤的儿童，这些儿童通常（15名中的13名）位于后排座椅，且受伤发生在正面碰撞中（15名中的11名）。有几名（15名中的5名）儿童未系安全带或前向式儿童安全座椅固定不当。损伤严重程度评分差异很大（5 - 50）。
在严重的正面或 rear 碰撞中，使用前向式儿童安全座椅的儿童可能会因与前方车内部件碰撞而遭受一系列下肢损伤。碰撞现场摄影可提供有关受伤风险解剖部位的有用信息，并提醒急诊科医护人员注意可能存在的细微损伤。 （注：原文中“rear”未翻译完整，推测可能是“ rear-end”即“追尾”之意，但按要求未添加解释，保留原文形式）
