Shaw Greg, Lessley David, Ash Joseph, Poplin Jerry, McMurry Tim, Sochor Mark, Crandall Jeff
a University of Virginia , Center for Applied Biomechanics , Charlottesville , Virginia.
b University of Virginia , PBHS Public Health Sciences Admin , University of Virginia School of Medicine , Charlottesville , Virginia.
Traffic Inj Prev. 2017 Jan 2;18(1):77-82. doi: 10.1080/15389588.2016.1193599. Epub 2016 Jun 3.
The 2 objectives of this study are to (1) examine the rib and sternal fractures sustained by small stature elderly females in simulated frontal crashes and (2) determine how the findings are characterized by prior knowledge and field data.
A test series was conducted to evaluate the response of 5 elderly (average age 76 years) female postmortem human subjects (PMHS), similar in mass and size to a 5th percentile female, in 30 km/h frontal sled tests. The subjects were restrained on a rigid planar seat by bilateral rigid knee bolsters, pelvic blocks, and a custom force-limited 3-point shoulder and lap belt. Posttest subject injury assessment included identifying rib cage fractures by means of a radiologist read of a posttest computed tomography (CT) and an autopsy. The data from a motion capture camera system were processed to provide chest deflection, defined as the movement of the sternum relative to the spine at the level of T8. A complementary field data investigation involved querying the NASS-CDS database over the years 1997-2012. The targeted cases involved belted front seat small female passenger vehicle occupants over 40 years old who were injured in 25 to 35 km/h delta-V frontal crashes (11 to 1 o'clock).
Peak upper shoulder belt tension averaged 1,970 N (SD = 140 N) in the sled tests. For all subjects, the peak x-axis deflection was recorded at the sternum with an average of -44.5 mm or 25% of chest depth. The thoracic injury severity based on the number and distribution of rib fractures yielded 4 subjects coded as Abbreviated Injury Scale (AIS) 3 (serious) and one as AIS 5 (critical). The NASS-CDS field data investigation of small females identified 205 occupants who met the search criteria. Rib fractures were reported for 2.7% of the female occupants.
The small elderly test subjects sustained a higher number of rib cage fractures than expected in what was intended to be a minimally injurious frontal crash test condition. Neither field studies nor prior laboratory frontal sled tests conducted with 50th percentile male PMHS predicted the injury severity observed. Although this was a limited study, the results justify further exploration of the risk of rib cage injury for small elderly female occupants.
本研究的两个目的是:(1)研究身材矮小的老年女性在模拟正面碰撞中所遭受的肋骨和胸骨骨折情况;(2)确定这些研究结果如何通过既往知识和现场数据来表征。
进行了一系列测试,以评估5名老年女性尸体(平均年龄76岁)在30公里/小时的正面雪橇测试中的反应,这些尸体在质量和尺寸上与第5百分位的女性相似。受试者通过双侧刚性膝垫、骨盆固定块以及定制的力限制三点式肩部和腰部安全带被约束在刚性平面座椅上。测试后对受试者的损伤评估包括通过放射科医生对测试后计算机断层扫描(CT)和尸检的解读来识别肋骨骨折。对运动捕捉摄像系统的数据进行处理,以提供胸部偏移量,定义为胸骨在T8水平相对于脊柱的移动。一项补充性的现场数据调查涉及查询1997年至2012年期间的NASS-CDS数据库。目标案例涉及40岁以上系安全带的前排小型女性乘用车乘客,他们在25至35公里/小时的速度变化正面碰撞(11点至1点)中受伤。
在雪橇测试中,肩部安全带的峰值张力平均为1970牛(标准差 = 140牛)。对于所有受试者,在胸骨处记录到的x轴峰值偏移量平均为-44.5毫米,即胸部深度的25%。根据肋骨骨折的数量和分布得出的胸部损伤严重程度,有4名受试者被编码为简略损伤量表(AIS)3(严重),1名受试者被编码为AIS 5(危急)。对小型女性的NASS-CDS现场数据调查确定了205名符合搜索标准的乘客。报告有2.7%的女性乘客发生肋骨骨折。
在本应是轻度损伤的正面碰撞测试条件下,身材矮小的老年受试对象遭受的肋骨骨折数量高于预期。无论是现场研究还是之前用第50百分位男性尸体进行的实验室正面雪橇测试,都未能预测到所观察到的损伤严重程度。尽管这是一项有限的研究,但结果证明有必要进一步探索身材矮小的老年女性乘客肋骨损伤的风险。