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“挥鞭伤”会发生在低速后碰撞事故中吗?

Do "whiplash injuries" occur in low-speed rear impacts?

作者信息

Castro W H, Schilgen M, Meyer S, Weber M, Peuker C, Wörtler K

机构信息

Academy of Manual Medicine, Westfälische Wilhelms-Universität Münster, Germany.

出版信息

Eur Spine J. 1997;6(6):366-75. doi: 10.1007/BF01834062.

Abstract

A study was conducted to find out whether in a rear-impact motor vehicle accident, velocity changes in the impact vehicle of between 10 and 15 km/h can cause so-called "whiplash injuries". An assessment of the actual injury mechanism of such whiplash injuries and comparison of vehicle rear-end collisions with amusement park bumper car collisions was also carried out. The study was based on experimental biochemical, kinematic, and clinical analysis with volunteers. In Europe between DM 10 and 20 billion each year is paid out by insurance companies alone for whiplash injuries, although various studies show that the biodynamic stresses arising in the case of slight to moderate vehicle damage may not be high enough to cause such injuries. Most of these experimental studies with cadavers, dummies, and some with volunteers were performed with velocity changes below 10 km/h. About 65% of the insurance claims, however, take place in cases with velocity changes of up to 15 km/h. Fourteen made volunteers (aged 28-47 years; average 33.2 years) and five female volunteers (aged 26-37 years; average 32.8 years) participated in 17 vehicle rear-end collisions and 3 bumper car collisions. All cars were fitted with normal European bumper systems. Before, 1 day after and 4-5 weeks after each vehicle crash test and in two of the three bumper car crash tests a clinical examination, a computerized motion analysis, and an MRI examination with Gd-DTPA of the cervical spine of the test persons were performed. During each crash test, in which the test persons were completely screened-off visually and acoustically, the muscle tension of various neck muscles was recorded by surface electromyography (EMG). The kinematic responses of the test persons and the forces occurring were measured by accelerometers. The kinematic analyses were performed with movement markers and a screening frequency of 700 Hz. To record the acceleration effects of the target vehicle and the bullet vehicle, vehicle accident data recorders were installed in both. The contact phase of the vehicle structures and the kinematics of the test persons were also recorded using high-speed cameras. The results showed that the range of velocity change (vehicle collisions) was 8.7-14.2 km/h (average 11.4 km/h) and the range of mean acceleration of the target vehicle was 2.1-3.6 g (average 2.7 g). The range of velocity change (bumper car collisions) was 8.3- 10.6 km/h (average 9.9 km/h) and the range of mean acceleration of the target bumper car was 1.8-2.6 g (average 2.2 g). No injury signs were found at the physical examinations, computerized motion analyses, or at the MRI examinations. Only one of the male volunteers suffered a reduction of rotation of the cervical spine to the left of 10 degrees for 10 weeks. The kinematic analysis very clearly showed that the whiplash mechanism consists of translation/extension (high energy) of the cervical spine with consecutive flexion (low energy) of the cervical spine: hyperextension of the cervical spine during the vehicle crashes was not observed. All the tests showed that the EMG signal of the neck muscles starts before the head movement takes place. The stresses recorded in the vehicle collisions were in the same range as those recorded in the bumper car crashes. From the extent of the damage to the vehicles after a collision it is possible to determine the level of the velocity change. The study concluded that, the "limit of harmlessness" for stresses arising from rear-end impacts with regard to the velocity changes lies between 10 and 15 km/h. For everyday practice, photographs of the damage to cars involved in a rear-end impact are essential to determine this velocity change. The stress occurring in vehicle rear-end collisions can be compared to the stress in bumper car collisions.

摘要

一项研究旨在查明在汽车追尾事故中,碰撞车辆速度变化在10至15公里/小时之间是否会导致所谓的“挥鞭伤”。同时还对这类挥鞭伤的实际损伤机制进行了评估,并将车辆追尾碰撞与游乐园碰碰车碰撞进行了比较。该研究基于对志愿者进行的实验性生化、运动学和临床分析。在欧洲,每年仅保险公司就为挥鞭伤赔付100亿至200亿德国马克,尽管各种研究表明,在车辆轻微至中度受损的情况下产生的生物动力学应力可能不足以导致此类损伤。大多数针对尸体、假人和一些志愿者的实验研究是在速度变化低于10公里/小时的情况下进行的。然而,约65%的保险索赔发生在速度变化高达15公里/小时的情况下。14名男性志愿者(年龄在28至47岁之间;平均33.2岁)和5名女性志愿者(年龄在26至37岁之间;平均32.8岁)参与了17次车辆追尾碰撞和3次碰碰车碰撞。所有车辆均配备了普通的欧洲保险杠系统。在每次车辆碰撞测试前、测试后1天以及4至5周后,以及在3次碰碰车碰撞测试中的2次测试后,对测试人员的颈椎进行了临床检查、计算机化运动分析和使用钆喷酸葡胺的磁共振成像检查。在每次碰撞测试中,测试人员在视觉和听觉上完全被屏蔽,通过表面肌电图(EMG)记录各种颈部肌肉的肌张力。通过加速度计测量测试人员的运动反应和产生的力。使用运动标记和700赫兹的筛选频率进行运动学分析。为记录目标车辆和碰撞车辆的加速度效应,在两车中均安装了车辆事故数据记录器。还使用高速摄像机记录了车辆结构的接触阶段和测试人员的运动学情况。结果表明,(车辆碰撞时的)速度变化范围为8.7至14.2公里/小时(平均11.4公里/小时),目标车辆的平均加速度范围为2.1至3.6克(平均2.7克)。(碰碰车碰撞时的)速度变化范围为8.3至10.6公里/小时(平均9.9公里/小时),目标碰碰车的平均加速度范围为1.8至2.6克(平均2.2克)。在体格检查(physical examinations有误,可能是physical examinations)、计算机化运动分析或磁共振成像检查中均未发现损伤迹象。只有一名男性志愿者的颈椎向左旋转减少了10度,持续了10周。运动学分析非常清楚地表明,挥鞭伤机制包括颈椎的平移/伸展(高能量)以及随后颈椎的屈曲(低能量):在车辆碰撞过程中未观察到颈椎的过伸。所有测试均表明,颈部肌肉的肌电图信号在头部运动发生之前就开始了。车辆碰撞中记录到的应力与碰碰车碰撞中记录到的应力处于同一范围。根据碰撞后车辆的损坏程度可以确定速度变化水平。该研究得出结论,就速度变化而言,追尾碰撞产生的应力的“无害极限”在10至15公里/小时之间。对于日常实践来说,拍摄追尾碰撞中涉事车辆的损坏照片对于确定这种速度变化至关重要。车辆追尾碰撞中产生的应力可以与碰碰车碰撞中的应力进行比较。

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