Davis C G
J Manipulative Physiol Ther. 1998 Nov-Dec;21(9):629-39.
There is a controversy regarding the likelihood of injuries sustained when one car strikes another at a relatively low speed with little or no vehicle damage. Plaintiffs often claim injuries whereas defendants counterclaim that injuries could not have occurred with such a relatively minor impact.
To review the dynamics of low-speed rear-end collisions resulting in little or no visible damage and to decide whether occupant injury can occur; also, to discuss diagnostic examination and treatment that may be helpful to the clinical practitioner.
A Medline search for articles discussing low-speed rear-end collisions was conducted. Other articles and studies were reviewed that discussed low-speed rear-end collisions and factors impacting the neuromusculoskeletal system relevant to clinical practitioners. Articles included were human low-speed rear-end tests, lab tests on cadavers, automotive engineering articles, and peer-reviewed journal articles on whiplash. A few live animal and simulation studies were considered for the background of possible injury mechanism and vehicular deformation. Excluded were non-rear-end collison and single case reports.
The data were studied to find a relationship between the resultant vehicle dynamics and occupant movement, biological mechanisms of injury and the neurological mechanisms causing complaints. Data were also studied to investigate objective findings supporting subjective complaints.
In low-impact collisions, there are usually no skid marks and minor or no visible damage to the vehicle. There is a lack of relationship between occupant injury, vehicle speed and/or damage. There does not seem to be an absolute speed or amount of damage a vehicle sustains for a person to experience injury. Crash tests indicate that a change of vehicle velocity of 4 km/hr (2.5 mph) may produce occupant symptoms. Vehicle damage may not occur until 14-15 km/hr (8.7 mph). Occupant soft tissue and joint injuries resulting from low-speed vehicle collisions respond positively to afferent stimulation of mechanoreceptors. The diagnosis of the occupant injuries relies on standard orthopedic neurological testing, autonomic concomitant signs and qualitative and quantitative testing.
当一辆汽车以相对较低的速度撞上另一辆车且车辆几乎没有损坏或没有损坏时，关于所受伤害的可能性存在争议。原告经常声称受到了伤害，而被告则反驳称，如此相对较小的撞击不可能导致受伤。
回顾几乎没有可见损坏的低速追尾碰撞的动力学情况，并确定乘员是否可能受伤；此外，讨论对临床医生可能有帮助的诊断检查和治疗方法。
对Medline上讨论低速追尾碰撞的文章进行了检索。还查阅了其他讨论低速追尾碰撞以及与临床医生相关的影响神经肌肉骨骼系统的因素的文章和研究。纳入的文章包括人体低速追尾试验、尸体实验室试验、汽车工程文章以及关于挥鞭样损伤的同行评审期刊文章。为了了解可能的损伤机制和车辆变形的背景，还考虑了一些活体动物和模拟研究。排除的是非追尾碰撞和单病例报告。
对数据进行研究，以找出车辆动力学结果与乘员运动、损伤的生物学机制以及导致不适的神经学机制之间的关系。还对数据进行研究，以调查支持主观不适的客观发现。
在低冲击力碰撞中，通常没有刹车痕迹，车辆损坏较小或没有可见损坏。乘员受伤与车速和/或损坏之间缺乏关联。似乎不存在车辆遭受某种绝对速度或损坏量就会导致人员受伤的情况。碰撞试验表明，车辆速度变化4公里/小时（2.5英里/小时）可能会使乘员出现症状。直到车速达到14 - 15公里/小时（8.7英里/小时）才可能出现车辆损坏。低速车辆碰撞导致的乘员软组织和关节损伤对机械感受器的传入刺激反应良好。对乘员损伤的诊断依赖于标准的骨科神经学检查、自主伴随体征以及定性和定量检查。
