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Purpose: This study presents cases of fracture-dislocation of the thoracic spine in extension during severe rear impacts. The mechanism of injury was investigated. Methods: Four crashes were investigated where a lap-shoulder-belted, front-seat occupant experienced fracture-dislocation of the thoracic spine and paraplegia in a severe rear impact. Police, investigator and medical records were reviewed, the vehicle was inspected and the seat detrimmed. Vehicle dynamics, occupant kinematics and injury mechanisms were determined in this case study. Results: Each case involved a lap-shoulder-belted occupant in a high retention seat with ≻1,700 Nm moment or ≻5.5 kN strength for rearward loading. The crashes were offset rear impacts with 40-56 km/h delta V involving under-ride or override by the impacting vehicle and yaw of the struck vehicle. In each case, the occupant's pelvis was restrained on the seat by the open perimeter frame of the seatback and lap belt.

Current finite element models of head impact involve a geometrically simplified fluid-filled shell composed of homogeneous, linear and (visco) elastic materials as the primary surrogate of the human skull and brain. The numerical procedure, which solves the mechanical response to impact, requires and presumes continuity of stress and displacement between elements, a defined boundary condition simulating the neck attachment and a known forcing function. Our critical review of the models discussed, primarily, the technical aspects of the approximations made to simulate the head and the limitations of the proposed analytical tools in predicting the response of biological tissue. The following critical features were identified as major factors which compromised the accuracy and objectivity of the models: - The brain was approximated by a fluid contained in an elastic or rigid shell with no provision for relative motion between the shell and fluid.

Injury and disability associated with head (brain), neck (spinal cord) and facial injury account for 61.7% of the total societal Harm in the most recent estimate of motor-vehicle related crash injuries. This paper discusses the need for accurate information on translational and rotational acceleration of the head as the first step in critiquing the Head Injury Criterion (HIC) and other injury predictive methods, and developing a fuller understanding of brain and spinal cord injury mechanisms. A measurement system has been developed using linear accelerometers to accurately determine the 3D translational and rotational acceleration of the Hybrid III dummy head. Our concept has been to use the conventional triaxial accelerometer in the dummy's head to assess translational acceleration, and three rows of in-line linear accelerometers and a least squares analysis to compute statistical best-fits for the rotational acceleration about three orthogonal axes.

The objective of this study was to analyze rear crashes for the risk of serious injury (AIS 3+) by delta V. Rear impacts were analyzed for occupants sitting in front seats of light vehicles. Data was obtained from NASS-CDS for calendar years 1991-2004. Tow-away crashes with ≤15 mph rear delta V account for 67% of rear impacts and 15% of serious injury. Even for crashes <30 mph delta V, the risk for serious injury is only 0.24% (less than 1 per 420 exposed occupants). Risks increase for higher delta Vs. Individual cases in the 1997-2004 NASS-CDS electronic database were reviewed for serious injury in crashes with ≤15 mph delta V and ≥35 mph for light vehicles with calendar year >1996 to better understand injury mechanisms. Nine cases were available where a front-seat occupant was seriously injured in ≤15 mph rear delta V impact. Most cases involved older occupants, some of whom had stenosis of the cervical spine.

A “central” theory for the biomechanics of brain injury is proposed that includes the construct that acceleration of the head, per se, is not the proximate cause of injury. Rather, rapid motion of the skull causes displacement of the hard bony structures of the head against the soft tissues of the brain, which lag in their motion due to inertia and loose coupling to the skull. Relative displacement between brain and skull produces deformation of brain tissue and stretching of bridging veins, which contribute to the tissue-level causes of brain injury. The first step in an accurate interpretation of brain injury risk in dummies involves the measurement of the three-dimensional components of translational and rotational acceleration of the head.