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This paper reports on a study that examines the effect of shoulder belt load limiters and pretensioners as well as crash and occupant factors that influence upper torso harm in real-world frontal crashes. Cases from the University of Michigan International Center for Automotive Medicine (ICAM) database were analyzed. Additional information was used from other databases including the National Highway Traffic Safety Administration (NHTSA) New Car Assessment Program (NCAP), the Insurance Institute for Highway Safety (IIHS), the National Automotive Sampling System - Crashworthiness Data System (NASS-CDS), and patient data available from the University of Michigan Trauma Center. The ICAM database is comprised of information from real-world crashes in which occupants were seriously injured and required treatment at a Level 1 Trauma Center.

Crash safety researchers have an increased concern regarding the decreased thoracic deflection and the contributing injury causation factors among the elderly population. Sternum fractures are categorized as moderate severity injuries, but can have long term effects depending on the fragility and frailty of the occupant. Current research has provided detail on rib morphology, but very little information on sternum morphology, sternum fracture locations, and mechanisms of injury. The objective of this study is two-fold (1) quantify sternum morphology and (2) document sternum fracture locations using computed tomography (CT) scans and crash data. Thoracic CT scans from the University of Michigan Hospital database were used to measure thoracic depth, manubriosternal joint, sternum thickness and bone density. The sternum fracture locations and descriptions were extracted from 63 International Center for Automotive Medicine (ICAM) crash cases, of which 22 cases had corresponding CT scans.