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The lower limb is frequently injured during motor vehicle accidents. Some injuries, such as severe pelvic fractures, posterior dislocations of the hip, fractured femurs, and tibial plateau fractures, have their most common cause as motor vehicle related trauma. Musculoskeletal injuries usually take months to heal. Even optimal treatment leaves a significant percentage of those injured with permanent impairments. For some injuries the impairment may develop and/or worsen as the “recovered” victim ages. The long term consequences of major injuries of the musculoskeletal system are discussed in this paper.

In a frontal automotive crash, the driver's foot is usually stepping on the brake pedal as an instinctive response to avoid a collision. The tensile force generated in the Achilles tendon produces a compressive preload on the tibia. If there is intrusion of the toe board after the crash, an additional external force is applied to the driver's foot. A series of dynamic impact tests using human cadaveric specimens was conducted to investigate the combined effect of muscle preloading and external force. A constant tendon force was applied to the calcaneus while an external impact force was applied to the forefoot by a rigid pendulum. Preloading the tibia significantly increased the tibial axial force and the combination of these forces resulted in five tibial pylon fractures out of sixteen specimens.

Objective: This study investigated the incidence of abdominal injuries in frontal crashes by occupant age and seating position. It determined the risk for abdominal injury (AIS 2+) by organ and injury source. Methods: 1997-2015 NASS-CDS was analyzed to estimate the occurrence of abdominal injuries in non-ejected, belted occupants involved in frontal crashes. Vehicles were included with 1997+ model year (MY). The annual incidence and rate for different types of abdominal injury were estimated with standard errors. The sources for abdominal injury were determined. Results: 77.8% of occupants were drivers, 16.7% were right-front passengers and 5.4% were rear passengers. Rear passengers accounted for 77.1% of 8-11 year old (yo) and 17.2% of 12-17 yo group. The risk for moderate abdominal injury (MAIS 2 + abdo) was 0.30% ± 0.053% in drivers, 0.32% ± 0.086% in right-front passengers and 0.38% ± 0.063% in rear occupants.

An understanding of the injuries of the lower limb requires a knowledge of the terminology describing the injuries. To understand injuries one should also appreciate how injured tissue recovers. This paper summarizes the terminology of lower limb injuries. It also explains the basic concepts of injury healing and the classification of injuries.

This paper details the development of an abdominal injury assessment device for loading due to belt restraint submarining in the Hybrid III family of dummies. The design concept and criteria, response criteria, choice of injury criterion, and validation are explained. Conclusions of this work are: 1) Abdominal injury assessment for belt loading due to submarining is now possible in the Hybrid III family of dummies. 2) The abdomen developed has biofidelity in its force deflection characteristics for belt loading, is capable of detecting the occurrence of submarining, and can be used to determine the probability of abdominal injury when submarining occurs. 3) Installation of the abdomen in the Hybrid III dummy does not change the dummy kinematics when submarining does not occur. 4) When submarining does occur, the dummy kinematics are very similar to baseline Hybrid III kinematics, except for torso angle.

The purpose of this study was to investigate approaches evaluating the performance of safety systems in crash tests and by analytical simulations. The study was motivated by the need to consider the adequacy of injury criteria and tolerance levels in FMVSS 208 measuring safety performance of restraint systems and supplements. The study also focused on additional biomechanical criteria and performance measures which may augment FMVSS 208 criteria and alternative ways to evaluate dummy responses rather than by comparison to a tolerance level. Additional analysis was conducted of dummy responses from barrier crash and sled tests to gain further information on the performance of restraint systems. The analysis resulted in a new computer program which determined several motion and velocity criteria from measurements made in crash tests.

Blunt impacts to the back of the torso can occur in vehicle crashes due to interaction with unrestrained occupants, or cargo in frontal crashes, or intrusion in rear crashes, for example. Six pendulum tests were conducted on the back of an instrumented 50th percentile male Hybrid III ATD (Anthropomorphic Test Device) to determine kinematic and biomechanical responses. The impact locations were centered with the top of a 15-cm diameter impactor at the T1 or at T6 level of the thoracic spine. The impact speed varied from 16 to 24 km/h. Two 24 km/h tests were conducted at the T1 level and showed repeatability of setup and ATD responses. The 16 and 24 km/h tests at T1 and T6 were compared. Results indicated greater head rotation, neck extension moments and neck shear forces at T1 level impacts. For example, lower neck extension was 2.6 times and 3.8 times greater at T1 versus T6 impacts at 16 and 24 km/h, respectively.

Purpose: This study investigates NASS-CDS data on basilar skull fractures by crash type and injury source for various crash scenarios to understand the injury risks, injury mechanisms and contact sources. Methods: 1993-2008 NASS-CDS data was used to study basilar skull fractures in adult front occupants by crash type and injury source. Injury risks were determined using weighted data for occupants with known injury status in 1994+ model year vehicles. In-depth analysis was made of far-side occupants in side impacts and rear crashes using the NASS electronic cases. Results: Basilar skull fractures occur in 0.507 ± 0.059% of rollovers and 0.255 ± 0.025% of side impacts. The lowest risk is in rear impacts at 0.015 ± 0.007%. The most common contact source is the roof, side rails and header (39.0%) in rollovers, the B-pillar (25.8%) in side impacts and head restraint (55.3%) in rear crashes.

The effect of muscular response on occupant dynamics was studied in human volunteers exposed to low level impact acceleration. The study includes identification of muscular response, correlation of electromyographic activity with reaction force, and investigation of the effects of muscular restraint during impact. Human volunteers were subjected to −Gx impact acceleration in a simulated automobile environment while EMG activity of various lower extremity muscles was monitored. The seat and floor pan were supported on load cells which measured all restraining forces. Nine–accelerometer modules and high-speed photography were used to measure kinematics. Identical runs were made with an embalmed cadaver and dummy for comparison. Static EMG and force traces as well as dynamic results for various acceleration levels are presented. Differences between tensed and relaxed states are compared and discussed as to EMG response, force levels, and head kinematics.

Side impact pendulum tests were conducted on Eurosid I and Biosid to assess the biofidelity of the thorax, abdomen and pelvis, and determine injury tolerance levels. Each body region was impacted at 4.5, 6.7, and 9.4 m/s using test conditions which duplicate cadaver impacts with a 15 cm flat-circular 23.4 kg rigid mass. The cadaver database establishes human response and injury risk assessment in side impact. Both dummies showed better biofidelity when compared to the lowest-speed cadaver response corridor. At higher speeds, peak force was substantially higher. The average peak contact force was 1.56 times greater in Biosid and 2.19 times greater in Eurosid 1 than the average cadaver response. The Eurosid I abdomen had the most dissimilar response and lacks biofidelity. Overall, Biosid has better biofidelity than Eurosid I with an average 21% lower peak load and a closer match to the duration of cadaver impact responses for the three body regions.

This paper contains a review of current information on biological structure, material properties and failure characteristics of bone, articular cartilage, ligament and tendon. The load-deformation response of biological tissues is presented with particular reference to the microstructure of the material. Although many of the tissues have been characterized as linear, elastic and isotropic materials, they actually have a more complicated response to load, which includes stiffening with increasing strain, inelastic yield, and strain rate sensitivity. Failure of compact and cancellous bone depends on the rate, type, and direction of loading. Soft biological tissues are vlscoelastie and exhibit a higher load tolerance with an increasing rate of loading. The paper includes a discussion on the basic principles of biomechanics and emphasizes material properties and failure characteristics of biological tissues subjected to impact loading.

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.

Life threatening chest injury can involve partial or full tears of the aorta. Investigations of fatal injuries in automobile accidents indicate that aortic trauma occurs in 10-20% of the cases. The major sites of aortic trauma include the aortic isthmus, the root, and the aortic insertion at the diaphragm - all of which are points of aortic tethering. The biomechanics of the injury process involve stretching of the vessel from points of tethering and hydrodynamic increases in blood pressure, which stretch the tissue to failure at a strain of about 150%. The non-isotropic stretch response of aortic tissue is discussed with reference to the frequent transverse orientation of the laceration. Congenital and pathophysiological conditions also influence the failure characteristics of the tissue. The significant factors associated with traumatic injury of the aorta are discussed in this review paper which is based on published technical information.

Knee bolsters on the lower instrument panel have been designed to control occupant kinematics during sudden deceleration. However, a wide variability in car occupant anthropometry and choice of seating posture indicates that lower-extremity contacts with the impingement bolster could predominantly load the flexed leg through the knee (acting through the femur) or through the tibia (acting through the knee joint). Potential injuries associated with these types of primary loading may vary significantly and an understanding of potential trauma mechanisms is important for proper occupant restraint.

In this study, U.S. crash data was analyzed to better understand bounce-over rollovers. Crash data was reviewed to evaluate the distribution of bounce-over crashes and injuries, initiation objects and impact locations. In passenger cars, bounce-over crashes account for 8.4% of rollovers but involve 36.2% of the seriously injured belted drivers. Most bounce-overs are initiated by contact with narrow objects such as a pole, tree or barrier, or large objects such as a ditch or embankment. Contact often occurs in the front of the vehicle. After contact, the vehicle yaws and rolls, and serious injuries are often sustained to the head. Based on field data, a laboratory test was developed to simulate a narrow object bounce-over. The test consists of towing a vehicle laterally on a fixture towards a stationary, angled barrier resting in gravel. The moving fixture is decelerated and the vehicle is released. The vehicle front impacts the edge of the barrier, simulating a narrow object impact.

Rollovers are an important vehicle safety issue. Various technologies have been developed to help prevent rollovers from occurring, but the evaluation of rollover resistance typically involves vehicle-handling tests that are conducted on flat road surfaces with a uniform or split coefficient of friction. The purpose of this study is to determine the precipitating events leading to rollovers by analyzing real-world rollover crashes. This is a first step in identifying and developing vehicle tests that are representative of the principal driving scenarios leading to rollovers. The sequence of events leading to rollovers was determined from 63 in-depth investigated cases in the NASS-CDS database from 1995-1999. The sequence was evaluated by vehicle maneuvers, vehicle stability, surface type, road and shoulder transition condition, posted and estimated speeds, vehicle type and driver injury severity.

Thoracic impact response and injuries of living and postmortem porcine siblings were investigated to quantify comparative differences. Thirteen male animals, averaging 61.4 kg, from five different porcine litters comprised the two animal samples. Porcine brothers were subjected to similar impact exposures for which at least one brother was tested live, anesthetized and another dead, post rigor with vascular repressurization. Statistically significant differences in biomechanical responses and injuries were observed between live and postmortem siblings. On the average the anesthetized live animals demonstrated a greater thoracic compliance, as measured by increased normalized total deflections (21% Hi), and reduced overall injuries (AIS 14% Lo and rib fractures 26% Lo) at lower peak force levels (13% Lo) than did the postmortem subjects. However, individual comparisons of “match-tested” siblings demonstrated very similar responses in some cases.

A femur fracture injury criterion is presented that assesses the dependence of the permissible human knee load on the duration of the primary force exposure. Currently a constant allowable femur load limit of 7.6 kN (1700 lb) is specified in FMVSS 208, but recently the Federal Government proposed elevating the allowable limit to 10.0 kN (2250 lb), which is in excess of the limited experimental average static femur fracture force of 8.90 kN (2000 lb). A general analysis of all of the available biomechanics data and mathematical models on femoral impact response and fracture indicates a significant load time dependence for primary pulse durations below 20 ms that can elevate the permissible femur load above the Federally proposed allowable limit of 10.0 kN (2250 lb).

The causes for 131 fatal crashes of lap-shoulder belted occupants were analyzed for crash causation and avoidance opportunities. Fourteen crash scenarios were determined to depict the situation and circumstance of the accidents. Each scenario is discussed in relation to driver age, actions, behavior, errors and aggressiveness, as well as crash type and other factors influencing the crash. Nearly a third of crashes involved a rapid, unpredictable onset by reckless action or mistake of another driver. The remainder were caused by the driver of the case-vehicle. Some were single vehicle crashes primarily related to excessive speed, aggressive driving, and drifting out of lane. The others were multi-vehicle crashes due primarily to inadvertent errors. The most common errors were right-of-way violations at an intersection, loss of control on wet roads, impact of a stationary vehicle, and lane changing errors.