Trauma Biomechanics: Accidental injury in traffic and sports

256 Pages·2010·3.93 MB·English

by  Kai-Uwe Schmitt

Trauma Biomechanics
Third Edition
· ·
Kai-Uwe Schmitt Peter F. Niederer
·
Markus H. Muser Felix Walz
Trauma Biomechanics
Accidental Injury in Traffic and Sports
Third Edition
123
PD Dr.Kai-UweSchmitt
Prof.Dr.PeterF.Niederer (emeritiert)
Institute for Biomedical Engineering
University and ETH Zurich
ETZF90
Gloriastrasse 35
CH-8092 Zurich
Dr.MarkusH.Muser
Prof. Dr. med. Felix Walz
AGU
Winkelriedstrasse 27
CH-800¨6 Zurich
ISBN978-3-642-03712-2 e-ISBN978-3-642-03713-9
DOI10.1007/978-3-642-03713-9
SpringerHeidelbergDordrechtLondonNewYork
LibraryofCongressControlNumber:2009938113
(cid:2)c Springer-VerlagBerlinHeidelberg2010
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Preface
Injury is a leading cause of death, hospitalisation and disability world-wide.
The World Health Organization predicts that unintentional injuries arising
from road traffic incidents will rise to take third place in the rank order of
international disease burden by the year 2030. Although these statistics and
the associated economic costs are staggering, the effect of unintentional
injury and death from trauma is more apparent, and more disturbing, when
seen personally. By a young age, nearly everyone in the world, regardless
of region, wealth or education, has had a relative or someone that they
know killed or disabled in an "accident". The quality of life and financial
effects on the injured person and their families and friends are plainly
evident and clearly devastating. Many unintentional injuries are in reality
not accidents; they could be prevented with changes in policy, education, or
through improved safety devices. Arrayed against these preventable
injuries, a diverse group of injury prevention researchers and practitioners
work to decrease the incidence of unintentional injury.
In trauma biomechanics, the principles of mechanics are used to
understand how injuries happen at the level of the bones, joints, organs and
tissues of the body. This knowledge is central in the development,
characterization and improvement of safety devices such as helmets and
seat belts and in the safe design of vehicles and equipment used for
transportation, occupation and recreation. The field of trauma biomechanics
is highly interdisciplinary, with engineers and physicists being centrally
involved with medical practitioners and many other experts. This book,
Trauma Biomechanics, is organized as a short primer of this subject and it
provides a logical overview of the field. It is written to be accessible to a
range of students or practitioners, while still providing considerable detail
in each section. Each chapter contains plentiful and up-to-date references to
guide readers who require more information on a particular topic.
In contrast to the relative abundance of texts that describe basic
biomechanics, sports biomechanics, gait analysis and orthopaedic
biomechanics this is one of only two or three texts focused on trauma
VI Preface
biomechanics that I am aware of. I have used a previous version of the book
as a required text for a combined senior undergraduate- and graduate- level
Mechanical Engineering class called the "Fundamentals of Injury
Biomechanics" at the University of British Columbia. The students
commented positively on the layout and accessibility of the book and they
used it as a key reference in the assigned problems and project work in the
class. I think the short primer structure of the book helped to make it
accessible to the students. It is possible to start reading at the beginning of
any chapter and quickly come up to speed with the most important basic
knowledge about the anatomy, tolerance and injury prevention techniques
for that region of the body. This is of great utility for students but also for
people working in injury research contexts were they can be asked to
rapidly switch their focus from injury in one area of the body or from one
mechanism to another. This can occur not only while studying in university
but also in many industrial and academic research contexts. For example,
this is frequently required of people working on government-sponsored
injury reconstruction teams or who are engaged in reconstructing injuries in
the litigation context.
I recommend this book as a key basic resource for anyone interested in
injury prevention. Everyone, from graduate students working in an
academic injury biomechanics setting to engineers, physicists, clinicians,
surgeons, kinesiologists, biologists, statisticians and social scientists
working in the broad field of injury prevention, frequently has questions
about how injuries happen in various parts of the body. This book is an
essential and accessible resource to anyone with these questions.
Peter A. Cripton
Associate Professor of Mechanical Engineering
and Associate Faculty Member of the Department of Orthopaedics
The University of British Columbia
Preface - 2nd edition
Everyday, more than 140’000 people are injured, 3000 killed, and 15’000
disabled for life everyday on the world's roads. Likewise, sports related
injuries are numerous and have a significant socio-economic impact. The
field of trauma biomechanics, or injury biomechanics, uses the principles of
mechanics to study the response and tolerance level of biological tissues
under extreme loading conditions. Through an understanding of mechanical
factors that influence the function and structure of human tissues,
countermeasures can be developed to alleviate or even eliminate such
injuries.
This book, Trauma-Biomechanics, surveys a wide variety of topics in
injury biomechanics including anatomy, injury classification, injury
mechanism, and injury criteria. It is the first collection I am aware of that
lists regional injury reference values, or injury criterion, either currently in
use or proposed by both U.S. and European communities. Although the
book is meant to be an introduction for medical doctors and engineers who
are beginners in the field of injury biomechanics, sufficient references are
provided for those who wish to conduct further research, and even
established researchers will find it useful as a reference for finding the
biomechanical background of each proposed injury mechanism and injury
criterion. As more people become aware of and understand this subject, it
will someday lead to better mitigation and prevention of automotive and
sports related injuries. I like this book very much and believe that you will
find the same.
King H. Yang
Professor of Biomedical Engineering
and Mechanical Engineering
Director of Bioengineering Center
Wayne State University
Acknowledgements
The positive feedback that we have obtained from students and colleagues
and in particular from our readers of the previous editions was the major
source of motivation to tackle this third edition. Thank you! We highly
appreciate the various suggestions which were of great help to further
develop the book.
In the present third edition the contents were updated with the latest
knowledge and references and known mistakes and typos were corrected
(surely adding a few new ones). As a particularly important addition for
students, exercises of various levels of complexity were added.
Nevertheless, we kept the original focus of the book. It primarily offers an
introductory overview on different aspects of trauma biomechanics, but
also serves as a quick reference for experts.
Thus we hope to provide a suitable starting point for sharing our
excitement and enthusiasm about this field of biomechanics research.
Kai-Uwe Schmitt, Peter Niederer, Markus Muser, Felix Walz
Contents
1 Introduction ..............................................................................................1
1.1 About the contents of this book .........................................................3
1.2 Historical remarks............................................................................10
1.3 References........................................................................................16
2 Methods in Trauma Biomechanics .........................................................17
2.1 Statistics, field studies, databases ....................................................17
2.2 Basic concepts of biomechanics ......................................................21
2.3 Injury criteria, injury scales and injury risk ....................................26
2.4 Accident reconstruction ...................................................................30
2.5 Experimental models .......................................................................34
2.6 Standardised test procedures ...........................................................39
2.6.1 Anthropomorphic test devices ...................................................47
2.7 Numerical methods .........................................................................54
2.8 Summary..........................................................................................58
2.9 Exercises...........................................................................................59
2.10 References .....................................................................................60
3 Head Injuries ..........................................................................................63
3.1 Anatomy of the head .......................................................................63
3.2 Injuries and injury mechanisms .......................................................65
3.3 Mechanical response of the head ....................................................70
3.4 Injury criteria for head injuries ........................................................75
3.4.1 Head Injury Criterion (HIC) ......................................................75
3.4.2 Head Protection Criterion (HPC) ..............................................77
3.4.3 3 ms criterion (a ) .................................................................77
3ms
3.4.4 Generalized Acceleration Model for Brain Injury Threshold ...77
3.5 Head injuries in sports.......................................................................79
3.6 Head injury prevention......................................................................84
3.6.1 Head injury prevention in pedestrians.........................................85
3.7 Summary .........................................................................................88
X Contents
3.8 Exercises...........................................................................................88
3.9 References........................................................................................89
4 Spinal Injuries .........................................................................................95
4.1 Anatomy of the spine ......................................................................96
4.2 Injury mechanisms ..........................................................................99
4.3 Biomechanical response and tolerances ........................................107
4.4 Injury criteria .................................................................................112
4.4.1 Neck injury criterion NIC .......................................................113
4.4.2 N neck injury criterion ..........................................................114
ij
4.4.3 Neck protection criterion N ................................................115
km
4.4.4 Lower Neck Load Index (LNL) ..............................................118
4.4.5 Neck injury criteria in ECE and FMVSS ................................119
4.4.6 Further neck injury criteria.......................................................121
4.4.7 Correlating neck injury criteria to the injury risk ....................122
4.5 Spinal injuries in sports...................................................................124
4.6 Prevention of soft tissue neck injury...............................................126
4.6.1 Head restraint geometry and padding material..........................127
4.6.2 Controlling head restraint position............................................129
4.6.3 Controlling seat back motion....................................................131
4.7 Summary .......................................................................................133
4.8 Exercises.........................................................................................133
4.9 References......................................................................................134
5 Thoracic Injuries ...................................................................................143
5.1 Anatomy of the thorax ...................................................................143
5.2 Injury mechanisms ........................................................................145
5.2.1 Rib fractures ............................................................................147
5.2.2 Lung injuries ...........................................................................148
5.2.3 Injuries to other thoracic organs ..............................................149
5.3 Biomechanical response ................................................................153
5.3.1 Frontal loading ........................................................................153
5.3.2 Lateral loading ........................................................................157
5.4 Injury tolerances and criteria .........................................................159
5.4.1 Acceleration and force ............................................................159
5.4.2 Thoracic Trauma Index (TTI) .................................................160
5.4.3 Compression Criterion (C) ......................................................161
5.4.4 Viscous Criterion (VC) ...........................................................161
5.4.5 Combined Thoracic Index (CTI) .............................................162
5.4.6 Other criteria ............................................................................162
5.5 Thoracic injuries in sports...............................................................163
Contents XI
5.6 Summary........................................................................................163
5.7 Exercises.........................................................................................163
5.8 References .....................................................................................165
6 Abdominal Injuries ...............................................................................169
6.1 Anatomy of the abdomen ..............................................................169
6.2 Injury mechanisms ........................................................................170
6.3 Testing the biomechanical response ..............................................173
6.4 Injury tolerance .............................................................................175
6.4.1 Injury criteria ...........................................................................176
6.5 Influence of seat belt use ...............................................................177
6.6 Abdominal injuries in sports..........................................................178
6.7 Summary........................................................................................178
6.8 Exercises.........................................................................................178
6.9 References .....................................................................................179
7 Injuries of the Pelvis and the Lower Extremities .................................183
7.1 Anatomy of the lower limbs ..........................................................183
7.2 Injury mechanisms ........................................................................185
7.2.1 Injuries of the pelvis and the proximal femur .........................190
7.2.2 Leg, knee and foot injury ........................................................192
7.3 Impact tolerance of the pelvis and the lower extremities ..............194
7.4 Injury criteria .................................................................................198
7.4.1 Compression force ..................................................................199
7.4.2 Femur Force Criterion (FFC) ..................................................199
7.4.3 Tibia Index (TI) .......................................................................199
7.4.4 Other criteria ...........................................................................200
7.5 Pelvic and lower extremity injuries in sports..................................200
7.6 Prevention of lower extremity injuries ............................................204
7.6.1 Pedestrian injury conuntermeasures.........................................205
7.7 Summary .......................................................................................206
7.8 Exercises.........................................................................................206
7.9 References......................................................................................208
8 Injuries of the Upper Extremities .........................................................213
8.1 Anatomy of the upper limbs ..........................................................213
8.2 Injury incidences and mechanisms ................................................215
8.3 Impact tolerance ............................................................................217
8.4 Injury criteria and evaluation of injury risk from airbags .............219
8.5 Upper extremity injuries in sports..................................................221
8.6 Summary........................................................................................226