Trauma Biomechanics
Kai-Uwe Schmitt. Peter F. Niederer Felix Walz Trauma Biomechanics Introduetion to Aecidentallnjury ~ Springer
PD Dr. KAI-UWE SCHMITT Prof. Dr. sc. techno PETER F. NIEDERER Prof. Dr. med. FELIX WALZ Institute for Biomedical Engineering Swiss Federal Institute of Technology (ETH) and University of Zurich Gloriastrasse 35 8092 Zurich Switzerland ISBN 978-3-540-22299-6 ISBN 978-3-662-05448-2 (ebook) DOI 10.1007/978-3-662-05448-2 Cataloging-in-Publication Data applied for Bibliographic information published by Die Deutsche Bibliothek Die Deutsche Bibliothek lists this publication in the Deutsche Nationalbibliografie; detailed bibliographic data is available in the Internet at <hup:/idnb.ddb.de>. This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation,reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and perm iss ion for use must always be obtained from Springer-Verlag. Violations are liable to prosecution under German Copyright Law. Springer-Verlag Berlin Heidelberg 2004 Originally published by Springer-Verlag Berlin Heidelberg New York in 2004. The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product liability: The publisher cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature. Coverdesign: Design and Production, Heidelberg 62/3020 uw Printed on acid-free paper - 5 4 3 2 I 0 -
Preface The 2004 World Health Day is dedicated to the theme of road safety by the World Health Organization (WHO) due mostly to the enormous socioeconomic costs attributed to trafik accidents. More than 140,000 people are injured, 3,000 killed, and 15,000 disabled for life everyday on the world's roads. 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 c1assification, 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 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 authors are gratefully indebted to several friends and colleagues, who assisted in the development of this book through their scientific work, comments and discussions. Particularly we would like to acknowledge the contributions of Prof. Dr. Klaus Langwieder and Dr. Markus Muser. Furthermore we would like to thank the members of the board of the International Research Council on the Biomechanics of Impact (lrcobi) for their support. Kai-Uwe Schmitt, Peter Niederer, Felix Walz
Contents 1 Introduction... 1 2 Methods in Traurna-Biomechanics... 7 2.1 Statistics, field studies, databases... 7 2.2 Injury criteria, injury scales and injury risk... 9 2.3 Basic technical definitions and accident reconstruction... 13 2.4 Experimental models... 15 2.5 Crash testing... 18 2.5.1 Anthropomorphic test devices... 20 2.5.2 Standardised test procedures... 27 2.6 Numerical methods... 32 2.7 References... 36 3 Head Injuries... 39 3.1 Anatomy ofthe head... 39 3.2 Injuries and injury mechanisms....41 3.3 Mechanical response ofthe head....46 3.4 Injury criteria for head injuries... 50 3.4.1 Head Injury Criterion (HIC)... 51 3.4.2 Head Protection Criterion (HPC)... 52 3.4.3 3 ms criterion (a3ms)... 53 3.4.4 Generalized Acceleration Model for Brain Injury Threshold... 53 3.5 References... 55 4 Spinal Injuries... 57 4.1 Anatomy ofthe spine... 58 4.2 Injury mechanisms... 61 4.3 Biomechanical response and tolerances... 69 4.4 Injury criteria... 73 4.4.1 Neck injury criterion NIC... 74 4.4.2 N ij neck injury criterion... 75
VIII Contents 4.4.3 Neck protection criterion Nkm... 76 4.4.4 Intervetebra1 neck injury criterion (IV-NIC)... 79 4.4.5 Neck displacement criterion (NDC)... 80 4.4.6 Lower Neck Load Index (LNL)... 81 4.4.7 Neck injury criteria in ECE and FMVSS... 81 4.4.8 Corre1ating neck injury criteria to the injury risk... 83 4.5 References... 85 5 Thoracic Injuries... 91 5.1 Anatomy ofthe thorax... 91 5.2 Injury mechanisms... 93 5.2.1 Rib fractures... 95 5.2.2 Lung injuries... 96 5.2.3 Injuries to other thoracic organs... 97 5.3 Biomechanica1 response... 99 5.3.1 Fronta110ading... 99 5.3.2 Latera110ading... 1 04 5.4 Injury to1erances and criteria... 105 5.4.1 Acceleration and force... 107 5.4.2 Thoracic Trauma Index (TTI)... 107 5.4.3 Compression Criterion (C)... 108 5.4.4 Viscous Criterion (VC)... 108 5.4.5 Combined Thoracic Index (CTI)... 109 5.4.6 Other criteria... 110 5.5 References... 110 6 AbdominalInjuries... 113 6.1 Anatomy of the abdomen... 113 6.2 Injury mechanisms... 114 6.3 Testing the biomechanical response... 117 6.4 Injury tolerance... 119 6.4.1 Injury criteria... 120 6.5 Influence of seat be1t use... 120 6.6 References... 121 7 Injuries ofthe Pelvis and the Lower Extremities... 123 7.1 Anatomy ofthe lower limbs... 123 7.2 Injury mechanisms... 125 7.2.1 Injuries of the pe1vis and the proximal femur... 130 7.2.2 Leg, knee and foot injury... 132 7.3 Impact tolerance ofthe pelvis and the lower extremities... 134
Contents IX 7.4 Injury criteria... 137 7.4.1 Compression force... 137 7.4.2 Femur Force Criterion (FFC)... 138 7.4.3 Tibia Index (TI)... 138 7.4.4 Other criteria... 139 7.5 References... 139 8 Injuries ofthe Upper Extremities... 141 8.1 Anatomy ofthe upper limbs... 141 8.2 Injury incidences and mechanisms... 143 8.3 Impact tolerance... 145 8.4 Injury criteria and evaluation ofinjury risk from airbags... 146 8.5 References... 148 9 Injury prevention... 151 9.1 Prevention ofhead injuries... 152 9.2 Prevention ofsoft tissue neck injury... 153 9.2.1 Head restraint geometry and padding material... 154 9.2.2 Self-aligning head restraint (SAHR)... 161 9.2.3 WHIPS seat... 162 9.2.4 Damping seat slide... 162 9.2.5 WipGARD... 165 9.3 Prevention ofpelvic injuries and injuries ofthe lower extremities 166 9.4 Pedestrian injury countermeasures... 167 9.5 References... 172