Table Of Content·
Kai-UweSchmitt PeterF.Niederer
·
MarkusH.Muser FelixWalz
TraumaBiomechanics
·
Kai-Uwe Schmitt Peter F. Niederer
·
Markus H. Muser Felix Walz
TraumaBiomechanics
Accidental injury in traffic and sports
Second Edition
With88Figuresand30Tables
123
PDDr.sc.techn.Kai-UweSchmitt
Prof.Dr.sc.techn.PeterF.Niederer
Dr.sc.techn.MarkusH.Muser
Prof.Dr.med.FelixWalz
UniversityandETHZurich
InstituteforBiomedicalEngineering,
ETZF90
Gloriastraße35
8092Zurich
Switzerland
[email protected]
LibraryofCongressControlNumber:2007931452
ISBN978-3-540-73872-5SpringerBerlinHeidelbergNewYork
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Preface
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 adn
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 authors are gratefully indebted to their friends and colleagues, who
assisted in the development of this book through their scientific work,
comments and discussions. Furthermore we would like to thank the
members of the board of the International Research Council on the
Biomechanics of Injury (IRCOBI) for their support.
Kai-Uwe Schmitt, Peter Niederer, Markus Muser, Felix Walz
Contents
1 Introduction ..............................................................................................1
1.1 About the contents of this book .........................................................2
1.2 Historical remarks...............................................................................7
2 Methods in Trauma-Biomechanics ........................................................15
2.1 Statistics, field studies, databases ....................................................15
2.2 Injury criteria, injury scales and injury risk ....................................19
2.3 Basic technical definitions and accident reconstruction .................23
2.4 Experimental models .......................................................................29
2.5 Standardised test procedures ...........................................................34
2.5.1 Anthropomorphic test devices ...................................................40
2.6 Numerical methods .........................................................................48
2.7 References .......................................................................................52
3 Head Injuries ..........................................................................................55
3.1 Anatomy of the head .......................................................................55
3.2 Injuries and injury mechanisms .......................................................57
3.3 Mechanical response of the head ....................................................62
3.4 Injury criteria for head injuries ........................................................66
3.4.1 Head Injury Criterion (HIC) ......................................................67
3.4.2 Head Protection Criterion (HPC) ..............................................68
3.4.3 3 ms criterion (a ) .................................................................69
3ms
3.4.4 Generalized Acceleration Model for Brain Injury Threshold ...69
3.5 Head injuries in sports.......................................................................71
3.6 Head injury prevention......................................................................73
3.6.1 Head injury prevention in pedestrians.........................................75
3.7 References .......................................................................................78
4 Spinal Injuries .........................................................................................83
4.1 Anatomy of the spine ......................................................................84
4.2 Injury mechanisms ..........................................................................87
VIII Contents
4.3 Biomechanical response and tolerances ..........................................95
4.4 Injury criteria ...................................................................................99
4.4.1 Neck injury criterion NIC .......................................................100
4.4.2 N neck injury criterion ..........................................................101
ij
4.4.3 Neck protection criterion N ................................................103
km
4.4.4 Intervetebral neck injury criterion (IV-NIC) ...........................106
4.4.5 Neck displacement criterion (NDC) ........................................106
4.4.6 Lower Neck Load Index (LNL) ..............................................107
4.4.7 Neck injury criteria in ECE and FMVSS ................................107
4.4.8 Correlating neck injury criteria to the injury risk ....................109
4.5 Spinal injuries in sports...................................................................111
4.6 Prevention of soft tissue neck injury...............................................112
4.6.1 Head restraint geometry and padding material..........................114
4.6.2 Controlling head restraint position............................................115
4.6.3 Controlling seat back motion....................................................117
4.7 References .....................................................................................119
5 Thoracic Injuries ...................................................................................127
5.1 Anatomy of the thorax ...................................................................127
5.2 Injury mechanisms ........................................................................129
5.2.1 Rib fractures ............................................................................131
5.2.2 Lung injuries ...........................................................................132
5.2.3 Injuries to other thoracic organs ..............................................133
5.3 Biomechanical response ................................................................135
5.3.1 Frontal loading ........................................................................135
5.3.2 Lateral loading ........................................................................141
5.4 Injury tolerances and criteria .........................................................143
5.4.1 Acceleration and force ............................................................143
5.4.2 Thoracic Trauma Index (TTI) .................................................143
5.4.3 Compression Criterion (C) ......................................................144
5.4.4 Viscous Criterion (VC) ...........................................................144
5.4.5 Combined Thoracic Index (CTI) .............................................145
5.4.6 Other criteria ............................................................................146
5.5 Thoracic injuries in sports...............................................................146
5.6 References .....................................................................................147
6 Abdominal Injuries ...............................................................................149
6.1 Anatomy of the abdomen ..............................................................149
6.2 Injury mechanisms ........................................................................150
6.3 Testing the biomechanical response ..............................................153
6.4 Injury tolerance .............................................................................155
Contents IX
6.4.1 Injury criteria ...........................................................................156
6.5 Influence of seat belt use ...............................................................157
6.6 Abdominal injuries in sports...........................................................157
6.7 References .....................................................................................158
7 Injuries of the Pelvis and the Lower Extremities .................................161
7.1 Anatomy of the lower limbs ..........................................................161
7.2 Injury mechanisms ........................................................................163
7.2.1 Injuries of the pelvis and the proximal femur .........................168
7.2.2 Leg, knee and foot injury ........................................................170
7.3 Impact tolerance of the pelvis and the lower extremities ..............172
7.4 Injury criteria .................................................................................176
7.4.1 Compression force ..................................................................176
7.4.2 Femur Force Criterion (FFC) ..................................................176
7.4.3 Tibia Index (TI) .......................................................................177
7.4.4 Other criteria ...........................................................................177
7.5 Pelvic and lower extremity injuries in sports..................................178
7.6 Prevention of lower extremity injuries ............................................181
7.6.1 Pedestrian injury conuntermeasures.........................................182
7.7 References .....................................................................................183
8 Injuries of the Upper Extremities .........................................................187
8.1 Anatomy of the upper limbs ..........................................................188
8.2 Injury incidences and mechanisms ................................................189
8.3 Impact tolerance ............................................................................191
8.4 Injury criteria and evaluation of injury risk from airbags .............193
8.5 Upper extremity injuries in sports...................................................194
8.6 References .....................................................................................198
9 Impairment and injuries resulting from chronic mechanical exposure...201
9.1 Occupational health.........................................................................204
9.2 Sports..............................................................................................206
9.2.1 Non contact sports.....................................................................206
9.2.2 Contact sports............................................................................208
9.3 Household work..............................................................................208
9.4 Conclusions.....................................................................................208
9.5 References.......................................................................................209
1 Introduction
The human being is exposed to mechanical loads throughout his or her life.
Besides gravity and forces due to electromagnetic fields, there is a great
variety of forces acting on the human body from contacts with the
surrounding; in addition, numerous forces are generated in the course of
physiological processes inside the body in the different organs and tissues.
Throughout evolution, all forms of life adapted their physiology to
mechanical interactions; some of them to the extent that a proper function
in fact requires the influence of forces, for example bone remodelling.
The science of biomechanics is devoted to the analysis, measurement
and modelling of the effects which are observed under the various
mechanical loading situations primarily in humans, but also in animals and
plants. As this definition suggests, a quantitative approach is thereby in the
foreground. The range of forces which is of interest is enormous: Internal
forces may originate from the action of molecules, contractile fibres on a
cellular level or muscles on a macroscopic scale, moreover, pressures and
shear stresses may be generated by biological fluid flows or active
biological transport processes including osmosis. External forces, in turn,
occurring in everyday life may span a virtually unlimited extent.
Accordingly, the forces of interest in biomechanics cover typically a range
from pN to MN (lower or higher forces, respectively, are hardly considered
because of lack of biological effect on the lower side or complete
devastation on the upper), and they may vary with time within picoseconds
to years.
An inevitable consequence of forces acting in- or outside the human
body consists of the possibility that they may cause injury. Such adverse
consequences are usually associated with the action of excessive external
forces impinging during unfavourable events with which we may be
confronted in daily life. Internal forces, in contrast, are mostly thought to be
governed by anatomical or physiological constraints which prevent the
occurrence of injury. Yet, broken ribs due to intense coughing, rupture of
muscle fibres because of tetanic contraction or endocardial bleeding in
