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Introduction
The U.S. Centers for Disease Control (CDC) reported that
injuries to the torso are the second major cause of death by
specific body region next to the head and neck.
During a motor vehicle impact, the thorax can contact various
components of the automobile interior, including restraint
systems. Contacts include unrestrained driver or passenger with
steering wheel or instrument panel, and contact with active or
passive restraints, including three point lap/shoulder belts,
two-point shoulder belts, knee bolsters, and air bags.
Injury to the thorax commonly occurs in frontal and side impacts
and in oblique directions intermediate to these two.
Epidemiology
Nirula and Pintar analyzed the National Automotive Sampling
System (NASS) databases from 1993 to 2001 and the Crash
Injury Research and Engineering Network (CIREN) databases
from 1996 to 2004.
The incidence of severe chest injury (AIS 3 and greater) in
NASS and CIREN were 5.5% and 33%, respectively.
The steering wheel, door panel, armrest and seat were identified
as contact points associated with an increased risk of severe
chest injury. The door panel and arm rest were consistently a
frequent cause of severe injury.
Nirula R, Pintar FA (2008) Identification of vehicle components associated with severe thoracic injury in motor vehicle crashes: a
CIREN and NASS analysis. Accident; analysis and prevention 40 (1):137-141. doi:10.1016/j.aap.2007.04.013
Epidemiology
In a study of motor vehicle crashes in the UK, Morris et al. examined
vehicle crash injury data to determine to determine the relative injury
risk of occupants of different age groups.
For all occupants, the body region most prone to injury in frontal
impact crashes was the chest.
Older and middle-aged occupants were at greater risk of sustaining
MAIS3+ chest injuries.
In frontal impacts, the majority of chest injuries were caused by the
restraint system, whereas other interior vehicle components
accounted for only 4% of the injuries.
A significant portion of middle-aged and older passengers were
female. A seat-belt pre-tensioner was found to have a general effect of
reducing the risk of MAIS 3+ chest injury to all age groups.
Morris A, Welsh R (2003) Requirements for the crash protection of older vehicle passengers. Annu Proc Assoc Adv Automot Med
47:165-180
Outline of talk
Epidemiology
Introduction to FMVSS 208
Chest anatomy
Chest injury mechanisms
Chest injury tolerance
Chest injury criteria adapted by NHTSA
and IIHS
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208 Phase In
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Aortic Trauma
In studies from the 1980s it was estimated that
7500-8000 cases of blunt aortic injury occurred
each year (Jackson, 1984; Mattox, 1989).
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Pulmonary Trunk
Heart
Aorta
SVC
Lung
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Diaphragm
Parametric Study
Impact angle (Velocity in m/s)
0 (6.5)
30 (6.5)
60 (6.5)
Impactor
Mass: 23 kg
Diameter: 150 mm
Edge Radius: 12 mm
L
P
120 (6.5)
A
180 (6.5)
150 (6.5)
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FE Aorta
Isthmus
Root
Mid Descending
Valve
Level of Hiatus
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Hardy WN, Shah CS, Kopacz JM, Yang KH, Van Ee CA, Morgan R, Digges K
(2006) Study of potential mechanisms of traumatic rupture of the aorta using
insitu experiments. Stapp Car Crash J 50:247-266
Hardy et al. investigated TRA mechanisms in PMHS in four quasi-static and one
dynamic tests . The quasi-static tests included anterior, superior, and lateral
displacement of the heart and aortic arch in the mediastinum, resulting in partial tears to
complete transection. All injuries occurred within the peri-isthmic region.
The average failure load and stretch were 148 N and 30 % for the quasi-static tests.
The results indicated that intraluminal pressure and whole-body acceleration are not
required for TRA to occur and that the role of the ligamentum-arteriosum is likely
limited.
The studies indicated that tethering of the descending thoracic aorta by the parietal
pleura was a principal aspect of this injury.
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Hardy WN, Shah CS, Mason MJ, Kopacz JM, Yang KH, King AI, Van Ee CA,
Bishop JL, Banglmaier RF, Bey MJ, Morgan RM, Digges KH (2008) Mechanisms
of traumatic rupture of the aorta and associated peri-isthmic motion and
deformation. Stapp Car Crash J 52:233-265
Hardy et al. investigated the mechanisms of traumatic rupture of the aorta (TRA) in
eight unembalmed PMHS which were inverted and tested in various dynamic blunt
loading modes . Impacts were conducted using a 32-kg impactor with a 152-mm face.
High-speed biplane x-rays of radiopaque markers on the aorta were used to visualize
aortic motion.
Clinically relevant TRA was observed in seven of the tests. Peak average longitudinal
Lagrangian strain was 0.644 and the average peak strain for all tests was 0.208 +/0.216. Peak intraluminal pressure was 165 kPa.
Longitudinal stretch of the aorta was found to be a principal component of injury
causation. Stretch of the aorta was generated by thoracic deformation, which was
required for injury to occur. Atherosclerosis further promoted injury.
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INJURY CRITERIA
IN FRONTAL IMPACT
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Acceleration Criterion
60 g limit in FMVSS 208 for adults.
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Critique
Spinal acceleration is an indicator of overall
severity of impact but does not necessarily
reflect local impact conditions.
Compression, rate of compression, and force
can account for these.
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Force Criterion
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Yoganandon et al (1993)
Morgan et al (1994)
Kallieris (1995)
Kuppa et al (1998)
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Compression Criterion
3 inch (76 mm) limit in old FMVSS 208
based on work of Kroell, Nahum and
Viano.
2.5 inch (63 mm) limit in new FMVSS
208 to limit probability of chest AIS to 4
or less.
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Loading to mid-sternum
(1970s)
Kroell et al (1971,74)
Nahum et al (1970, 1971, 1975)
Stalnaker (1973)
Lobdell (1973)
Neathery (1974)
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Compression Criterion
40% Cmax - 92 mm in 50th percentile
40% Cmax - flail chest - Nahum et al (1975)
40% Cmax - severe internal injury Viano (1978)
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Compression Criterion
32% Cmax - maintain rib cage integrity - 74 mm
- Viano (1978)
Old FMVSS 208 - 76 mm limit
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3 point belt
2 point belt/ knee bolster
3 point belt/ air bag
air bag/ knee bolster
air bag/ lap belt
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Data used
Chest bands at the 4th and 8th ribs
T1 triaxial accelerations
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Viscous Criterion
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Summary
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Compression/ acceleration
combinations were proposed
by the NHTSA but have not
been adopted
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THANK YOU
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