title: Critical analysis of injuries sustained in the TWA flight 800 midair disaster.
abstract: BACKGROUND
  Previous reports of commercial airline disasters have reviewed incidents occurring at takeoff and landing. The purpose of the present study, which represents the first analysis of aviation injuries incurred during a midflight incident, was to examine the injuries sustained by the victims of the TWA Flight 800 disaster and to determine any correlation of injuries with structural damage and seat location.
  
  
  METHODS
  Complete autopsy records, toxicology screening, and forensic analysis were reviewed. Injuries were assessed by anatomic region and severity by using the Abbreviated Injury Scale. The National Transportation Safety Board report of the investigation was applied to correlate individual injuries with seat location and structural damage. A comparison was performed against injury data from takeoff and landing incidents.
  
  
  RESULTS
  All 230 passengers of TWA Flight 800 were recovered as fatalities. Head, thoracic, and abdominal injuries were multiple and severe, contributing to the mortality of the occupants. Analysis revealed that the severity of injury and anatomic injury pattern did not generally correlate with seating position or structural damage. A comparison of these injuries with those of takeoff and landing crashes showed differences in injury pattern and severity.
  
  
  CONCLUSIONS
  Passengers of Flight 800 sustained instantaneous fatal blunt force injury. Analysis of the data revealed no global correlation between seat position and pattern of injury. In contrast to injuries incurred during crashes at takeoff and landing, these midflight injuries were too extreme to warrant a reappraisal of current passenger protective safety measures or standards.
authors.affiliation: Department of Surgery, University Hospital and Medical Center, State University of New York at Stony Brook, 11794-8191, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Vosswinkel
authors.forename: J E
authors.initials: JE
authors.lastname: McCormack
authors.forename: C E
authors.initials: CE
authors.lastname: Brathwaite
authors.forename: E R
authors.initials: ER
authors.lastname: Geller
mesh_terms: D015998:Abbreviated Injury Scale; D000060:Accidents, Aviation / Q000401:mortality / Q000517:prevention & control / Q000706:statistics & numerical data*; D001344:Autopsy; D003334:Coroners and Medical Examiners; D006801:Humans; D009104:Multiple Trauma / Q000145:classification / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control; D009518:New York / Q000453:epidemiology; D012307:Risk Factors; D012449:Safety; D014949:Wounds, Nonpenetrating / Q000145:classification / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control