title: Upper extremity fractures in restrained front-seat occupants.
abstract: BACKGROUND
  The aim of our study was to analyze the injury mechanism of upper extremity fractures in car crashes, to create a basis for developing prophylactic devices.
  
  
  RESULTS
  During 1985-1995, 3,260 restrained car drivers (1,228 front-seat passengers) were injured in 9,380 crashes involving cars. A total of 179 drivers (5.5%) (front-seat passengers: n = 53, 4.3%) sustained fractures of the arm. The hand (25%), wrist (23%), and forearm (23%) were affected most often, and the elbow (9%), upper arm (10%), and shoulder (10%) were seldom affected. No considerable differences of the injury mechanism were found comparing drivers with front-seat passengers. Fractures were mainly caused by head-on collisions (n = 119, 51%) or multiple collisions (n = 78, 34%). In 73% of the crashes (n = 166), delta-v exceeded 30 km/h (18.6 mph). A lower Delta-v resulted mainly in fractures affecting the shoulder and wrist.
  
  
  CONCLUSIONS
  Because more than half of the upper extremity fractures resulted from a direct impact to the hand, arm, or both, modifications to improve the energy absorption by padding dashboard and inner door or by additional airbags are promising.
authors.affiliation: Department of Traumatology, Hannover Medical School, Germany. Richter.Martinus@MH-Hannover.de
authors.forename: M
authors.initials: M
authors.lastname: Richter
authors.forename: D
authors.initials: D
authors.lastname: Otte
authors.forename: K
authors.initials: K
authors.lastname: Jahanyar
authors.forename: M
authors.initials: M
authors.lastname: Blauth
mesh_terms: D015998:Abbreviated Injury Scale; D000063:Accidents, Traffic / Q000517:prevention & control* / Q000706:statistics & numerical data* / Q000639:trends; D000328:Adult; D017677:Age Distribution; D017278:Air Bags; D001134:Arm Injuries / Q000145:classification / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D001336:Automobiles; D001696:Biomechanical Phenomena; D004867:Equipment Design; D006804:Ergonomics; D005260:Female; D050723:Fractures, Bone / Q000145:classification / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D020380:Needs Assessment; D011159:Population Surveillance; D012189:Retrospective Studies; D012307:Risk Factors; D012622:Seat Belts; D017678:Sex Distribution