Deceleration during 'real life' motor vehicle collisions - a sensitive predictor for the risk of sustaining a cervical spine injury?
BACKGROUND
The predictive value of trauma impact for the severity of whiplash injuries has mainly been investigated in sled- and crash-test studies. However, very little data exist for real-life accidents. Therefore, the predictive value of the trauma impact as assessed by the change in velocity of the car due to the collision (DeltaV) for the resulting cervical spine injuries were investigated in 57 cases after real-life car accidents.


METHODS
DeltaV was determined for every car and clinical findings related to the cervical spine were assessed and classified according to the Quebec Task Force (QTF).


RESULTS
In our study, 32 (56%) subjects did not complain about symptoms and were therefore classified as QTF grade 0; 25 (44%) patients complained of neck pain: 8 (14%) were classified as QTF grade I, 6 (10%) as QTF grade II, and 11 (19%) as QTF grade IV. Only a slight correlation (r = 0.55) was found between the reported pain and DeltaV. No relevant correlation was found between DeltaV and the neck disability index (r = 0.46) and between DeltaV and the QTF grade (r = 0.45) for any of the collision types. There was no DeltaV threshold associated with acceptable sensitivity and specificity for the prognosis of a cervical spine injury.


CONCLUSIONS
The results of this study indicate that DeltaV is not a conclusive predictor for cervical spine injury in real-life motor vehicle accidents. This is of importance for surgeons involved in medicolegal expertise jobs as well as patients who suffer from whiplash-associated disorders (WADs) after motor vehicle accidents.


BACKGROUND
The study complied with applicable German law and with the principles of the Helsinki Declaration and was approved by the institutional ethics commission.
Elbel
Martin
M
Center of Surgery, Department of Orthopedic Trauma, Hand, Plastic and Reconstructive Surgery, University of Ulm, Steinhövelstrasse 9, 89075, Ulm, Germany.
Kramer
Michael
M
Center of Surgery, Department of Orthopedic Trauma, Hand, Plastic and Reconstructive Surgery, University of Ulm, Steinhövelstrasse 9, 89075, Ulm, Germany.
Huber-Lang
Markus
M
Center of Surgery, Department of Orthopedic Trauma, Hand, Plastic and Reconstructive Surgery, University of Ulm, Steinhövelstrasse 9, 89075, Ulm, Germany.
Hartwig
Erich
E
Department of Trauma Surgery, Deaconesses Hospital, Karlsruhe - Rüppurr, Academic Teaching Hospital of Freiburg University, Diakonissenstrasse 28, 76199, Karlsruhe, Germany.
Dehner
Christoph
C
Center of Surgery, Department of Orthopedic Trauma, Hand, Plastic and Reconstructive Surgery, University of Ulm, Steinhövelstrasse 9, 89075, Ulm, Germany.