title: Injury patterns in frontal crashes: the association between knee-thigh-hip (KTH) and serious intra-abdominal injury.
abstract: Safety belts protect occupants in frontal impacts by reducing occupant deceleration and preventing the occupant from hitting interior vehicle components likely to cause injury. However, occupants moving forward during the impact may contact the safety belt webbing across their chest and abdomen. We hypothesized that if the occupant loaded their knee-thigh-hip (KTH) region with enough force to result in injury to this region-it might prevent compression (and injury) of their abdomen by the safety belt. Crash Injury Research and Engineering Network (CIREN) data were used to test the association between KTH and intra-abdominal injury related to safety belts. Odds ratios with 95% confidence limits (CL) and logistic regression models were used to assess statistical significance. Analyses were based on 706 CIREN adult, front seat occupants using their safety belt and injured in frontal crashes. Occupants with KTH injury were four times less likely (adjusted odds ratio=0.25, 95% CL 0.10, 0.62) to have concomitant serious intra-abdominal injury caused by the safety belt. Although safety belts save lives and prevent serious injury, some occupants may sustain serious intra-abdominal injury when the abdomen is loaded by the safety belt during a frontal impact. These results may be useful to motor vehicle manufacturers and others who design and test motor vehicle safety systems.
authors.affiliation: Department of Surgery, School of Medicine, University of California at San Diego, San Diego, CA, USA.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Lee
authors.forename: Carol
authors.initials: C
authors.lastname: Conroy
authors.forename: Raul
authors.initials: R
authors.lastname: Coimbra
authors.forename: Gail T
authors.initials: GT
authors.lastname: Tominaga
authors.forename: David B
authors.initials: DB
authors.lastname: Hoyt
mesh_terms: D015998:Abbreviated Injury Scale; D000007:Abdominal Injuries / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control*; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D005260:Female; D025981:Hip Injuries / Q000453:epidemiology; D006801:Humans; D007718:Knee Injuries / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012622:Seat Belts; D013848:Thigh / Q000293:injuries; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult