title: Foot-Ankle Fractures and Injury Probability Curves from Post-mortem Human Surrogate Tests.
abstract: This purpose of this study was to replicate foot-ankle injuries seen in the military and derive human injury probability curves using the human cadaver model. Lower legs were isolated below knee from seventeen unembalmed human cadavers and they were aligned in a 90-90 posture (plantar surface orthogonal to leg). The specimens were loaded along the tibia axis by applying short-time duration pulses, using a repeated testing protocol. Injuries were documented using pre- and post-test X-rays, computed tomography scans, and dissection. Peak force-based risk curves were derived using survival analysis and accounted for data censoring. Fractures were grouped into all foot-ankle (A), any calcaneus (B), and any tibia injuries (C), respectively. Calcaneus and/or distal tibia/pilon fractures occurred in fourteen tests. Axial forces were the greatest and least for groups C and B, respectively. Times attainments of forces for all groups were within ten milliseconds. The Weibull function was the optimal probability distribution for all groups. Age was significant (p < 0.05) for groups A and C. Survival analysis-based probability curves were derived for all groups. Data are given in the body of paper. Age-based, risk-specific, and continuous distribution probability curves/responses guide in the creation of an injury assessment capability for military blast environments.
authors.affiliation: Department of Orthopaedic Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226, USA. yoga@mcw.edu.|Department of Neurosurgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226, USA. yoga@mcw.edu.
authors.forename: Narayan
authors.initials: N
authors.lastname: Yoganandan
authors.affiliation: Department of Neurosurgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226, USA.
authors.forename: Sajal
authors.initials: S
authors.lastname: Chirvi
authors.affiliation: Department of Neurosurgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226, USA.
authors.forename: Frank A
authors.initials: FA
authors.lastname: Pintar
authors.affiliation: Department of Orthopaedic Surgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226, USA.
authors.forename: Harmeeth
authors.initials: H
authors.lastname: Uppal
authors.affiliation: Department of Neurosurgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Schlick
authors.affiliation: Division of Biostatistics, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI, 53226, USA.
authors.forename: Anjishnu
authors.initials: A
authors.lastname: Banerjee
authors.affiliation: Applied Physics Laboratory, Johns Hopkins University, Laurel, MD, USA.
authors.forename: Liming
authors.initials: L
authors.lastname: Voo
authors.affiliation: Applied Physics Laboratory, Johns Hopkins University, Laurel, MD, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Merkle
authors.affiliation: US Army Research Laboratory, Aberdeen Proving Ground, MD, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Kleinberger
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D064386:Ankle Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology; D002102:Cadaver; D005260:Female; D018409:Foot Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological
keywords: Biomechanics; Calcaneus fractures; Military injuries; Risk curves; Survival analysis; Tibia fractures; Weibull distribution