The influence of superficial soft tissues and restraint condition on thoracic skeletal injury prediction

Obese Occupant Response in Reclined and Upright Seated Postures in Frontal Impacts

The American population is getting heavier and automated vehicles will accommodate unconventional postures. While studies replicating mid-size and upright fore-aft seated occupants are numerous, experiments with post-mortem human subjects (PMHS) with obese and reclined occupants are sparse. The objective of this study was to compare the kinematics of the head-neck, torso and pelvis, and document injuries and injury patterns in frontal impacts. Six PMHS with a mean body mass index of 38.2 ± 5.3 kg/m2 were equally divided between upright and reclined groups (seatback: 23°, 45°), restrained by a three-point integrated belt, positioned on a semi-rigid seat, and exposed to low and moderate velocities (15, 32 km/h). Data included belt loads, spinal accelerations, kinematics, and injuries from x-rays, computed tomography, and necropsy. At 15 km/h speed, no significant difference in the occupant kinematics and evidence of orthopedic failure was observed. At 32 km/h speed, the primary difference between the cohorts was significantly larger Z displacements in the reclined occupant at the head (190 ± 32 mm, vs. 105 ± 33 mm p < 0.05) and femur (52 ± 18 mm vs. 30 ± 10 mm, p < 0.05). All the moderate-speed tests produced at least one thorax injury. Rib fractures were scattered around the circumference of the rib-cage in the upright, while they were primarily concentrated on the anterior aspect of the rib-cage in two reclined specimens. Although MAIS was the same in both groups, the reclined specimens had more bi-cortical rib fractures, suggesting the potential for pneumothorax. While not statistical, these results suggest enhanced injuries with reclined obese occupants. These results could serve as a data set for validating the response of restrained obese anthropometric test device (ATDs) and computational human body models.

Kinematic and Injury Response of Reclined PMHS in Frontal Impacts

Frontal impacts with reclined occupants are rare but severe, and they are anticipated to become more common with the introduction of vehicles with automated driving capabilities. Computational and physical human surrogates are needed to design and evaluate injury countermeasures for reclined occupants, but the validity of such surrogates in a reclined posture is unknown. Experiments with post-mortem human subjects (PMHS) in a recline posture are needed both to define biofidelity targets for other surrogates and to describe the biomechanical response of reclined occupants in restrained frontal impacts. The goal of this study was to evaluate the kinematic and injury response of reclined PMHS in 30 g, 50 km/h frontal sled tests. Five midsize adult male PMHS were tested. A simplified semi-rigid seat with an anti-submarining pan and a non-production threepoint seatbelt (pre-tensioned, force-limited, seat-integrated) were used. Global motions and local accelerations of the head, pelvis, and multiple vertebrae were measured. Seat and seatbelt forces were also measured. Injuries were assessed via post-test dissection. The initial reclined posture aligned body regions (pelvis, lumbar spine, and ribcage) in a way that reduced the likelihood of effective restraint by the seat and seatbelt: the occupant's pelvis was initially rotated posteriorly, priming the occupant for submarining, and the lumbar spine was loaded in combined compression and bending due to the inertia of the upper torso during forward excursion. Coupled with the high restraining forces of the seat and seatbelt, the unfavorable kinematics resulted in injuries of the sacrum/coccyx (four of five PMHS injured), iliac wing (two of five PMHS injured), lumbar spine (three of five PMHS injured), and ribcage (all five PMHS suffered sternal fractures, and three of five PMHS suffered seven or more rib fractures). The kinematic and injury outcomes strongly motivate the development of injury criteria for the lumbar spine and pelvis, the inclusion of intrinsic variability (e.g., abdomen depth and pelvis shape) in computational simulations of frontal impacts with reclined occupants, and the adaptation of comprehensive restraint paradigms to predicted variability of occupant posture.

Adapting load limiter deployment for frontal crash diversity

Objective: Current European restraint systems may not realize their full protection potential in real-world frontal crashes because they are highly optimized for specific conditions. This research sought to quantify the potential benefit of adapting seat belt load limit thresholds to a wider range of occupant and crash characteristics.Methods: Numerical simulations using Hybrid III dummies were conducted to determine how varying load limiter thresholds could affect occupant kinematics and injury outcome in frontal impacts. Occupant-compartment models were developed with a restraint system consisting of a frontal airbag and a 3-point belt with retractor, buckle pretensioner, and load limiting at the shoulder. Load limiting threshold was varied in 5 frontal impact scenarios, covering as wide a range of real frontal crash conditions as possible. The simulated thoracic injury risks were converted into injury probability values using Abbreviated Injury Scale (AIS) 2+ age-dependent thoracic risk curves. These values were then applied to a British real-world frontal impact sample to determine the injury reduction potential of optimized load limiting, taking into account occupant seating position, impact scenario, occupant size, and occupant age and assuming that an appropriate adaptive system was fitted to all cars.Results: In low-severity impacts, a low load limit provided the best chest protection, without increasing risk to other body regions, for both the 50th and 95th percentile dummies in both front seating positions. In high-severity impacts, the low limit was not recommended because it allowed the driver dummy to move into close proximity with the vehicle interior, although there appeared to be some benefit of lower load limiting for the 50th percentile front passenger dummy, due to the increased ride down space in that seating position. Adapting the load limit showed no injury reduction potential for 5th percentile drivers. Utilizing the best load limit threshold in real-world crashes could reduce the number of occupants with AIS 2+ chest injuries from belt loading from 377 to 251 (a 33% reduction), correspondingly reducing the number of occupants with AIS 2+ chest injuries (from all sources) in the whole frontal impact population from 496 to 370. This is a reduction in injury rate from 6.4% to 4.8%.Conclusions: The concept of an adaptive load limiter shows most promise in low-speed frontal crashes where it could lower the AIS 2+ chest injury risk for most front seat occupants, except the smallest of drivers. Generally, adaptive limiters show less potential effectiveness with increased crash severities. Overall, an intelligent adjustment of load limiting threshold could result in a reduction of at least a third of front seat occupants with AIS 2+ chest injuries associated with restraining loads and an overall reduction in AIS 2+ chest injury rate in frontal crashes from 6.4% to 4.8.

Real-World Rib Fracture Patterns in Frontal Crashes in Different Restraint Conditions

OBJECTIVE

The purpose of this study was to use the detailed medical injury information in the Crash Injury Research and Engineering Network (CIREN) to evaluate patterns of rib fractures in real-world crash occupants in both belted and unbelted restraint conditions. Fracture patterns binned into rib regional levels were examined to determine normative trends associated with belt use and other possible contributing factors.

METHODS

Front row adult occupants with Abbreviated Injury Scale (AIS) 3+ rib fractures, in frontal crashes with a deployed frontal airbag, were selected from the CIREN database. The circumferential location of each rib fracture (with respect to the sternum) was documented using a previously published method (Ritchie et al. 2006) and digital computed tomography scans. Fracture patterns for different crash and occupant parameters (restraint use, involved physical component, occupant kinematics, crash principal direction of force, and occupant age) were compared qualitatively and quantitatively.

RESULTS

There were 158 belted and 44 unbelted occupants included in this study. For belted occupants, fractures were mainly located near the path of the shoulder belt, with the majority of fractures occurring on the inboard (with respect to the vehicle) side of the thorax. For unbelted occupants, fractures were approximately symmetric and distributed across both sides of the thorax. There were negligible differences in fracture patterns between occupants with frontal (0°) and near side (330° to 350° for drivers; 10° to 30° for passengers) crash principal directions of force but substantial differences between groups when occupant kinematics (and contacts within the vehicle) were considered. Age also affected fracture pattern, with fractures tending to occur more anteriorly in older occupants and more laterally in younger occupants (both belted and unbelted).

CONCLUSIONS

Results of this study confirmed with real-world data that rib fracture patterns in unbelted occupants were more distributed and symmetric across the thorax compared to belted occupants in crashes with a deployed frontal airbag. Other factors, such as occupant kinematics and occupant age, also produced differing patterns of fractures. Normative data on rib fracture patterns in real-world occupants can contribute to understanding injury mechanisms and the role of different causation factors, which can ultimately help prevent fractures and improve vehicle safety.

Kinematics and dynamics of the pelvis in the process of submarining using PMHS sled tests

This study focused on a better understanding and characterization of the submarining phenomenon that occurs in frontal crashes when the lap belt slides over the anterior superi or iliac spine. Submarining is the consequence of the pelvis kinematics relative to the lap belt, driven by the equilibrium of forces and moments applied to the pelvis. The study had two primary purposes; the first was to provide new PMHS data in submarining test configurations, the second was to investigate the Hybrid II and Hybrid III dummies biofidelity regarding submarining. Several Post Mortem Human Subject (PMHS) studies have been published on this subject. However, the lack of information about the occupant initial positioning and the use of car seats make it difficult to reconstruct these tests. Furthermore, the two dummies are rarely compared to PMHS in submarining test configurations. A fifteen frontal sled test campaign was carried out on two Anthropomorphic Test Devices (ATDs) and nine PMHS. The test environment was designed to be reproducible. It consisted of a rigid seat, a 2-poi nts shoulder belt and a 2-points lap belt instrumented to record their 3D forces at anchorage. The subjects were instrumented with angular sensors at the sacrum, T1 and T12 levels to record their initial angles. Kinematics was measured at these three levels by means of three accelerometers and angular velocity sensors. A PMHS positioning procedure was developed to ensure repeatability. A pre-test was performed on each subject to characterize its lumbar spine static behavior. All the subjects were CT-scanned from head to toe prior to the test. The campaign was divided into three test configurations leading to different surrogates' interaction with the environment and different kinematics. This resulted in a wider range of behaviors for the dummies evaluation. The deceleration pulse, initial lap belt angle, lap belt slack, seat pan angle and footrest position varied. The Hybrid II and Hybrid III dummies and three PMHS were tested in each configuration. Forces and kinematics time history corridors based on the PMHS responses are provided for each configuration. The dummies' responses are evaluated against these targets. For the first configuration (40 km/h), the peak lap belt tension for both sides was between 3,000 N and 6,385 N for the three PMHS while it was around 4,700 N and 6,200 N in average for Hybrid II and Hybrid III respectively. The maximum pelvic rotation ranged from 41° to 80° for the PMHS and reached approximately 45° for the two dummies. For the other two configurations (50 km/h), the peak lap belt tension varied from 3,660 N to 7,180 N for the PMHS and was between 5,400 N and 6,100 N for Hybrid II and between 7,145 N and 7,900 N for Hybrid III. The maximum pelvic rotation ranged from 43° to 73° for the PMHS, while it reached approximately 54° and 46° for Hybrid II and Hybrid III respectively.

Rear seat occupant safety: kinematics and injury of PMHS restrained by a standard 3-point belt in frontal crashes

Very little experimental research has focused on the kinematics, dynamics, and injuries of rear-seated occupants. This study seeks to develop a baseline response for rear-seated post mortem human surrogates (PMHS) in frontal crashes. Three PMHS sled tests were performed in a sled buck designed to represent the interior rear-seat compartment of a contemporary mid-sized sedan. All occupants were positioned in the right-rear passenger seat and subjected to simulated frontal crashes with an impact speed of 48 km/h. The subjects were restrained by a standard, rear seat, 3-point seat belt. The response of each subject was evaluated in terms of whole-body kinematics, dynamics, and injury. All the PMHS experienced excessive forward translation of the pelvis resulting in a backward rotation of the torso at the time of maximum forward excursion. The three subjects experienced maximum normalized chest deflections of 30%, 45%, and 30%, respectively, and maximum 3 ms clip resultant chest accelerations of 50, 42, and 52 g, respectively. Additionally, each PMHS received at least 13 rib fractures (maximum of 29 fractures), and flexion-tension induced neck injuries initiating in the lower cervical spine (C4-T1). The neck trauma ranged from ligament damage (AIS 1) to complete cervical spine transection (AIS 5).

Biomechanical response of the pediatric abdomen, Part 2: injuries and their correlation with engineering parameters

This paper describes the injuries generated during dynamic belt loading to a porcine model of the 6-year-old human abdomen, and correlates injury outcomes with measurable parameters. The test fixture produced transverse, dynamic belt loading on the abdomen of 47 immediately post-mortem juvenile swine at two locations (upper/lower), with penetration magnitudes ranging from 23% - 65% of the undeformed abdominal depth, with and without muscle tensing, and over a belt penetration rate range of 2.9 m/s - 7.8 m/s. All thoracoabdominal injuries were documented in detail and then coded according to the Abbreviated Injury Scale (AIS). Observed injuries ranged from AIS 1 to AIS 4. The injury distribution matched well the pattern of injuries observed in a large sample of children exposed to seatbelt loading in the field, with most of the injuries in the lower abdomen. Univariate and multiple regression models were used to assess mechanical predictors as injury criteria for maximum AIS 2+ and 3+ outcomes, including peak belt tension and posterior reaction force, abdominal penetration, penetration rate, the viscous criterion, and a newly proposed criterion, FCmax, which is the maximum of the instantaneous product of loading rate and normalized penetration. The Goodman-Kruskal Gamma (gamma) was used to assess each parameter's ability to discriminate between injurious and non-injurious tests. Injury risk functions were generated for both outcomes by fitting a 2-parameter Weibull distribution to the injury data using survival analysis. The best discriminators were peak belt tension (gamma = 0.86 and 0.83, p < 0.01), the work done by the deforming thorax (gamma = 0.86 and 0.74, p < 0.01), and abdominal penetration (gamma = 0.89 and 0.66, p < 0.02). Penetration rate was not a good discriminator (gamma = 0.34 and 0.52), and the consideration of penetration rate decreased the discrimination of the viscous criterion (gamma = 0.67 and 0.58) relative to penetration alone. FCmax was a better discriminator of injury than the viscous criterion (gamma = 0.70 and 0.76, p < 0.01), indicating that the loading rate may be more related to injury outcome than the penetration rate.

Whole-body kinematic and dynamic response of restrained PMHS in frontal sled tests

The literature contains a wide range of response data describing the biomechanics of isolated body regions. Current data for the validation of frontal anthropomorphic test devices and human body computational models lack, however, a detailed description of the whole-body response to loading with contemporary restraints in automobile crashes. This study presents data from 14 frontal sled tests describing the physical response of postmortem human surrogates (PMHS) in the following frontal crash environments: A) (5 tests) driver position, force-limited 3-point belt plus airbag restraint (FLB+AB), 48 km/h deltaV. B) (3 tests) passenger position, FLB+AB restraint, 48 km/h deltaV. C) (3 tests) passenger position, standard (not force-limited) 3-point belt plus air bag restraint (SB+AB), 48 km/h deltaV. D) (3 tests) passenger position, standard 3-point belt restraint (SB), 29 km/h deltaV. Reported data include x-axis and z-axis (SAE occupant reference frame) accelerations of the head, spine (upper, middle, and lower), and pelvis; rate of angular rotation of the head about y-axis; displacements of the head, upper spine, pelvis and knee relative to the vehicle buck; and deformation contours of the upper and lower chest. A variety of kinematic trends are identified across the different test conditions, including a decrease in head and thorax excursion and a change in the nature of the excursion in the driver position compared to the passenger position. Despite this increase in forward excursion when compared to the driver's side FLB+AB tests, the passenger's side FLB+AB tests resulted in greater peak thoracic (T8) x-axis accelerations (passenger's side -29 g; driver's side -22 g;) and comparable maximum chest deflection (passenger's side - 23+/-3.1% of the undeformed chest depth; driver's side - 23+/-5.6%; ). In the 48 km/h passenger's side tests, the head excursion associated with the force-limiting belt system was approximately 15% greater than that for a standard belt system in tests that were otherwise identical. This was accompanied by a decrease in chest deflection of approximately 20% with the force-limiting system. Despite the decrease in test speed, the 29 km/h passenger's side tests with standard (not force-limiting) 3-point belt restraints resulted in maximum chest deflection (16+/-5.6% average) comparable to that observed in the 48 km/h, FLB+AB, driver's side tests (21+/-3.1% average). Finally, forward head excursion was slightly higher in the 29 km/h passenger's side tests (33+/-1.1 cm average) than in the 48 km/h driver's side tests (27+/-3.7 cm average), and was lower than that in the 48 km/h FLB+AB (58+/-4.4 cm average) and SB+AB (46+/-2.1 cm average) passenger's side tests.

Thoracic response to dynamic, non-impact loading from a hub, distributed belt, diagonal belt, and double diagonal belts

This paper presents thoracic response corridors developed using fifteen post-mortem human subjects (PMHS) subjected to single and double diagonal belt, distributed, and hub loading on the anterior thorax. We believe this is the first study to quantify the force-deflection response of the same thorax to different loading conditions using dynamic, non-impact, restraint-like loading. Subjects were positioned supine on a table and a hydraulic master-slave cylinder arrangement was used with a high-speed materials testing machine to provide controlled chest deflection at a rate similar to that experienced by restrained PMHS in a 48-km/h sled test. All loading conditions were tested at a nominally non-injurious level initially. When the battery of non-injurious tests was completed, a single loading condition was used for a final, injurious test (nominal 40% chest deflection). To minimize the influence of repeated testing, all subjects were preconditioned prior to each loading condition using 10 cycles of a 1-Hz sine wave, and the order in which the loading conditions were tested was varied across subjects. Thoracic response was characterized using the deflection at the midline of the sternum and a load cell mounted between the subject and the loading table. Responses were defined by cross-plotting the mid-sternal deflection (normalized to 50(th) male) and the posterior force (scaled to a 45-year-old, 50(th) male based on size and modulus) and then forming a +/-1-standard-deviation corridor that considered the variance in both force and deflection. Corridors were developed to a deflection level of 20% of the 50(th) percentile male's external chest depth. The distributed loading condition generated the stiffest response (3.33 kN at 4.6 cm), followed by the double diagonal belt condition (3.18 kN at 4.6 cm), the single diagonal belt (2.28 kN at 4.6 cm) and the hub (1.14 kN at 4.6 cm).

The effects of occupant age on patterns of rib fractures to belt-restrained drivers and front passengers in frontal crashes in Japan

The injuries sustained by elderly car occupants in traffic accidents are usually more severe than those of younger occupants. Accident statistics data show that injuries to elderly occupants frequently occur in the chest. Belted drivers and front seat passengers in cars involved in frontal collisions were investigated using detailed data on traffic accidents in Japan. From a total of 246 vehicle occupants, the total number of injuries among the 167 occupants listed as injured was 462. Most of the injuries to the chest were minor ones such as skin abrasions or contusions. However, 21 occupants sustained rib fractures and 7 persons even sustained internal organ injuries. Younger occupants appeared not to sustain rib fractures even in higher impact collisions. Conversely, elderly occupants frequently experienced rib fractures near the seat belt line even under lower impact severity. It was also typically observed that rib fractures in case of airbag deployment were more often found in the lower part of chest compared with those cases of seat belt restraint alone. Symptoms of these differences in injury are described in detail in consideration of the gender and age of occupants, airbag deployments, and accident severity. In addition, regression analysis was carried out to evaluate the influence of age on rib fractures. Results show that rib fractures in elderly occupants occur at a delta V 30 km/h lower than that of younger occupants.

The Utility of Hybrid III and THOR Chest Deflection for Discriminating Between Standard and Force-Limiting Belt Systems

Recent field data studies have shown that force-limiting belt systems reduce the occurrence of thoracic injuries in frontal crashes relative to standard (not force-limiting) belt systems. Laboratory cadaver tests have also shown reductions in trauma, as well as in chest deflection, associated with a force-limiting belt. On the other hand, tests using anthropomorphic test devices (ATDs) have shown trends indicating increased, decreased, or unchanged chest deflection. This paper attempts to resolve previous experimental studies by comparing the anterior-posterior and lateral chest deflections measured by the THOR and Hybrid III (H-III) dummies over a range of experimental conditions. The analysis involves nineteen 48-km/h and 57-km/h sled tests utilizing force-limiting and standard seat belt systems, both with an air bag. Tests on both the driver side and the passenger side are considered. The purpose of the study is to evaluate whether either dummy could differentiate between the two belt types over a range of sled pulse shapes, seating positions, and belt force limits. The comparison shows that both dummies exhibit significantly (p<0.05) greater maximum chest deflection (Cmax) with the standard belt. In the driver-side tests (3 kN force limit), Cmax for THOR and H-III was 51.6% and 64.4% greater while, in the passenger-side tests (4 kN force limit), Cmax was 16.6% and 30.6% greater. Lateral deflections increased similarly, as did resultant chest acceleration. It is concluded that, over the range of conditions considered here, both dummies consistently ranked the restraint systems appropriately. We conclude by hypothesizing several potential explanations for the different findings among studies in the literature.