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Journal Article

Citation

Shateri H, Cronin DS. Traffic Injury Prev. 2015; 16(7): 698-708.

Affiliation

University of Waterloo - Waterloo , Ontario , Canada.

Copyright

(Copyright © 2015, Informa - Taylor and Francis Group)

DOI

10.1080/15389588.2014.1003551

PMID

25664486

Abstract

OBJECTIVE Whiplash injuries can occur in automotive crashes and may cause long term health issues such as neck pain, headache, and visual and auditory disturbance. Evidence suggests that non-neutral head posture can significantly increase the potential for injury in a given impact scenario but epidemiological and experimental data is limited and does not provide a quantitative assessment of the increased potential for injury. Although there have been some attempts to evaluate this important issue using finite element models, none to date have successfully addressed this complex problem.

METHODS An existing detailed Finite Element neck model was evaluated in non-neutral positions and limitations were identified including musculature implementation and attachment, upper cervical spine kinematics in axial rotation, prediction of ligament failure, and the need for repositioning the model while incorporating initial tissue strains. The model was enhanced to address these issues and an iterative procedure was used to determine the upper cervical spine ligament laxities. The neck model was revalidated using neutral position impacts and compared to an out-of-position cadaver experiment in the literature. The effects of non-neutral position (axial head rotation) coupled with muscle activation were studied at varying impact levels.

RESULTS The laxities for the ligaments of the upper cervical spine were determined using four load cases and resulted in improved response and predicted failure loads relative to experimental data. The predicted head response from the model was similar to an experimental head-turned bench-top rear impact experiment. The parametric study identified specific ligaments with increased distractions due to an initial head-turned posture, and the effect of active musculature leading to reduced ligament distractions.

CONCLUSIONS The incorporation of ligament laxity in the upper cervical spine was essential to predict range of motion and traumatic response, particularly for repositioning of the neck model prior to impact. The results of this study identify a higher potential for injury in out-of-position rear collisions and identified at-risk locations based on ligament distractions. The model predicted higher potential for injury by as much as 50% based on ligament distraction for the out-of-position posture and reduced potential for injury with muscle activation. Importantly, this study demonstrated that the location of injury or pain depends on the initial occupant posture, so that both the location of injury and kinematic threshold may vary when considering common head positions while driving.


Language: en

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