Type II odontoid fracture from frontal impact

2005 ◽  
Vol 2 (4) ◽  
pp. 481-485 ◽  
Author(s):  
Narayan Yoganandan ◽  
Jamie L. Baisden ◽  
Dennis J. Maiman ◽  
Frank A. Pintar
Keyword(s):  
Motor Vehicle ◽  
Demographic Data ◽  
Seat Belt ◽  
Experimental Studies ◽  
Compressive Force ◽  
Odontoid Fracture ◽  
Tall Stature ◽  
Type Ii ◽  
Frontal Impact ◽  
Late Model

✓ The authors report a case of Type II odontoid fracture from a frontal impact sustained in the crash of a late-model motor vehicle. They discuss the biomechanical mechanisms of injury after considering patient demographic data, type and use of restraint systems including seatbelt and airbags, crash characteristics, and laboratory-based experimental studies. Multiple factors contributed to the Type II odontoid fracture: the patient's tall stature and intoxicated state; lack of manual three-point seat belt use; obliqueness of the frontal impact; and the most likely preflexed position of the head—neck complex at the time of impact, which led to contact of the parietal region with the A-pillar roof-rail area of the vehicle and resulted in the transfer of the dynamic compressive force associated with lateral bending. Odontoid fractures still occur in individuals involved in late-model motor vehicle frontal crashes, and because this injury occurs secondary to head impact, airbags may not play a major role in mitigating this type of trauma to an unrestrained occupant. It may be more important to use seat belts than to depend on the airbag alone for protection from injury.

Study on an Integrated Child Safety Seat

2010 ◽  
Vol 34-35 ◽  
pp. 517-522 ◽  
Author(s):  
Li Bo Cao ◽  
Huan Chen ◽  
Xi Juan Ren ◽  
Zhi Gao Ou Yang
Keyword(s):  
Motor Vehicle ◽  
Seat Belt ◽  
Simulation Models ◽  
Rear Seat ◽  
Child Safety ◽  
Frontal Impact ◽  
Simulation Test ◽  
Effective Protection ◽  
Sled Test ◽  
Safety Seat

A new integrated child safety seat is presented in this paper. The seat is a two-mode seat for a motor vehicle cooperable with an adult seat belt assembly to provide two modes operation including an adult seat mode and a child seat mode. The seat locates in the center of the rear seat. The structure of the seat was designed in detail. The height of the booster of the seat can be adjusted continuously according to the seated shoulder height of the child passenger. The depth of booster cushion also can be changed according to the size of the passenger. The sled test with the seat was conducted. The seat simulation models with different booster heights were developed using MADYMO software and validated. Then, these models were used to study the performance of the seat in frontal impact. Some key parameters of the seat were studied in simulation test. The results of the test and simulation show that the seat can provide effective protection for the children aged from 3 to 10 years in frontal impact.

Multilevel Validation of a Male Neck Finite Element Model With Active Musculature

2020 ◽  
Vol 143 (1) ◽  
Author(s):  
Jeffrey B. Barker ◽  
Duane S. Cronin
Keyword(s):  
Cervical Spine ◽  
Injury Risk ◽  
Muscle Activation ◽  
Computational Models ◽  
Soft Tissues ◽  
Motor Vehicle ◽  
Experimental Studies ◽  
Tissue Level ◽  
Open Loop ◽  
Frontal Impact

Abstract Computational models of the human neck have been developed to assess human response in impact scenarios; however, the assessment and validation of such models is often limited to a small number of experimental data sets despite being used to evaluate the efficacy of safety systems and potential for injury risk in motor vehicle collisions. In this study, a full neck model (NM) with active musculature was developed from previously validated motion segment models of the cervical spine. Tissue mechanical properties were implemented from experimental studies, and were not calibrated. The neck model was assessed with experimental studies at three levels of increasing complexity: ligamentous cervical spine in axial rotation, axial tension, frontal impact, and rear impact; postmortem human subject (PMHS) rear sled impact; and human volunteer frontal and lateral sled tests using an open-loop muscle control strategy. The neck model demonstrated good correlation with the experiments ranging from quasi-static to dynamic, assessed using kinematics, kinetics, and tissue-level response. The contributions of soft tissues, neck curvature, and muscle activation were associated with higher stiffness neck response, particularly for low severity frontal impact. Experiments presenting single-value data limited assessment of the model, while complete load history data and cross-correlation enabled improved evaluation of the model over the full loading history. Tissue-level metrics demonstrated higher variability and therefore lower correlation relative to gross kinematics, and also demonstrated a dependence on the local tissue geometry. Thus, it is critical to assess models at the gross kinematic and the tissue levels.

Conservative Management of Type II Odontoid Fractures in Older People: A Retrospective Observational Comparison of Osseous Union Versus Nonunion

Neurosurgery ◽  
2020 ◽  
Author(s):  
Suzanne McIlroy ◽  
Jordan Lam ◽  
Muhammad Faheem Khan ◽  
Asfand Baig Mirza ◽  
Jerry Ajayi Philip ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older People ◽  
Conservative Management ◽  
Demographic Data ◽  
Odontoid Fracture ◽  
Type Ii ◽  
Odontoid Fractures ◽  
Pain Disability ◽  
Osseous Union

Abstract BACKGROUND Type II odontoid fractures are a common cervical fracture in older people. Lower osseous-union rates are reported in those treated conservatively compared to surgically; however, the clinical relevance of a nonunion is unknown. OBJECTIVE To compare pain, disability, and quality of life in older people following conservative management of type II odontoid fractures demonstrating osseous-union and nonunion. METHODS Electronic records were searched from 2008 to 2018 for adults ≥65 yr with type II odontoid fracture, managed in a semi-rigid collar. Clinical and demographic data were retrieved from electronic patient notes. Surviving patients were invited to complete questionnaires to assess pain, disability, and quality of life. Ethical approval was granted. RESULTS A total of 125 patients were identified: 36 (29%) demonstrated osseous-union, 89 (71%) had nonunion, of which 33 (40%) had radiological instability. Mean age at fracture was 84 yr (osseous-union 83 yr; nonunion 84 yr). A total of 53 had deceased (41 nonunion). Median length of survival was 77 mo for osseous-union vs 50 mo for nonunion; P = .02. No patient developed myelopathy during the follow-up period. Questionnaire response rate was 39 (58%). There were no statistically significant differences between the groups in terms of pain, disability, or quality of life (P > .05). Both groups reported mild disability and pain but low quality of life. CONCLUSION Management with a semi-rigid collar in older people with type II odontoid fracture is associated with low levels of pain and disability without statistically significant differences between those demonstrating osseous-union or stable or unstable nonunions. Conservative management appears to be a safe treatment for older people with type II fractures.

scholarly journals Formation of the Traffic Flow Rate under the Influence of Traffic Flow Concentration in Time at Controlled Intersections in Tyumen, Russian Federation

2021 ◽  
Vol 13 (15) ◽  
pp. 8324
Author(s):  
Viacheslav Morozov ◽  
Sergei Iarkov
Keyword(s):  
Traffic Flow ◽  
Flow Rate ◽  
Traffic Congestion ◽  
Traffic Management ◽  
System Analysis ◽  
Motor Vehicle ◽  
Experimental Studies ◽  
Transport Systems ◽  
Experiment Planning ◽  
Traffic Light

Present experience shows that it is impossible to solve the problem of traffic congestion without intelligent transport systems. Traffic management in many cities uses the data of detectors installed at controlled intersections. Further, to assess the traffic situation, the data on the traffic flow rate and its concentration are compared. Latest scientific studies propose a transition from spatial to temporal concentration. Therefore, the purpose of this work is to establish the regularities of the influence of traffic flow concentration in time on traffic flow rate at controlled city intersections. The methodological basis of this study was a systemic approach. Theoretical and experimental studies were based on the existing provisions of system analysis, traffic flow theory, experiment planning, impulses, probabilities, and mathematical statistics. Experimental data were obtained and processed using modern equipment and software: Traficam video detectors, SPECTR traffic light controller, Traficam Data Tool, SPECTR 2.0, AutoCad 2017, and STATISTICA 10. In the course of this study, the authors analyzed the dynamics of changes in the level of motorization, the structure of the motor vehicle fleet, and the dynamics of changes in the number of controlled intersections. As a result of theoretical studies, a hypothesis was put forward that the investigated process is described by a two-factor quadratic multiplicative model. Experimental studies determined the parameters of the developed model depending on the directions of traffic flow, and confirmed its adequacy according to Fisher’s criterion with a probability of at least 0.9. The results obtained can be used to control traffic flows at controlled city intersections.

Cervical 1-2 Posterior Instrumented Fusion Utilizing Computer-Assisted Navigation With Harvest of Rib Strut Autograft: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Timothy J Yee ◽  
Michael J Strong ◽  
Matthew S Willsey ◽  
Mark E Oppenlander
Keyword(s):  
Surface Area ◽  
Odontoid Process ◽  
Odontoid Fracture ◽  
Patient Specific ◽  
Computer Assisted ◽  
Type Ii ◽  
Instrumented Fusion ◽  
Assisted Navigation ◽  
Patient Consent ◽  
Posterior Instrumented Fusion

Abstract Nonunion of a type II odontoid fracture after the placement of an anterior odontoid screw can occur despite careful patient selection. Countervailing factors to successful fusion include the vascular watershed zone between the odontoid process and body of C2 as well as the relatively low surface area available for fusion. Patient-specific factors include osteoporosis, advanced age, and poor fracture fragment apposition. Cervical 1-2 posterior instrumented fusion is indicated for symptomatic nonunion. The technique leverages the larger posterolateral surface area for fusion and does not rely on bony growth in a watershed zone. Although loss of up to half of cervical rotation is expected after C1-2 arthrodesis, this may be better tolerated in the elderly, who may have lower physical demands than younger patients. In this video, we discuss the case of a 75-yr-old woman presenting with intractable mechanical cervicalgia 7 mo after sustaining a type II odontoid fracture and undergoing anterior odontoid screw placement at an outside institution. Cervical radiography and computed tomography exhibited haloing around the screw and nonunion across the fracture. We demonstrate C1-2 posterior instrumented fusion with Goel-Harms technique (C1 lateral mass and C2 pedicle screws), utilizing computer-assisted navigation, and modified Sonntag technique with rib strut autograft.  Posterior C1-2-instrumented fusion with rib strut autograft is an essential technique in the spine surgeon's armamentarium for the management of C1-2 instability, which can be a sequela of type II dens fracture. Detailed video demonstration has not been published to date.  Appropriate patient consent was obtained.

scholarly journals Examining Risky Driving Behavior Among Older Drivers Using Self-Reported and Objective Data

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 465-465
Author(s):  
Jennifer Zakrajsek ◽  
Lisa Molnar ◽  
David Eby ◽  
David LeBlanc ◽  
Lidia Kostyniuk ◽  
...  
Keyword(s):  
Motor Vehicle ◽  
Seat Belt ◽  
Driving Behavior ◽  
Video Data ◽  
Older Drivers ◽  
Driving Frequency ◽  
Middle Aged ◽  
Risky Driving ◽  
Driving Behaviors ◽  
Study Results

Abstract Motor vehicle crashes represent a significant public health problem. Efforts to improve driving safety are multifaceted, focusing on vehicles, roadways, and drivers with risky driving behaviors playing integral roles in each area. As part of a study to create guidelines for developing risky driving countermeasures, 480 drivers (118 young/18-25, 183 middle-aged/35-55, 179 older/65 and older) completed online surveys measuring driving history, risky driving (frequency of engaging in distracted [using cell phone, texting, eating/drinking, grooming, reaching/interacting] and reckless/aggressive [speeding, tailgating, failing to yield right-of-way, maneuvering unsafely, rolling stops] driving behaviors), and psychosocial characteristics. A cluster analysis using frequency of the risky behaviors and seat belt use identified five risky behavior-clusters: 1) rarely/never distracted-rarely/never reckless/aggressive (n=392); 2) sometimes distracted-rarely/never reckless/aggressive (n=33); 3) sometimes distracted-sometimes reckless/aggressive (n=40); 4) often/always distracted-often/always reckless/aggressive (n=11); 5) no pattern (n=4). Older drivers were more likely in the first/lowest cluster (93.8% of older versus 84.2% of middle-aged and 59.3% of young drivers; p<.0001). Fifteen older drivers participated in a follow-up study in which their vehicles were equipped with a data acquisition system that collected objective driving and video data of all trips for three weeks. Analysis of video data from 145 older driver trips indicated that older drivers engaged in at least one distracted behavior in 115 (79.3%) trips. While preliminary, this suggests considerably more frequent engagement in distracted driving than self-reported and that older drivers should not be excluded from consideration when developing risky driving behavior countermeasures. Full study results and implications will be presented.

Lethal mechanisms in cases of inverted suspension from the lap component of seat belts

2021 ◽  
pp. 002580242199399
Author(s):  
Siobhan O’Donovan ◽  
Neil EI Langlois ◽  
Corinna van den Heuvel ◽  
Roger W Byard
Keyword(s):  
Motor Vehicle ◽  
Seat Belt ◽  
South Australia ◽  
Upper Airway ◽  
Motor Vehicle Crashes ◽  
Blood Alcohol ◽  
Neck Flexion ◽  
Seat Belts ◽  
Respiratory Compromise ◽  
Positional Asphyxia

A retrospective review of autopsy files at Forensic Science South Australia in Adelaide, Australia, was undertaken over a five-year period from January 2014 to December 2018 for all motor vehicle crashes with rollovers ending with the vehicle inverted and the occupants suspended by the lap component of their seat belts. There were five cases, all male drivers (aged 18–67 years; Mage = 32 years). Acute neck flexion or head wedging was noted in four cases, with facial petechiae in four and facial congestion in one. Deaths were due to positional asphyxia in four cases, with the combined effects of positional asphyxia and head trauma accounting for the remaining case. Although all drivers had evidence of head impact which may have caused incapacitation, in only one case was this considered severe enough to have contributed to death. A blood alcohol level above the legal limit for driving was detected in two cases, but no other drugs were detected. This series demonstrates another subset of cases of seat belt–associated deaths where suspension upside down by the lap component of a seat belt had occurred after vehicle rollovers. Predisposing factors include incapacitation of the victim and delay in rescue. The postulated lethal mechanism involved respiratory compromise from the weight of abdominal viscera on the diaphragm, as well as upper airway compromise due to kinking of the neck and wedging of the head.

Motor Vehicle Accident Trauma and Restraint Usage Patterns in Children Less Than 4 Years of Age

PEDIATRICS ◽  
1985 ◽  
Vol 76 (3) ◽  
pp. 382-386
Author(s):  
Phyllis F. Agran ◽  
Debora E. Dunkle ◽  
Diane G. Winn
Keyword(s):  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Seat Belt ◽  
Vehicle Interior ◽  
Use Patterns ◽  
Vehicle Accident ◽  
Restraint Use ◽  
Usage Patterns ◽  
Improper Use ◽  
Safety Seat

In a sample of children less than 4 years of age, treated in an emergency room after a motor vehicle accident, 22% were restrained in a child safety seat (improper and proper), 12% were restrained by a vehicle seat belt, and 70% were unrestrained. Trauma and injury patterns related to the various restraint use patterns are described. Most children in safety seats and seat-belted children, if injured, sustained minor contusions, abrasions, or lacerations. Injury among properly restrained children in safety seats was primarily the result of unavoidable mechanisms (eg, flying glass, intrusion). Improper use contributed to injury among safety-seat-restrained children, primarily by allowing the child to hit against the vehicle interior. Seat-belted children also were injured, primarily by hitting against the vehicle interior. Although some of the restrained children were seriously injured, in general, restrained children tended to sustain less serious and fewer injuries than the unrestrained children.

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