Monday, July 21, 2008

Lack of Relationship Between Vehicle Damage

A common empirical observation, made by those who treat these patients frequently, is that the extent of injuries to two occupants of the same vehicle often varies widely—largely as a result of the great diversity of human variables. In many cases, one occupant will be injured while another is not. This observation alone should be adequate to discourage the practice of calculating the occupant’s injury potential based only on assessment of impact magnitude. Such information should not be considered the final truth of a case, but rather used as a guide by the clinical professions in dealing with trauma and its consequences.

The doctor’s clinical experience, observation of the patient, history, exam / diagnostic test findings and correlation of the reported symptoms. Should lead to a rational and logical opinion as to “causation”, “apportionment” and source “pain generation”. “Any observer that reviews the same information should come to a similar conclusion concerning the impairment and/or disability”.

Studies have shown that one cannot depend on one variable to determine if an injury will occur. Injury cannot be reliably predicted by knowing the Delta-V. Krafft M, Kullgren A, Tin gvall C, Bostrom O, Fredriksson R. How crash severity in rear impacts influences short- and long-term consequences to the neck. Accid Anal Prev. 2000 Mar;32(2):187-95.

In a whiplash-type collision, the dynamic loads generated in the cervical spine are more complex than previously thought. Within the physiological range of cervical motion, considerable shear load was partially produced in the cervical spine, and was able to create micro-injury of soft tissues. This mechanical model cannot predict the tolerances of the neck structures and injury criteria. Matsushita T, Yamazaki N, Sato T, Hirabayashi K. Biomechanical and medical investigations of human neck injury in low-velocity collisions. Neuro-Orthopedics 1997; 21:27-45. Davis CG. Injury threshold: whiplash-associated disorders. J Manipulative Physiol Ther. 2000 Jul-Aug;23 (6) :420.

See the following studies regarding the correlation between damage to a vehicle and occupant injury:

Robbins, M. C. Lack of Relationship Between Vehicle Damage and Occupant Injury. Society of Automotive Engineers, 1997;970494, Detroit, MI.

Evans RW. Some observations on whiplash injuries. Neurol Clin. 1992 Nov;10(4) :975-9 7.

Hirsch SA, Hirsch PJ, Hiramoto H, Weiss A. Whiplash syndrome. Fact or fiction? Orthop Clin North Am. 1988 Oct;19(4):791-5.

Hijioka A, Narusawa K, Nakamura T. Risk factors for long-term treatment of whiplash injury in Japan: analysis of 400 cases. Arch Orthop Trauma Surg. 2001 Oct;121(9):490-3. (Treatment length with damage to ½ the vehicle is about the same with a vehicle with no damage.)

Olsson I, Bunketorp O, Carlsson G, et al.: An in-depth study of neck injuries in rear end collisions. 1990 International IRCOBI Conference, Bron, Lyon, France, September 12-14, 1-15, 1990.

Pennie B, Agambar L. Patterns of injury and recovery in whiplash. Injury. 1991 Jan;22(1):57-9.

Ryan GA, Taylor GW, Moore VM, Dolinis J. Neck strain in car occupants: injury status after 6 months and crash-related factors. Injury. 1994 Oct;25(8):533- 7.

Ryan GA, Taylor GW, Moore VM, Dolinis J. Neck strain in car occupants. The influence of crash-related factors on initial severity. Med J Aust. 1993 Nov 15;159(10):651-6.

Sturzenegger M, DiStefano G, Radanov BP, Schnidrig A. Presenting symptoms and signs after whiplash injury: the influence of accident mechanisms. Neurology. 1994 Apr;44(4):688-93.

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