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Dr. Christopher Quigley Presents: The Info You Need to Win Frontal Collision Cases

In this Webinar, Dr. Quigley will discuss what you need to know to win your frontal collision cases, including: what factors cause more damage to victims of frontal collisions, and how you can use these factors to argue your client’s case.

Dr. Christopher Quigley:

All right, we’ve got another minute here, we’ll give the other folks another minute and we’ll jump-start with this one.

Dr. Christopher Quigley:

This is a recent article, 2019 in the Journal Traffic Injury Prevention, and it’s titled, Automotive injury trends in contemporary fleet: Belted occupants in frontal collisions. The vast majority of literature is in rear-impact collisions. So this is a sort of an odd bird, but it’s a really good odd bird. Talk about some very good concepts that you need to put into everyday practice.

Dr. Christopher Quigley:

So these researchers are out of the University of Virginia and saying included occupants between 13 and 97 years of age with a mean age of 32 years, half men, half women, who were involved in a crash with a principal direction of force between 10 and two o’clock, head-on collisions and restrained by a three-point belt. Pregnant occupants past their first trimester, ejected occupants in crashes involving any rollover were excluded. Additional variables in the assessment were a Delta V, which is your change in velocity, sex, age, height, body, mass index, and vehicle model year. Serious or fatal injuries are assessed using the abbreviated injury scale. Now Mary, are you familiar with that one? The AAS scale.

Speaker 2:

Yeah, a little bit.

Dr. Christopher Quigley:

All right. So it’s basically a six segmented assessment scale. It starts from one which is minor, two is moderate, three is serious, four is severe, five is critical, and six is maximal untreatable, probably AKA dead. So key points here. Automobile safety has experienced substantial changes since the late 1980s and early 1990s. Newer vehicles are associated with lower crash related mortality related to pre-1994 vehicles, mainly because they keep you in the vehicle better and airbags. Airbags change injuries. You still get injured with an airbag, but different kind of injuries. An analysis from 2013 now found that more recent model years are associated with reduced risk of serious injury for crash types. Results. Number of frontal crashes, 22,854. Total number of occupants assessed, 31,254. A total of 18,441 people sustained a total of 69,404 injuries. Approximately 3.8 injuries per injured occupant. So this is a really… that’s a good number for us because it’s very important when you especially do those initial intakes you ask about the whole body.

Dr. Christopher Quigley:

Typically when we see a patient, we focus on the most important area for a regular patient. But for a care accident patient, you’ve got to deal with all of them. You’ve got to deal with the neck, the low back and the hands, wrists, ribs or whatever. You got to get… Bring them all out.

Dr. Christopher Quigley:

Arm, forearm, hand, and wrist injuries remain steady in prevalence. Skeletal thoracic injuries, and [inaudible 00:03:34] foreign issues were amongst common injury types. The prevalence of skeletal thoracic injury increased significantly from the younger to the older age group occurring almost three times as often as any other injury type in the older cohort. Among older occupants with skeletal thoracic injuries, nearly half were in a seating location other than the driver’s seat. All right. So that’s just two good pearls there for us. Number one, the older, the more are you getting injured. All right. And then nearly half were in the seating location other than a driver’s seat. So, I think part of that is going to be the driver is going to be more aware of the collision. That’s the big advantage of the driver has most of the time. Not always. Sometimes I had a recent crash. I had a young man who was sitting in the backseat with his head down on his phone and he got rear-ended. So, that’s a bad position. He didn’t see him coming. He was unaware. He got rear-ended and that is a very common finding.

Dr. Christopher Quigley:

Newer model year vehicles, 2009 and later, generally carry less risk of injury in front-on collisions with belted occupants compared to older model year vehicles. The greatest reductions can be observed in skull fracture, knee, thigh, hip injuries, including knee injuries specifically, and ankle injuries. Statistically significant reductions were also observed in cervical spine injury, abdominal injury, and rib fracture injury. So remember this is front impacts. It’s actually the opposite in the rear impact. In the rear impact, you see more cervical spine injury because the fact is the bumpers are stiffer.

Dr. Christopher Quigley:

Statistically significant reductions were not observed for sternal fracture or rib fractures. Now the caveat with that is these things are hard to find. X-rays are really difficult to see fractures in this area. So many times you got to use what’s called a bone scan when they do the radioactive glucose in there, and you can see where the fractures are. I had one in the lumbar spine and it really didn’t show up well. And we did bone scan and it showed up like a Christmas tree. Abdominal and lumbar spine injuries continue to occur with similar frequency compared to other injury types in newer model year vehicles. The most common musculoskeletal injury types in the vehicles of model year 2009 and later were just a skeletal, thorax, ribs and sternum, arm, and hand and wrist in that order. Improvements in thoracic injury protection have landed behind other body regions. Females are at greater risk of injury compared to males, even after controlling for Delta V H height, BMI and vehicle model year. Another really key point.

Dr. Christopher Quigley:

It has been reported that female drivers have a higher rate of injurious crashes per million miles traveled when compared to males. The odds of a belt restrained female driver sustaining serious injuries is 47% higher than a belt restrained male driver when both were involved in comparable crashes. The author suggests that sex itself has an effect on an injury tolerance. They say… They conclude that the possibility of a bone mineral density being different and differences in bone and ligament material properties are going to cause more injury. Now, the other factor to look at is just the neck diameter, right? Our body diameter for that matter.

Dr. Christopher Quigley:

Brain injuries, concussions exhibited a trend toward an increased risk in vehicles newer than 2009. Upper extremity injuries continue to be the most prevalent injuries in newer model vehicles. Chief among these injuries are the injuries to the arm, forearm, hand and wrist. Despite continually prevalence, upper extremity injuries have historically received little attention in the automobile safety research community. While they carry a lesser threats of life, upper extremity injuries have the potential to detrimentally affect long-term quality of life through persistent disability. It creates prevalence of hand and risk injury is particularly concerning because they’re persistent functional defects in this area can have drastic consequences on short and longterm occupational capabilities as well as tasks in everyday life.

Dr. Christopher Quigley:

All right, findings and conclusions. Newer model vehicles after 2009 carry less risk of injury. The largest reductions in injury is to the lower extremities and risk of skull fracture. Between the model years, there was no risk and change of rib fracture or sternum injury. Females are at greater risk for injury compared to males. And injuries also remain common in the arm, hand, and wrist for all ages studied. So, questions?

Speaker 2:

Let’s see. No, I don’t think so.

Dr. Christopher Quigley:

Yeah. It’s a nice article. Goes over… I really like the review of the females being more injurious, the older people getting injuries. So a lot of important concepts you deal with on a day-to-day basis in case.

Speaker 2:

Yeah, no definitely. Because I definitely see significant with female drivers because most of the time they’re driving with the seat closer to the steering wheel because they can’t reach the pedals.

Dr. Christopher Quigley:

Now if they had my book, they would have known about those pedal extenders you can clamp onto the pedals to make them longer so you can not be so up close against it.