Chinese Journal of Traumatology最新文献

{"title":"Dental trauma related to orotracheal intubation: Prospective study of 43 cases.","authors":"Yosra Mabrouk, Mohamed Hbib Grissa, Souha Ben Youssef","doi":"10.1016/j.cjtee.2024.08.007","DOIUrl":"https://doi.org/10.1016/j.cjtee.2024.08.007","url":null,"abstract":"<p><strong>Purpose: </strong>Orotracheal intubation is one of the most frequently used techniques in emergency procedures and especially in anesthesia and resuscitation. Teeth may be \"victims\" of the orotracheal intubation. Several factors may predispose to these accidents. The aim of this study is to determine the incidence of oral trauma that occurs during scheduled and urgent oral tracheal intubation, and identify the risk factors, the types and locations of these dental injuries.</p><p><strong>Methods: </strong>It is a cross-sectional study that lasted 6 months from June to November 2022. This study was carried out in several departments. An examination of the dental and periodontal status of patients who will undergo surgery under general anesthesia was performed before the operation according to the surgical program. Yet, in emergency settings, this examination was not possible. Patients with anterior edentation and patients refusing participation in the study were excluded. After the surgery, included patients were examined to detect eventual dental trauma such as fracture, luxation, and contusion. Collected data were entered and analyzed using SPSS version 18 software. The Wilcoxon Mann-Whitney U test was used to compare quantitative variables. The Chi-square test was used to compare qualitative variables with a statistical significance level of 5% (p < 0.05).</p><p><strong>Results: </strong>There were 43 patients included in the study, and dental trauma was noted in 11 patients (25.6%). Their mean age was (59.8 ± 15.4) years. The statistical analysis shows that there is a significant relationship between age (over 40 years old) and trauma (p = 0.004). Among the traumatized group, orotracheal intubation was undergone for 8 cases according to the surgical program whereas it was performed, for 3 cases, in emergency settings. The difference between the 2 types of intervention is statistically significant (p = 0.045). The odds ratio was 0.086 (95% CI: 0.008 - 0.942). A Mallampati score of 1 was rated for 6 injured (54.5%). The difference between the difficulty of the intubation evaluated by the Mallampati score and the occurrence of trauma was statistically insignificant (p = 0.278). The dental partial dislocation was the most frequent trauma (6 cases, 54.5%). The maxillary teeth were the most affected (n = 13, 72.2%).</p><p><strong>Conclusion: </strong>According to the present study, the incidence of orotracheal intubation dental traumas is relatively high. The age of the patient is one of the factors predisposing to these traumas. In scheduled surgery, orotracheal intubation is quietly performed during general anesthesia, and the risk of incidence of dental trauma is reduced than in emergency settings.</p>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autologous osteoperiosteal transplantation for cystic osteochondral lesions of the talus: Bone reconstruction is essential","authors":"Yuxuan Wei ,&nbsp;Zhuhong Chen ,&nbsp;Nian Sun ,&nbsp;Zhu Tang ,&nbsp;Hao Guo ,&nbsp;Canjun Zeng","doi":"10.1016/j.cjtee.2024.08.006","DOIUrl":"10.1016/j.cjtee.2024.08.006","url":null,"abstract":"<div><h3>Purpose</h3><div>Autologous osteoperiosteal transplantation (AOPT) is one of the most feasible and effective techniques for cystic osteochondral lesions of the talus (OLT). However, few reports have been reported about the process of graft-host bone healing and bone articular surface reconstruction, which help us to further understand the actual situation of bone healing and modify surgical methods.</div></div><div><h3>Methods</h3><div>The case series study retrospectively evaluated 33 osteochondral lesions in 30 patients undertaking AOPT for OLT with subchondral cysts from December 2016 to October 2021. According to CT observation, we used 4 variables to describe the bony articular repair, including the integration of the articular surface, the height of the bone filling, the status of bone union, and the appearance of bone resorption or cystic change. We also analyzed the demographic data and clinical function. Descriptive statistics were used for demographic and clinical variables. Normally distributed data were presented as mean ± SD, and non-normally distributed data were presented as median (Q₁, Q₃). Associations between these variables and the primary clinical outcomes were examined using <em>t</em>-test or one-way ANOVA test for continuous variables.</div></div><div><h3>Results</h3><div>The patients’ mean age was (41.7 ± 14.0) years old and the mean follow-up time was (29.6 ± 17.8) months. The chondral lesion size was (14.3 ± 4.1) mm. The cyst depth was (10.9 ± 3.7) mm. Significant improvements were observed in functional outcomes (according to the numeric rating scale for pain when walking and the American orthopedic foot and ankle society score) between the preoperative and latest follow-up evaluations, from 4.2 ± 2.1 to 2.2 ± 2.0 (<em>p</em> &lt; 0.001), and from 66.8 ± 12.9 to 83.2 ± 10.4, respectively (<em>p</em> &lt; 0.001). The overall satisfaction reached 8.3 of 10 points. All patients returned to sports and their median daily steps reached 8000 steps with 27 (81.8%) patients walking over 6000 steps daily. According to CT observation, “discontinuous bony articular surface and gap &gt; 1 mm” was found in 27 grafts (81.8%), and “below the level of the adjacent articular surface, ≤ 1 mm” in a third of the grafts. Abnormal height of bone filling affected numeric rating scale score (<em>p</em> = 0.049) and American Orthopedic Foot and Ankle Society score (<em>p</em> = 0.027). Of note, bone resorption or cystic changes appeared in up to 13 autografts (39.4%).</div></div><div><h3>Conclusions</h3><div>AOPT is an effective and acceptable technique for cystic OLT. Bone reconstruction is essential for large cystic OLT. How to get better bony articular reconstruction and avoid cyst recurrence should still be paid more attention.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 6","pages":"Pages 395-402"},"PeriodicalIF":1.8,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FM1-Editorial board","authors":"","doi":"10.1016/S1008-1275(24)00087-7","DOIUrl":"10.1016/S1008-1275(24)00087-7","url":null,"abstract":"","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 5","pages":"Page i"},"PeriodicalIF":1.8,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127524000877/pdfft?md5=f9ab6cb03a9fc5b7affcc310aad54534&pid=1-s2.0-S1008127524000877-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142083245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent spinal subdural hematoma following percutaneous kyphoplasty: A unique case report","authors":"Wen-Hui Liu,&nbsp;Xin-Min Lin,&nbsp;Xin-Yu Lu,&nbsp;Hai Han,&nbsp;Liang-Zhi Zhang,&nbsp;Hai-Xian Lin,&nbsp;Zi-Wen Liu","doi":"10.1016/j.cjtee.2024.08.005","DOIUrl":"10.1016/j.cjtee.2024.08.005","url":null,"abstract":"<div><div>Spinal intradural (subdural and subarachnoid) hematoma following percutaneous kyphoplasty is an extremely rare complication. In this report, we described a case of 2 episodes of subarachnoid hemorrhage with delayed paralysis after kyphoplasty. A 73-year-old man underwent percutaneous kyphoplasty in our hospital an osteoporotic vertebral fracture at the T12 level. On the 55 h after kyphoplasty for T12 osteoporotic vertebral fracture, he developed paralysis of the lower limbs. An emergency posterior decompression from T8 to L2 was performed. And the subarachnoid hematomas were removed. Postoperatively, the neurological symptoms improved rapidly. However, 2 weeks after the operation, the patient experienced a setback with severe neurological decline (paraplegia with sensory and autonomic dysfunction). An emergency posterior decompression from T5 to L2 was performed. The subarachnoid hematomas were removed. This case reflects the cause and progression of spinal subdural hematoma. Previous literature has debated the best treatment approach for spinal subarachnoid hemorrhage, but the prognosis of patients is heavily dependent on precise symptom evaluation and localization.</div></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 6","pages":"Pages 354-358"},"PeriodicalIF":1.8,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An experimental study of a novel external fixator based on universal joints for the rapid initial stabilization of mandibular comminuted fractures","authors":"Zhi-Qiang Hu ,&nbsp;Tai-Qiang Dai ,&nbsp;Lu Zhao ,&nbsp;Xun Li ,&nbsp;Xu Gong ,&nbsp;Hao Jia ,&nbsp;Hai-Tao Kong ,&nbsp;Bo-Lei Cai ,&nbsp;Shi-Ping Chang ,&nbsp;Lei Tian","doi":"10.1016/j.cjtee.2024.06.002","DOIUrl":"10.1016/j.cjtee.2024.06.002","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;p&gt;Shaping and assembling contemporary external fixators rapidly for the severe mandibular fractures remains a challenge, especially in emergency circumstance. We designed a novel external fixator that incorporates universal joints to provide the stabilization for mandibular comminuted fractures. This study aims to confirm the efficacy of this novel external fixator through biomechanical tests &lt;em&gt;in vitro&lt;/em&gt; and animal experiments.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;&lt;em&gt;In vitro&lt;/em&gt; biomechanical tests were conducted using 6 fresh canine with mandibular defect to simulate critical comminuted fractures. Three mandibles were stabilized by the novel external fixator and other mandibles were fixed by 2.5 mm reconstruction plates. All fixed mandibles were subjected to loads of 350 N on the anterior regions of teeth and 550 N on the first molar of the unaffected side. The stability was evaluated based on the maximum displacement and the slope of the load-displacement curve. In animal experiments, 9 beagles with comminuted mandibular fractures were divided into 3 groups, which were treated with the novel external fixation, reconstruction plate, and dental arch bar, respectively. The general observation, the changes in animals’ weight, and the surgical duration were recorded and compared among 3 groups. The CT scans were performed at various intervals of 0 day (immediately after the surgery), 3 days, 7 days, 14 days, 21 days, and 28 days to analyze the displacement of feature points on the canine mandible and situation of fracture healing at 28 days. The statistical significance was assessed by the two-way analysis of variance test followed by the Bonferroni test, enabling multiple comparisons for all tests using GraphPad Prism10.1.0 (GraphPad Inc, USA).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;The outcomes of the biomechanical tests indicated that no statistically significant differences were found in terms of the maximum displacement (&lt;em&gt;p&lt;/em&gt; = 0.496, 0.079) and the slope of load displacement curves (&lt;em&gt;p&lt;/em&gt; = 0.374, 0.349) under 2 load modes between the external and internal fixation groups. The animal experiment data showed that there were minor displacements of feature points between the external and internal fixation groups without statistic difference, while the arch bar group demonstrated inferior stability. The CT analysis revealed that the best fracture healing happened in the internal fixation group, followed by the external fixation and arch baring at 28 days after fixation. The external fixation group had the shortest fixation duration (25.67 ± 3.79) min compared to internal fixation ((70.67 ± 4.51) min, &lt;em&gt;p&lt;/em&gt; &lt; 0.001) and arch baring ((42.00 ± 3.00) min, &lt;em&gt;p&lt;/em&gt; = 0.046).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;p&gt;The conclusion of this study highlighted the efficacy and reliability of this novel external fixator in managing mandibular fractures rapidly, offering a viable option for the initial stabilization of comm","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 5","pages":"Pages 254-262"},"PeriodicalIF":1.8,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127524000786/pdfft?md5=6cc6bd0bf0faeffec971383e3b68797c&pid=1-s2.0-S1008127524000786-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141702826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A serial case study of the combined use of intraoperative CT and surgical navigation system for the removal of small foreign bodies in the maxillofacial region","authors":"Dong-Yang Ma ,&nbsp;Shu-Meng Zhang ,&nbsp;Chao-Yuan Pang ,&nbsp;Wen-Kai Zhang ,&nbsp;Bing-Wu Wang","doi":"10.1016/j.cjtee.2024.07.005","DOIUrl":"10.1016/j.cjtee.2024.07.005","url":null,"abstract":"<div><h3>Purpose</h3><p>The removal of small foreign bodies embedded within the deep soft tissues of the maxillofacial region is a complex and challenging task for maxillofacial surgeons. The purpose of this study was to explore the efficacy of the combination of intraoperative CT and surgical navigation for the removal of small foreign objects in the maxillofacial region.</p></div><div><h3>Methods</h3><p>A serial case study was conducted involving all consecutive patients who underwent surgical removal of small foreign bodies in the maxillofacial region. The combination of intraoperative CT and a surgical navigation system was used at a single medical institution from January 2018 to December 2022. Comprehensive data, including patient demographics, characteristics of the foreign bodies, previous surgical interventions, duration of the surgical procedure, and removal success rate were collected for this study. Relevant data were recorded into Microsoft Excel sheet and analyzed using SPSS version 22.0.</p></div><div><h3>Results</h3><p>Nine patients (6 males and 3 females) were included in this study, with an average age of 37 years. Each patient had previously undergone an unsuccessful removal attempt utilizing conventional surgical methods based on preoperative CT imaging or C-arm guidance at a local healthcare facility. Four patients also experienced unsuccessful attempts with preoperative CT image-based navigation systems. However, by employing the combined approach of intraoperative CT and surgical navigation, the foreign bodies were successfully removed in all 9 patients. The mean duration of the surgical procedure was 59 min, and the average size of the foreign bodies was approximately 26 mm³. Postoperative follow-up exceeding 6 months revealed no complications.</p></div><div><h3>Conclusion</h3><p>The combined use of a surgical navigation system and intraoperative CT represents a potent and effective strategy for the precise localization and subsequent removal of small foreign bodies from the soft tissue structures of the maxillofacial region. This integrative approach appears to increase the success rate of surgical interventions in such cases.</p></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 5","pages":"Pages 279-283"},"PeriodicalIF":1.8,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127524000774/pdfft?md5=0847c8cbc1ff91a7e3af144edf367cf5&pid=1-s2.0-S1008127524000774-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internal iliac artery ligation as a damage control method in hemodynamically unstable pelvic fractures: A systematic review of the literature","authors":"Hui Li,&nbsp;Tao Ai,&nbsp;Guang-Bin Huang,&nbsp;Jun Yang,&nbsp;Gong-Bin Wei,&nbsp;Jin-Mou Gao,&nbsp;Ping He,&nbsp;Xue-Mei Cao,&nbsp;Ding-Yuan Du","doi":"10.1016/j.cjtee.2024.07.004","DOIUrl":"10.1016/j.cjtee.2024.07.004","url":null,"abstract":"<div><h3>Purpose</h3><p>Internal iliac artery ligation (IIAL) has been used as a damage control procedure to treat hemodynamically unstable pelvic fracture for many years. However, there is ongoing debate regarding the effectiveness and safety of this hemostatic method. Therefore, we performed a systematic literature review to assess the efficacy and safety of IIAL for pelvic fracture hemostasis.</p></div><div><h3>Methods</h3><p>Three major databases, PubMed, Embase, and Google Scholar, were searched to screen eligible original studies published in English journals. Two reviewers independently read the titles, abstracts, and full texts of all literature. Articles were included if they reported the use and effects of IIAL.</p></div><div><h3>Results</h3><p>A total of 171 articles were initially identified, with 22 fully meeting the inclusion criteria. Among the analyzed cases, up to 66.7% of patients had associated abdominal and pelvic organ injuries, with the urethra being the most frequently injured organ, followed by the bowel. The outcomes of IIAL for achieving hemostasis in pelvic fractures were found to be satisfactory, with an effective rate of 80%. Hemorrhagic shock was the leading cause of death, followed by craniocerebral injury. Notably, no reports of ischemic complications involving the pelvic organs due to IIAL were found.</p></div><div><h3>Conclusion</h3><p>IIAL has a good effect in treating hemodynamically unstable pelvic fracture without the risk of pelvic organ ischemia. This procedure should be considered a priority for hemodynamically unstable pelvic fracture patients with abdominal organ injuries.</p></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 5","pages":"Pages 288-294"},"PeriodicalIF":1.8,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127524000762/pdfft?md5=baf39e90eba1df71efed5ca7247d451b&pid=1-s2.0-S1008127524000762-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141697990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative analysis of the protective performance of bicycle helmet with multi-direction impact protection system in oblique impact tests","authors":"Yong Han ,&nbsp;Hao Yang ,&nbsp;He Wu ,&nbsp;Di Pan ,&nbsp;Bing-Yu Wang","doi":"10.1016/j.cjtee.2024.03.002","DOIUrl":"10.1016/j.cjtee.2024.03.002","url":null,"abstract":"<div><h3>Purpose</h3><p>The current study aimed to assess the protective performance of helmets equipped with multi-directional impact protection system (MIPS) under various oblique impact loads.</p></div><div><h3>Methods</h3><p>Initially, a finite element model of a bicycle helmet with MIPS was developed based on the scanned geometric parameters of an actual bicycle helmet. Subsequently, the validity of model was confirmed using the KASK WG11 oblique impact test method. Three different impact angles (30°, 45°, and 60°) and 2 varying impact speeds (5 m/s and 8 m/s) were employed in oblique tests to evaluate protective performance of MIPS in helmets, focusing on injury assessment parameters such as peak linear acceleration (PLA) and peak angular acceleration (PAA) of the head.</p></div><div><h3>Results</h3><p>The results demonstrated that in all impact simulations, both assessment parameters were lower during impact for helmets equipped with MIPS compared to those without. The PAA was consistently lower in the MIPS helmet group, whereas the difference in PLA was not significant in the no-MIPS helmet group. For instance, at an impact velocity of 8 m/s and a 30° inclined anvil, the MIPS helmet group exhibited a PAA of 3225 rad/s² and a PLA of 281 g. In contrast, the no-MIPS helmet group displayed a PAA of 8243 rad/s² and a PLA of 292 g. Generally, both PAA and PLA parameters decreased with the increase of anvil angles. At a 60° anvil angles, PAA and PLA values were 664 rad/s² and 20.7 g, respectively, reaching their minimum.</p></div><div><h3>Conclusion</h3><p>The findings indicated that helmets incorporating MIPS offer enhanced protection against various oblique impact loads. When assessing helmets for oblique impacts, the utilization of larger angle anvils and rear impacts might not adequately evaluate protective performance during an impact event. These findings will guide advancements in helmet design and the refinement of oblique impact test protocols.</p></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 4","pages":"Pages 226-234"},"PeriodicalIF":1.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127524000282/pdfft?md5=787d8b5b461bf00e07af81ce12571e1b&pid=1-s2.0-S1008127524000282-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140137524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of muscle activation on lumbar injury under a specific +Gz load","authors":"Kang Lei ,&nbsp;Chen-Zhu Zhao ,&nbsp;Fan Li ,&nbsp;Shu-Lin Liu ,&nbsp;Peng Yang","doi":"10.1016/j.cjtee.2024.04.006","DOIUrl":"10.1016/j.cjtee.2024.04.006","url":null,"abstract":"<div><h3>Purpose</h3><p>The present study aimed to analyze the influence of muscle activation on lumbar injury under a specific +Gz load.</p></div><div><h3>Methods</h3><p>A hybrid finite element human body model with detailed lumbar anatomy and lumbar muscle activation capabilities was developed. Using the specific +Gz loading acceleration as input, the kinematic and biomechanical responses of the occupant's lower back were studied for both activated and deactivated states of the lumbar muscles.</p></div><div><h3>Results</h3><p>The results indicated that activating the major lumbar muscles enhanced the stability of the occupant's torso, which delayed the contact between the occupant's head and the headrest. Lumbar muscle activation led to higher strain and stress output in the lumbar spine under +Gz load, such as the maximum Von Mises stress of the vertebrae and intervertebral discs increased by 177.9% and 161.8%, respectively, and the damage response index increased by 84.5%.</p></div><div><h3>Conclusion</h3><p>In both simulations, the occupant's risk of lumbar injury does not exceed 10% probability. Therefore, the activation of muscles could provide good protection for maintaining the lumbar spine and reduce the effect of acceleration in vehicle travel direction.</p></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 4","pages":"Pages 218-225"},"PeriodicalIF":1.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127524000579/pdfft?md5=45ec2c3eabcb06166fbfc383a95e3f3c&pid=1-s2.0-S1008127524000579-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study on the application of diffuse axonal multi-axis general evaluation for brain injury assessment in small overlap barrier crash test","authors":"Zhi Fu ,&nbsp;Yi Chang ,&nbsp;Tao Xiong ,&nbsp;Wen-Kai Gao ,&nbsp;Kui Li ,&nbsp;Yu Liu","doi":"10.1016/j.cjtee.2024.04.005","DOIUrl":"10.1016/j.cjtee.2024.04.005","url":null,"abstract":"<div><h3>Purpose</h3><p>Head injury criterion (HIC) companied by a rotation-based metric was widely believed to be helpful for head injury prediction in road traffic accidents. Recently, the Euro-New Car Assessment Program utilized a newly developed metric called diffuse axonal multi-axis general evaluation (DAMAGE) to explain test device for human occupant restraint (THOR) head injury, which demonstrated excellent ability in capturing concussions and diffuse axonal injuries. However, there is still a lack of comprehensive understanding regarding the effectiveness of using DAMAGE for Hybrid Ⅲ 50th percentile male dummy (H50th) head injury assessment. The objective of this study is to determine whether the DAMAGE could capture the risk of H50th brain injury during small overlap barrier tests.</p></div><div><h3>Methods</h3><p>To achieve this objective, a total of 24 vehicle crash loading curves were collected as input data for the multi-body simulation. Two commercially available mathematical dynamic models, namely H50th and THOR, were utilized to investigate the differences in head injury response. Subsequently, a decision method known as simple additive weighting was employed to establish a comprehensive brain injury metric by incorporating the weighted HIC and either DAMAGE or brain injury criterion. Furthermore, 35 sets of vehicle crash test data were used to analyze these brain injury metrics.</p></div><div><h3>Results</h3><p>The rotational displacement of the THOR head is significantly greater than that of the H50th head. The maximum linear and rotational head accelerations experienced by H50th and THOR models were (544.6 ± 341.7) m/s², (2468.2 ± 1309.4) rad/s² and (715.2 ± 332.8) m/s², (3778.7 ± 1660.6) rad/s², respectively. Under the same loading condition during small overlap barrier (SOB) tests, THOR exhibits a higher risk of head injury compared to the H50th model. It was observed that the overall head injury response during the small overlap left test condition is greater than that during the small overlap right test. Additionally, an equation was formulated to establish the necessary relationship between the DAMAGE values of THOR and H50th.</p></div><div><h3>Conclusion</h3><p>If H50th rather than THOR is employed as an evaluation tool in SOB crash tests, newly designed vehicles are more likely to achieve superior performance scores. According to the current injury curve for DAMAGE and brain injury criterion, it is highly recommended that HIC along with DAMAGE was prioritized for brain injury assessment in SOB tests.</p></div>","PeriodicalId":51555,"journal":{"name":"Chinese Journal of Traumatology","volume":"27 4","pages":"Pages 200-210"},"PeriodicalIF":1.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1008127524000567/pdfft?md5=b4bde7a09029508e141e4f70f8e1e473&pid=1-s2.0-S1008127524000567-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141064557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}