Acceleration related injury of the cervical spine in restrained car drivers. Investigations on the trauma mechanism and severity of injury.

ABSTRACT

The analysis of 1,176 whiplash-type neck distortions was sought from a total of 3,838 restrained car driver incident reports. The percentage of these injuries increased from less than 10 % in 1985 to over 30 % in 1997. These occurred mostly with head-on or with multiple collisions, and only in 15 % with pure rear-end collisions. In 23,2 %, δv amounted 10 km/h or less, which corresponds to a very minor crash. The average δv was the highest in the cases of head-on collisions. Letters were sent to the injured to find out about the duration and type of complaints caused by a cervical spine injury. Of the 138 patients who returned the questionnaires, 121 (88 %) indicated that they had or were still suffering from their symptoms. Percentage of various complaints were as follows pain (74 %), tension (6 %) and stiffness (5 %) in the head (27 %), neck (55 %) and shoulder (8 %). The duration of the complaints was longest after multiple collisions and when the onset of complaints was later than 24 hours after trauma. Women and elderly persons predominated slightly in the group with longer duration of complaints. A correlation between the severity of the accompanying injuries and duration of complaints occurred. Also, with this retrospective study there was considerable difficulties in the lack of adequate follow-up for these patients with less severe injuries. In order to better evaluate this problem, prospective studies are necessary which include documentation of diagnosis, treatment protocols, duration and type of complaints.