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Crash analysis of lower extremity injuries in children restrained in forward-facing car seats during front and rear
Tellen D Bennett1, Robert Kaufman, Melissa Schiff
1Department of Pediatrics, University of Washington, Seattle, Washington, USA.
Insights
Children in forward-facing car seats can sustain lower extremity injuries from impacting the car interior during severe crashes. Proper car seat securing is crucial to prevent these injuries.
Area of Science:
- Pediatric trauma
- Automotive safety engineering
- Biomechanics of injury
Background:
- Limited data exists on lower extremity injuries in children using forward-facing car seats during frontal and rear impacts.
- Understanding these injuries is crucial for improving child occupant protection.
Purpose of the Study:
- To describe the mechanism, crash characteristics, and spectrum of lower extremity injuries in children using forward-facing car seats.
- To identify risk factors and injury patterns associated with these types of crashes.
Main Methods:
- Analysis of crash reconstructions from the Crash Injury Research and Engineering Network (CIREN) for injury mechanisms.
- Evaluation of children aged 1-4 years with lower extremity injuries from the National Automotive Sampling System (NASS) Crashworthiness Data System (CDS) database.
- Inclusion of data from frontal and rear impact cases.
Main Results:
- Crash reconstructions indicated leg contact with front seatbacks as a likely injury mechanism.
- Fifteen children in forward-facing car seats sustained lower extremity injuries, primarily in frontal impacts (11/15) and rear seating positions (13/15).
- Five children were in unbelted or improperly secured car seats; Injury Severity Scores ranged from 5 to 50.
Conclusions:
- Children in forward-facing car seats are at risk of lower extremity injuries from impacting vehicle interior components during severe frontal or rear crashes.
- Crash scene photography can aid in identifying at-risk anatomical sites and potential subtle injuries.
- Properly securing car seats is essential to mitigate injury risk.
Background:
The mechanism, crash characteristics, and spectrum of lower extremity injuries in children restrained in forward-facing car seats during front and rear impacts have not been described.
Methods:
We identified in two databases children who sustained lower extremity injuries while restrained in forward-facing car seats. To identify the mechanism, we analyzed crash reconstructions from three frontal-impact cases from the Crash Injury Research and Engineering Network. To further describe the crash and injury characteristics we evaluated children between 1 and 4 years of age with lower extremity injuries from front or rear impacts in the National Automotive Sampling System (NASS) Crashworthiness Data System (CDS) database.
Results:
Crash reconstruction data demonstrated that the likely mechanism of lower extremity injury was contact between the legs and the front seatbacks. In the CDS database, we identified 15 children with lower extremity injuries in a forward-facing child seat, usually (13 out of 15) placed in the rear seat, incurred in frontal impacts (11 out of 15). Several (5 out of 15) children were in unbelted or improperly secured forward-facing car seats. Injury Severity Scores varied widely (5-50).
Conclusions:
Children in forward-facing car seats involved in severe front or rear crashes may incur a range of lower extremity injury from impact with the car interior component in front of them. Crash scene photography can provide useful information about anatomic sites at risk for injury and alert emergency department providers to possible subtle injury.
