Prediction of skull fracture risk for children 0-9 months old through validated parametric finite element model and...

Area of Science:

• Biomechanics
• Pediatric Trauma
• Forensic Science

Background:

• Pediatric skull fracture risk assessment tools are not well-established, primarily due to a scarcity of cadaver testing data.
• Previous pediatric cadaver drop tests by Weber lacked detailed injury measurements, limiting their direct application.
• Existing injury assessment tools often fail to account for morphological variations in pediatric skulls.

Purpose of the Study:

• To reconstruct historical pediatric cadaver drop tests using advanced finite element (FE) models.
• To develop skull fracture risk curves for infants aged 0-9 months.
• To evaluate the predictive accuracy of FE model-derived stress responses versus kinematic measures for pediatric skull fractures.

Main Methods:

• Reconstruction of 50 pediatric cadaver drop tests using parametric pediatric head FE models.
• Morphing FE models to match reported subject ages, head sizes/shapes, and skull thicknesses.
• Development of skull fracture risk curves using logistic regression analysis on model-predicted head injury measures.

Main Results:

• Model-predicted skull stress responses (von Mises stress, shear stress, first principal stress) were superior predictors of pediatric skull fracture compared to kinematic measures (peak head acceleration, head injury criterion [HIC]).
• Skull fracture risk curves were successfully developed for infants aged 0-9 months.
• The study confirmed the feasibility of using individualized FE models for predicting pediatric head injuries.

Conclusions:

• Age- and size/shape-appropriate head FE models are feasible for predicting pediatric head injuries.
• FE models can capture morphological variations crucial for accurate injury prediction, outperforming single generic models.
• This approach enhances the understanding of pediatric skull fracture biomechanics and improves injury assessment.