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Injury to the knee in car accidents
268
Injury
are surveyed. In many pancreatic or duodenal injuries there are alternatives to this extreme step. STURM,J. T., QUATTLEBAUM, F. W., MOWLEM,A., and PERRY, _I. F. (1973), ‘ Patterns of injury requiring pancreatoduodenectomy ‘, Surgery Gynec. Obstet., 137, 629. Organization Prevention Experience
Topics
with
and Accident
mass casualties
Describing the organization dealing with 38 dead and 83 wounded in ai American prison. WILLIAMS.R. W.. BURNS.G. P.. ANDERSEN. M. N.. READING, 6. P., BORDER, j. R., MINDELL, E.‘R., and SCHENK, W. G., jun. (1974), ‘ Mass casualties in a maximum security institution ‘, Ann. Surg., 179, 592. Accident
proneness
Rodstein of New York describes the clinical syndrome of accident proneness with particular reference to car accidents. This condition is a personal idiosyncrasy which predisposes certain individuals to a high accident rate. Such individuals have considerable psychopathology and frequently have the following characteristics: male youth with early exposure to violence, unhappy family life, tendency to lie and steal. In adults there is an abnormal marital relationship, or sexual conflict, divorce, frequent change of job, irresponsibility and aggressiveness. The person with frequent automobile accidents is usually male, younger than average, often drunk, and comes from a disturbed background. The basis of the proneness is a conflict with authority and the unconsciously provoked accident is an expression of resentment and revenge with the expression of destruction of self or others, monetary gain from insurance claim and the possibility of attention and sympathy. It occurs in people with a distinctive personality profile. RODSTEIN, M. (1974), ’ Accident proneness ‘, J.A.M.A.,
229, 1495.
The air bag
There are 1871 cars in the USA that have been fitted with the protective air bag and 16 of them have been involved in accidents severe enough to inflate the bag (it inflates within 40 milliseconds of impact). These cars have travelled 50 million miles and none of the accidents resulted in serious injury, except in one case where sharp deceleration (without impact) did not cause the bag to inflate. Stunt drivers were only bruised when they drove their car into a solid barrier at 25 m.p.h. Analysis of experience so far shows that the noise of inflation did not cause auditory damage. There were no contusions from the bag itself. The fear that the deflated bag after impact might become draped over the driver’s head was not borne out. The sensor is set to act on a 15 m.p.h. barrier crash and is sensitive to impact within an arc 30” on each
: the
British Journal of Accident
Surgery Vol. ~/NO. 3
side of the car. The bag costs about flO0 and is only fitted to large luxury cars. These facts were given by Drs Frankel and States and are rather impressive. They predict, however, that air bag systems may not become available for some time and they recommend safety harness which has been so successful in Australia since the use of them became compulsory. Air bags win passing marks in tests with humans at the wheel. FRANKEL,V. H. (1974), J.A.M.A., 227, 1109. Injury
to the knee in car accidents
The knee is the most likely area to be injured in a car accident. Professor Nagel from Stanford, California reports on the findings in 74 accidents involving 222 people, 153 of whom were injured. About half of these had knee injuries from contact with the dashboard. Fifty-one of the 80 injured knees were classed ‘ mild ‘, 10 had lacerations in front of the knee and patellar fractures and 8 had ‘ severe ’ injuries, fractures into the knee joint or cruciate ligament tears. Seat belts minimized the trauma but were of no value when the impact pushed the dashboard backwards against the knee. He explained the fact that some knee injuries occurred when belts were worn too loosely or when they stretched too much on stress. Older people were prone to fractures of the tibia1 plateaux, whereas cruciate ligament injuries occurred in young people. Drivers’ knees often suffer badly in accidents. NAGEL, D. A. (1974), J.A.M.A.,227,111. Intensive
care
The British Journal of Hospital Medicine, 11, No. 6 (June, 1974) has the following articles on this subiect. ‘The’ Organization, design and staffing of intensive therapy units ‘_ 1. R. VERNER,p. 828. ’ Respiratory problems in intensive care units ‘. J. C. ST~DDARD,p. 832. ‘ Renal aspects of intensive care ‘. V. PARSONS,p. 843. ‘The bacteriology of intensive care ‘. H. GAYA, p. 853. ‘ Metabolic aspects of intensive care ‘. S. P. ALLISON, p. 860. Psychological aspects of intensive care ‘. S. BAXTER, p. 875. In this last article it is interesting to see that there is little mention of relatives and none of medical social workers. Organization
of an accident
department
Dr Hardy writes as a ‘ temporary medical assistant of long experience, if of no other desirable qualifications ‘, of one of the hundred odd departments in Britain with fewer than 25,000 new patients a year. His department’s relationship with the general practitioners is such that it has few general medical cases to deal with. Three-quarters of the patients had suffered injury, mostly mild and well within the
Injury
are surveyed. In many pancreatic or duodenal injuries there are alternatives to this extreme step. STURM,J. T., QUATTLEBAUM, F. W., MOWLEM,A., and PERRY, _I. F. (1973), ‘ Patterns of injury requiring pancreatoduodenectomy ‘, Surgery Gynec. Obstet., 137, 629. Organization Prevention Experience
Topics
with
and Accident
mass casualties
Describing the organization dealing with 38 dead and 83 wounded in ai American prison. WILLIAMS.R. W.. BURNS.G. P.. ANDERSEN. M. N.. READING, 6. P., BORDER, j. R., MINDELL, E.‘R., and SCHENK, W. G., jun. (1974), ‘ Mass casualties in a maximum security institution ‘, Ann. Surg., 179, 592. Accident
proneness
Rodstein of New York describes the clinical syndrome of accident proneness with particular reference to car accidents. This condition is a personal idiosyncrasy which predisposes certain individuals to a high accident rate. Such individuals have considerable psychopathology and frequently have the following characteristics: male youth with early exposure to violence, unhappy family life, tendency to lie and steal. In adults there is an abnormal marital relationship, or sexual conflict, divorce, frequent change of job, irresponsibility and aggressiveness. The person with frequent automobile accidents is usually male, younger than average, often drunk, and comes from a disturbed background. The basis of the proneness is a conflict with authority and the unconsciously provoked accident is an expression of resentment and revenge with the expression of destruction of self or others, monetary gain from insurance claim and the possibility of attention and sympathy. It occurs in people with a distinctive personality profile. RODSTEIN, M. (1974), ’ Accident proneness ‘, J.A.M.A.,
229, 1495.
The air bag
There are 1871 cars in the USA that have been fitted with the protective air bag and 16 of them have been involved in accidents severe enough to inflate the bag (it inflates within 40 milliseconds of impact). These cars have travelled 50 million miles and none of the accidents resulted in serious injury, except in one case where sharp deceleration (without impact) did not cause the bag to inflate. Stunt drivers were only bruised when they drove their car into a solid barrier at 25 m.p.h. Analysis of experience so far shows that the noise of inflation did not cause auditory damage. There were no contusions from the bag itself. The fear that the deflated bag after impact might become draped over the driver’s head was not borne out. The sensor is set to act on a 15 m.p.h. barrier crash and is sensitive to impact within an arc 30” on each
: the
British Journal of Accident
Surgery Vol. ~/NO. 3
side of the car. The bag costs about flO0 and is only fitted to large luxury cars. These facts were given by Drs Frankel and States and are rather impressive. They predict, however, that air bag systems may not become available for some time and they recommend safety harness which has been so successful in Australia since the use of them became compulsory. Air bags win passing marks in tests with humans at the wheel. FRANKEL,V. H. (1974), J.A.M.A., 227, 1109. Injury
to the knee in car accidents
The knee is the most likely area to be injured in a car accident. Professor Nagel from Stanford, California reports on the findings in 74 accidents involving 222 people, 153 of whom were injured. About half of these had knee injuries from contact with the dashboard. Fifty-one of the 80 injured knees were classed ‘ mild ‘, 10 had lacerations in front of the knee and patellar fractures and 8 had ‘ severe ’ injuries, fractures into the knee joint or cruciate ligament tears. Seat belts minimized the trauma but were of no value when the impact pushed the dashboard backwards against the knee. He explained the fact that some knee injuries occurred when belts were worn too loosely or when they stretched too much on stress. Older people were prone to fractures of the tibia1 plateaux, whereas cruciate ligament injuries occurred in young people. Drivers’ knees often suffer badly in accidents. NAGEL, D. A. (1974), J.A.M.A.,227,111. Intensive
care
The British Journal of Hospital Medicine, 11, No. 6 (June, 1974) has the following articles on this subiect. ‘The’ Organization, design and staffing of intensive therapy units ‘_ 1. R. VERNER,p. 828. ’ Respiratory problems in intensive care units ‘. J. C. ST~DDARD,p. 832. ‘ Renal aspects of intensive care ‘. V. PARSONS,p. 843. ‘The bacteriology of intensive care ‘. H. GAYA, p. 853. ‘ Metabolic aspects of intensive care ‘. S. P. ALLISON, p. 860. Psychological aspects of intensive care ‘. S. BAXTER, p. 875. In this last article it is interesting to see that there is little mention of relatives and none of medical social workers. Organization
of an accident
department
Dr Hardy writes as a ‘ temporary medical assistant of long experience, if of no other desirable qualifications ‘, of one of the hundred odd departments in Britain with fewer than 25,000 new patients a year. His department’s relationship with the general practitioners is such that it has few general medical cases to deal with. Three-quarters of the patients had suffered injury, mostly mild and well within the