Upper extremity injury patterns in side-impact crashes

The objective of this study was to characterize upper extremity injuries in side-impact motor vehicle collisions from Crash Injury Research and Engineering Network data obtained between 1998 and 2012. Side-impact crashes were defined as a principal direction of force between 60° and 120°, or 240° and 300°. Injuries were stratified by type, anatomic location, and Abbreviated Injury Scale severity. Occupant variables (age, sex, height, weight, body mass index, Injury Severity Score, number of injuries, seat position) and crash variables (delta-V, maximum crush, injury source, vehicle type, object struck, near-side/far-side) were included in the analyses. Statistical analysis of the data included descriptive statistics and bivariate regression analyses. There were 917 injuries among 413 occupants included in the analyses. The most common injury type was soft tissue injury (72.3%). The majority of fractures were to the clavicle (41.5%). The door was the most common injury source for upper extremity injuries (33.7%). Side-impact collisions have greater proximal upper extremity injury incidence compared to frontal impact collisions. Due to the high number and severity of upper extremity injuries resulting from contact to the door, we recommend further study on door structure safety. Mitigating upper extremity injuries in collisions will potentially improve functional outcomes and reduce human and economic costs.