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Knee Injuries in Restrained Car Drivers in German Road Traffic Accidents

Haasper, Carl MD; Otte, Dietmar ME; Knobloch, Karsten MD; Probst, Christian MD; Board, Timothy N. MD; Krettek, Christian MD, FRACS, FRCS; Richter, Martinus MD

The Journal of Trauma: Injury, Infection, and Critical Care: July 2008 - Volume 65 - Issue 1 - p 136-141
doi: 10.1097/TA.0b013e318166d72d
Original Articles

Background: The purpose of this study was to estimate the prevalence of knee injuries in real world car crashes in Germany. Restrained car drivers (RCD) were included in a medical and technical analysis to create a basis for preventive measures.

Methods: Technical and medical data were collected at the scene, shortly after the crash. Two time periods (group A, 1985–1993; group B, 1995–2003) were compared focusing on knee injuries [abbreviated injury scale (AISKnee)]. Technical analysis included type of collision, impact angle, and relative velocity. Medical analysis included injury pattern and severity (AIS, maximum AIS).

Results: About 5,972 RCD were included in this study from a total of 22,804 victims involved in 16,563 crashes. In total, severe injuries (AISKnee 2/3) occurred in 1.2% (82 patients) of all RCD. The knee injury prevalence significantly decreased over time (group A vs. B, p < 0.0001). A so-called dashboard injury was registered in 5.8% (n = 5).

Conclusions: The overall prevalence for knee injuries in RCD involved in road traffic accidents was low and decreased over time. Higher loads were necessary to cause ligamentous injuries of the knee than fractures in the knee region. Because direct impact caused most of the injuries, modifications of the interior and exterior design should reduce the incidence of these injuries. A dashboard injury was very rare.

From the Trauma Department (C.H., K.K., C.P., C.K., M.R.), Accident Research Unit (D.O.), Hannover Medical School, Hannover, Germany; Department for Trauma (M.R.), Orthopaedic and Foot Surgery, Coburg Clinical Center, Coburg, Germany; and Department of Trauma and Orthopaedics (T.N.B.), University of Manchester, Manchester, United Kingdom.

Submitted for publication October 31, 2006.

Accepted for publication December 31, 2007.

Address for reprints: Carl Haasper, MD, Trauma Department, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1/OE 6230, D-30625 Hannover, Germany; email:

© 2008 Lippincott Williams & Wilkins, Inc.