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Abstract: Introduction: In the U.S. alone, an estimated 30,000 knee–thigh–hip (KTH) injuries occur annually in frontal motor vehicle collisions. These fractures typically occur through occupant contact with the vehicle''s knee bolster. Research has suggested that knee airbags (KABs) can mitigate the forces sustained during this contact, resulting in decreased injury risk; however, previous research has been limited by small sample sizes or by occurring in a controlled setting. The objective of the current study is to determine the effectiveness of KABs on KTH fracture risk using nationally representative, real-world data. Methods: Using combined data from the Crash Injury Research and Engineering Network and the National Automotive Sampling Survey, a matched cohort study was conducted among front-seat occupants of vehicles involved in a frontal collision occurring from 2000 to 2009. Occupants exposed to a KAB deployment were matched to occupants with no KAB deployment based on age ±5 years, sex, seatbelt use, vehicle seating position (i.e., driver or front passenger), car vehicle body type, collision impact, and sampling weight. A Cox proportional hazards model was used to calculate risk ratios (RRs) and associated 95% confidence intervals (95% CI) to estimate the association between KAB deployment and lower extremity fracture risk. Results: There was no association between KAB deployment and risk of lower extremity fracture (RR 0.83, 95% CI 0.52–1.31). A notable pattern in fracture risk, though not statistically significant, was observed, with a decreased risk of hip (RR 0.72, 95% CI 0.26–1.97) and thigh fracture (RR 0.81, 95% CI 0.32–2.05), and an increased risk of tibia/fibula (RR 1.23, 95% CI 0.52–2.90) and foot fracture (RR 1.96, 95% CI 0.72–5.32). Conclusions: The results of the current study suggest that KABs are not associated with the risk of lower extremity fractures. However, given the small sample size of the current study, it is difficult to definitively say whether the observed injury pattern is representative of the true pattern. [Copyright &y& Elsevier]

Abstract: Airbag-based methods for crew impact attenuation have been highlighted as a potential simple, lightweight means of enabling safe land-landings for the Orion Crew Exploration Vehicle, and the next generation of ballistic shaped spacecraft. To investigate the feasibility of this concept during a nominal 7.62m/s Orion landing, a full-scale personal airbag system 24% lighter than the Orion baseline has been developed, and subjected to 38 drop tests on land. Through this effort, the system has demonstrated the ability to maintain the risk of injury to an occupant during a 7.85m/s, 0° impact angle land-landing to within the NASA specified limit of 0.5%. In accomplishing this, the personal airbag system concept has been proven to be feasible. Moreover, the obtained test results suggest that by implementing anti-bottoming airbags to prevent direct contact between the system and the landing surface, the system performance during landings with 0° impact angles can be further improved, by at least a factor of two. Additionally, a series of drop tests from the nominal Orion impact angle of 30° indicated that severe injury risk levels would be sustained beyond impact velocities of 5m/s. This is a result of the differential stroking of the airbags within the system causing a shearing effect between the occupant seat structure and the spacecraft floor, removing significant stroke from the airbags. [Copyright &y& Elsevier]

Introduction: High-speed motor vehicle accidents (MVAs) are an important cause of brachial plexus injury (BPI). Some case reports have demonstrated shoulder seat belt use resulting in traction injuries to the brachial plexus. We used a national trauma registry to determine the association between seat belt use and brachial plexus injury in MVAs., Methods: The authors queried the National Trauma Databank between 2016 and 2017 for patients with a hospital admission following an MVA. Cases with BPI were identified using International Classification of Diseases, Tenth Edition, Clinical Modification, diagnosis codes. Case-control matching by age and sex was performed to identify 2 non-BPI controls for every case of BPI. Multivariable conditional logistic regression adjusting for body mass index, alcohol use, and drug use was then performed to determine the adjusted association between safety equipment use (seat belt use and airbag deployment) and BPI., Results: A total of 526,007 cases of MVAs were identified, of which 704 (0.13%) sustained a BPI. The incidences of BPI in patients were the following without any protective device (0.16%), with airbag deployment alone (0.08%), with seat belt use alone (0.08%), and with combined airbag deployment and seat belt use (0.07%). Following 1:2 case-control matching by age and sex and multivariable conditional logistic regression, seat belt use (odds ratio [OR] 0.55; 95% confidence interval [CI] 0.42-0.71; P < 0.001) and airbag deployment (OR 0.52; 95% CI 0.33-0.82; P = 0.004) were found to be associated with decreased odds for BPI, with the least odds observed with combined seat belt use and airbag deployment (OR 0.49; 95% CI 0.33-0.74; P = 0.001)., Conclusions: Despite anecdotal evidence suggesting increased likelihood of BPI with shoulder seat belt use, case-control analysis from a national trauma registry demonstrated that both seat belt use and airbag deployment are associated with lower odds of sustaining BPIs in MVAs, with the greatest protective effect observed with combined use. Future studies adjusting for rider location (passenger vs. driver) and other potential confounders such as make, type and speed of vehicle may help further characterize this association., (Copyright © 2021 Elsevier Inc. All rights reserved.)