Injury differences between small and large overlap frontal crashes.

Because small overlap impacts have recently emerged as a crash mode posing great injury risk to occupants, a detailed analysis of US crash data was conducted using the NASS/CDS and CIREN databases. Frontal crashes were subcategorized into small overlap impact (SOI) and large overlap impact (LOI) using crash and crush characteristics from the datasets. Injuries to head, spine, chest, hip and pelvis, and lower extremities were parsed and compared between crash types. MAIS 3+ occupants in NASS/CDS and CIREN demonstrated increased incidence of head, chest, spine, and hip/pelvis injuries in SOI compared to LOI. In NASS/CDS, subgaleal hematoma represented 48.6% of SOI head injury codes but 27.6% in LOI. Cervical spine posterior element fractures also represented greater proportions of SOI spine injuries (e.g., facet fractures: 27.8 vs. 14.0%), and proximal femur fractures represented a greater proportion of hip/pelvis injuries (e.g., intertrochanteric fracture: 32.5 vs. 11.8%). Tarsal/metatarsal fractures were a lesser proportion of lower extremity injuries in SOI compared to LOI. Occupant contact points inducing these injuries were observed in CIREN cases in some instances without compartment intrusion. These injuries suggest the substantial role of occupant kinematics in SOI which may induce suboptimal occupant restraint interaction.