Patterns of injury to restrained children in side impact motor vehicle crashes: the side impact syndrome

J Trauma. 2003 Jun;54(6):1094-101. doi: 10.1097/01.TA.0000067288.11456.98.


Background: Injury patterns among children in frontal collisions have been well documented, but little information exists regarding injuries to children in side impact collisions.

Methods: Restrained children 14-years-old or younger admitted to the hospital for crash injuries were analyzed. Data concerning injuries, medical treatment, and outcome were correlated with crash data. Case reviews achieved consensus regarding injury contact points. Side impacts were compared with frontal impacts. These results were then compared with data from the National Automotive Sampling System.

Results: There were no differences between the groups with respect to age, sex, restraint type, or seat position. Compared with frontal crashes, children in side impacts were more likely to have an Injury Severity Score > 15 (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.7-5.8) and were more likely to have Abbreviated Injury Scale score 2+ injuries to the head (OR, 2.5; 95% CI, 1.4-4.4), chest (OR, 4.0; 95% CI, 2.0-8.0), and cervical spine (OR, 3.7; 95% CI, 1.2-11.3). When compared with National Automotive Sampling System data, similar trends were seen regarding Abbreviated Injury Scale score 2+ injuries to the head, chest, and extremities.

Conclusion: In this study population, side impacts resulted in more injuries to the head, cervical spine, and chest. Knowledge of this pattern-the side impact syndrome-can help guide diagnosis, treatment, and prevention strategy.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Accidents, Traffic / classification
  • Accidents, Traffic / statistics & numerical data*
  • Adolescent
  • Age Distribution
  • Child
  • Child, Preschool
  • Cohort Studies
  • District of Columbia / epidemiology
  • Female
  • Humans
  • Infant
  • Injury Severity Score
  • Male
  • Seat Belts / statistics & numerical data*
  • Sex Distribution
  • Wounds and Injuries / classification
  • Wounds and Injuries / epidemiology*