Dynamic Axial Tolerance of the Human Foot-Ankle Complex

Yoganandan, Narayan; Pintar, Frank A.; Boynton, Melbourne D.; Begeman, Paul C.; Prasad, Priya; Kuppa, Shashi; Morgan, Richard M.; Eppinger, Rolf H.

doi:10.4271/962426

Cited by 75 publications

(35 citation statements)

References 12 publications

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“…However, there was no clear description of the lower limb injury pattern, nor were there any results on the outcomes of these injuries. As a result, researchers in the field have resorted to extrapolating injury profiles from studies based on automotive impact loading conditions [24,25]. Based on these cadaveric studies, current NATO guidelines stipulate that the critical injury threshold for AV-mine tests is 5.4 kN, measured in the tibia component of a Hybrid III anthropometric test device [26].…”

Section: Current Clinical Focusmentioning

confidence: 99%

In-vehicle extremity injuries from improvised explosive devices: current and future foci

Ramasamy

Masouros

Newell

et al. 2011

Phil. Trans. R. Soc. B

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The conflicts in Iraq and Afghanistan have been epitomized by the insurgents' use of the improvised explosive device against vehicle-borne security forces. These weapons, capable of causing multiple severely injured casualties in a single incident, pose the most prevalent single threat to Coalition troops operating in the region. Improvements in personal protection and medical care have resulted in increasing numbers of casualties surviving with complex lower limb injuries, often leading to long-term disability. Thus, there exists an urgent requirement to investigate and mitigate against the mechanism of extremity injury caused by these devices. This will necessitate an ontological approach, linking molecular, cellular and tissue interaction to physiological dysfunction. This can only be achieved via a collaborative approach between clinicians, natural scientists and engineers, combining physical and numerical modelling tools with clinical data from the battlefield. In this article, we compile existing knowledge on the effects of explosions on skeletal injury, review and critique relevant experimental and computational research related to lower limb injury and damage and propose research foci required to drive the development of future mitigation technologies.

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Section: Current Clinical Focusmentioning

confidence: 99%

In-vehicle extremity injuries from improvised explosive devices: current and future foci

Ramasamy

Masouros

Newell

et al. 2011

Phil. Trans. R. Soc. B

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“…This low risk level is currently used for injury assessment capabilities in the military. 35,40 The present risk-specific and continuous distribution responses extracted from survival analysis will serve as a fundamental set for examining factors such as the role of posture from additional experiments and guide the military in the creation of an injury assessment capability for blast environments. A limitation of the study is that results are applicable to velocities shown in Table 1 and booted specimens.…”

Section: Discussionmentioning

confidence: 99%

“…Experimental studies have been used to quantify the external mechanical forces associated with these injuries, and to understand their mechanisms of injury. 4,11,18,33,40,43 A majority of this research has focused on loads simulating motor vehicle environments to the plantar surface of unembalmed post-mortem human surrogate (PMHS) preparations. No personal protective equipment had been used.…”

Section: Introductionmentioning

confidence: 99%

Foot–Ankle Fractures and Injury Probability Curves from Post-mortem Human Surrogate Tests

et al. 2016

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This purpose of this study was to replicate foot-ankle injuries seen in the military and derive human injury probability curves using the human cadaver model. Lower legs were isolated below knee from seventeen unembalmed human cadavers and they were aligned in a 90-90 posture (plantar surface orthogonal to leg). The specimens were loaded along the tibia axis by applying short-time duration pulses, using a repeated testing protocol. Injuries were documented using pre- and post-test X-rays, computed tomography scans, and dissection. Peak force-based risk curves were derived using survival analysis and accounted for data censoring. Fractures were grouped into all foot-ankle (A), any calcaneus (B), and any tibia injuries (C), respectively. Calcaneus and/or distal tibia/pilon fractures occurred in fourteen tests. Axial forces were the greatest and least for groups C and B, respectively. Times attainments of forces for all groups were within ten milliseconds. The Weibull function was the optimal probability distribution for all groups. Age was significant (p < 0.05) for groups A and C. Survival analysis-based probability curves were derived for all groups. Data are given in the body of paper. Age-based, risk-specific, and continuous distribution probability curves/responses guide in the creation of an injury assessment capability for military blast environments.

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“…Research on cadaver lower leg tolerance to fracture under dynamic axial impacts performed by Yoganandan et al [10], Seipel et al [8], Kuppa et al [5] and Funk et al [1], are very useful. In general, the loading mechanism acting on the lower leg during an AT mine strike and in frontal car crashes is comparable [2].…”

Section: Discussionmentioning

confidence: 99%

“…In the latter, axial loading is applied via the pedal or the toepan. Within a NATO working group [2] it has been decided to use the axial tibia load injury model developed by Yoganandan [10], which recognizes that age is an important factor in lower leg fracture tolerance. Because the specimens tested are usually old, the injury risk models developed without considering this factor [5,8] give severe tolerance values.…”

Section: Discussionmentioning

confidence: 99%

Occupant Lower Leg Injury Assessment in Landmine Detonations under a Vehicle

Horst

Simms

Maasdam

et al. 2005

IUTAM Symposium on Impact Biomechanics: From Fundamental Insights to Applications

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Abstract.Occupant safety has a high priority in peacekeeping military operations. During an anti tank (AT) mine detonation under a vehicle, the global and local impulse load threaten occupant safety. The proximity of the occupant's feet to the vehicle floor (through direct contact, or via pedals/foot rests) means that lower leg injuries occur frequently in AT mine strikes. Analysis of these injuries has proceeded with surrogate legs originally developed for automotive impacts. However, none of these has been validated for the loading conditions present in a mine strike. Recently, a combined experimental and numerical approach was used to obtain greater confidence in the injury assessment method with lower leg surrogates used in AT mine strike tests. Blast tests were performed using the standard Hybrid III dummy to study the differences between the standard Denton leg and the Thor lower leg model (Thor-Lx).Computational models of the test setups were created using a commercial multi-body code (Madymo) to investigate whether virtual testing could be used for future parameter studies in vehicle design. The current study focused on the validation of the Hybrid III Denton leg. The simulations showed good correspondence to the experimental data and are therefore suitable for use in injury assessment.

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Dynamic Axial Tolerance of the Human Foot-Ankle Complex

Cited by 75 publications

References 12 publications

In-vehicle extremity injuries from improvised explosive devices: current and future foci

In-vehicle extremity injuries from improvised explosive devices: current and future foci

Foot–Ankle Fractures and Injury Probability Curves from Post-mortem Human Surrogate Tests

Occupant Lower Leg Injury Assessment in Landmine Detonations under a Vehicle

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