Importancia de la biomecánica del impacto en la valoración pericial del síndrome del latigazo cervical

  1. Carlos Represas Vázquez 1
  2. José Ignacio Muñoz Barús 2
  3. Aurelio Luna Maldonado 3
  1. 1 Medicina Legal y Forense, A Coruña
  2. 2 Universidade de Santiago de Compostela
    info

    Universidade de Santiago de Compostela

    Santiago de Compostela, España

    ROR https://ror.org/030eybx10

  3. 3 Universidad de Murcia
    info

    Universidad de Murcia

    Murcia, España

    ROR https://ror.org/03p3aeb86

Mostrar afiliaciones +
Revista:
Revista española de medicina legal: órgano de la Asociación Nacional de Médicos Forenses

ISSN: 0377-4732

Año de publicación: 2016

Volumen: 42

Número: 2

Páginas: 72-80

Tipo: Artículo

DOI: 10.1016/J.REML.2015.10.001 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Revista española de medicina legal: órgano de la Asociación Nacional de Médicos Forenses

Objetivos de desarrollo sostenible

Resumen

Argumentos de diferente naturaleza (impacto epidemiológico, indefinición diagnóstica, ausencia de pruebas objetivas de daño) justifican la necesidad de la biomecánica del impacto en el diagnóstico médico-legal de causalidad del síndrome postraumático cervical (whiplash associated dissorders) en terminología anglosajona. Su investigación biomecánica tiene dos etapas bien definidas de interés médico-legal: la investigación en laboratorio (animales, cadáveres, y fundamentalmente voluntarios) y el estudio de colisiones reales, a lo que ha contribuido el desarrollo de dispositivos de recogida de datos. Esta investigación ha permitido identificar parámetros físicos de la colisión (cambio de velocidad, aceleración) relacionados con el riesgo de lesiones cervicales, así como otros factores de riesgo. Aunque la utilización médico-legal de los umbrales que delimitan el riesgo de lesión poblacional no es pacífica en la literatura, existen suficientes evidencias que permiten individualizar estos umbrales de riesgo de lesión en el diagnóstico médico-legal de la causalidad, si bien exige un profundo conocimiento.

Referencias bibliográficas

  • 1 C. Arregui-Dalmases, R. Teijeira, M.C. Rebollo-Soria, J.R. Kerrigan, J.R. Crandall La biomecánica del impacto: una herramienta para la medicina en la investigación del accidente de tráfico Rev Esp Med Leg, 37 (2011), pp. 97-104 Article Download PDF
  • 2 R. Howard, R. Harding, S. Krenrich The biomechanics of whiplash in low velocity collisions. SAE paper no. 1999-01-3235 Society of Automotive Engineers (1999)
  • 3 K. Schmitt, P. Niederer, F. Walz Trauma biomechanics introduction to accidental injury (3.ª ed.), Springer, Berlin (2009)
  • 4 M. Freeman, S. Kholes Applications and limitations of forensic biomechanics: a Bayesian perspective J Forensic Leg Med, 17 (2010), pp. 67-77 Article Download PDF
  • 5 M. Curatolo, N. Bogduk, P. Ivancic, S. McLean, G. Siegmund, B. Winkelstein The role of tissue damage in whiplash associated disorders Spine, 36 (Suppl.) (2011), pp. S309-S315
  • 6 C. Worsflod When range of motion is not enough: towards an evidence-based approach to medico-legal reporting in whiplash injury J Forensic Leg Med, 17 (2010), pp. 67-77
  • 7 A. Morris, P. Thomas Neck injuries in the UK co-operative crash study J. Pike (Ed.), Neck injury biomechanics, SAE International, Warrendale (2009), pp. 253-265
  • 8 L. Strender, M. Lundin, K. Nell Interexaminer reliability in physical examination of the neck J Manip Physiol Ther, 20 (1997), pp. 516-520
  • 9 M. Seffinger, W. Najm, S. Mishra, A. Adams, V.M. Dickerson, L. Murphy, et al. Reliability of spinal palpation for diagnosis of back and neck pain: a systematic review of the literature Spine (Phila Pa 1976), 29 (2004), pp. 413-425
  • 10 J. Pool, J. Hoving, H. de Vet, H. van Mameren, L. Bouter The interexaminer reproducibility of physical examination of the cervical spine J Manip Physiol Ther, 27 (2004), pp. 84-90 Article Download PDF
  • 11 J. Maigne, F. Chantelot, G. Chatellier Interexaminer agreement of clinical examination of the neck in manual medicine Ann Phys Rehabil Med, 52 (2009), pp. 41-48 Article Download PDF
  • 12 S. Haldeman, L. Carroll, D. Cassidy A best evidence synthesis on neck pain: findings, from the bone and Joint decade 2000-2010: task force on neck pain and its associated disorders Spine, 33 (Suppl.) (2008), pp. S1-S220
  • 13 C. Represas, D.N. Vieira, T. Magalhães, R. Dias, S. Frazão, J.M. Suárez-Peñaranda, et al. No cash no whiplash?: influence of the legal system on the incidence of whiplash injury J Forensic Leg Med, 15 (2008), pp. 353-355 Article Download PDF
  • 14 P. Capilla, H. González Simulación en patología dolorosa crónica del raquis cervical (cervicalgia/esguince cervical) Rev Esp Med Leg, 38 (2012), pp. 76-84
  • 15 R. Banks, R. Harding, H. Smith Assessing injury potential in rear-end vehicle collisions N. Yoganandan, F. Pintar (Eds.), Frontiers in whiplash trauma, IOS Press, Amsterdam (2000), pp. 25-40
  • 16 M. Elbel, M. Kramer, M. Huber-Lang, E. Hartwig, C. Dehner Deceleration during real life motor collisions – a sensitive predictor for the risk of sustaining a cervical spine injury? Patient Saf Surg, 3 (2009), pp. 1-8
  • 17 K. Schmitt, F. Walz, D. Vetter, M. Muser Whiplash injury: cases with a long period of sick leave need biomechanical assessment Eur Spine J, 12 (2003), pp. 247-254
  • 18 A. Luna, C. Represas Traumatismos cervicales leves. Criterios de causalidad. Aplicación de los estudios biomecánicos Responsab Civil, 8 (2013), pp. 38-44
  • 19 N. Nishimura, C. Simms, D. Wood Impact characteristics of a vehicle population in low speedy front to rear collisions Accid Anal Prev, 79 (2015), pp. 1-12 Article Download PDF
  • 20 C. Arregui, M. Seguí, J. Luzón, F.J. López Fundamentos de biomecánica en las lesiones por accidente de tráfico Etrasa ed., Madrid (2012)
  • 21 J. Forman, F. López-Valdés, S. Duprey, D. Bose, E. del Pozo de Diós, D. Subit, et al. The tolerante of the human body to automobile collision impact–a systematic review of injury biomechanics research, 1999–2009 Accid Anal Prev, 80 (2015), pp. 7-17 Article Download PDF
  • 22 A. Kullgren, H. Stigson, M. Krafft Development of whiplash associated disorders for male and female car occupants in cars launched since the 80s in different impact directions IRCOBI Conference on the Biomechanics of Impact (2013)
  • 23 A. Linder, M. Avery, M. Krafft, A. Kullgren Change of velocity and pulse characteristics in rear impact: real world and vehicle tests data Enhanced Safety of Vehicles (ESV) Conference (2003)
  • 24 S. Imler, M. Heller, C. Raasch, H. Watson, J. Zhao The effect of rear impact collision delta-v and restraint satuts on injury autcome. SAE paper n.°. 2014-01-0524 Society of Automotive Engineers (2014)
  • 25 M. Freeman, L. Nordhoff Jr. Crash speedy and injury risk: epidemiologic and forensic considerations L. Nordhoff Jr. (Ed.), Motor vehicle collision injuries. Biomechanics, diagnosis and management (2.ª ed.), Jones and Bartlett Publishers, Boston (2005), pp. 363-389
  • 26 A. Bartsch, L. Gilbertson, V. Prakash, D. Morr, J. Wiechel Minor crashes and whiplash in the United States 52ª AAAM Conference (2008)
  • 27 P. Niehoff, H. Gabler The accuracy of winsmash delta-v estimates: the influence of vehicle type, stiffness, and impact mode Annu Proc Assoc Adv Automot Med, 50 (2006), pp. 70-86
  • 28 M. Svensson Neck injuries in car collisions: injury mechanisms Proc. Injury in Low Velocity Collision Conference (2005)
  • 29 A. Linder, M. Avery, M. Krafft, A. Kullgren, M. Svensson Acceleration pulses and crash severity in low velocity rear impacts – real World data and barrier tests Enhanced Safety of Vehicles (ESV) Conference (2001)
  • 30 M. Krafft, A. Kullgren, S. Malm, A. Ydenius Influence of crahs severity on various whiplash injury symptoms: a study on reale-life rear-end crashes with recorder crash pulses Enhanced Safety of Vehicles (ESV) Conference (2005)
  • 31 S. Himmetoglu The influence of crash pulse shape on seat-ocuppant response in rear impacts Expert Simposium on Accidente Research (ESAR) Conference (2010)
  • 32 T. McClune, A. Burton, G. Waddell Whiplash associated disorders: a review of the literature to guide patient information and advice Emerg Med J, 19 (2002), pp. 499-506
  • 33 W. McConnell, R. Howard, J. Van Poppel, R. Krause, H. Guzman, J. Bomar, et al. Human head and neck kinematics alter low velocity rear-end impactos – understanding whiplash J. Pike (Ed.), Neck injury biomechanics, SAE International, Warrendale (2009), pp. 163-181
  • 34 T. Szabo, J. Welcher Human subject kinematics and electromyographic activity turing low speedy rear impacts J. Pike (Ed.), Neck injury biomechanics, SAE International, Warrendale (2009), pp. 517-537
  • 35 W. Castro, M. Schilgen, S. Meyer, M. Weber, C. Peuker, K. Wörtler Do whiplash injuries occur in low speedy rear impacts? Eur Spine J, 6 (1997), pp. 366-375
  • 36 J. Brault, J. Wheeler, G. Siegmund, E. Brault Clinical response of human subjetcs t orear-end automobile collisions Arch Phys Med Rehabil, 79 (1998), pp. 72-80 Article Download PDF
  • 37 C.H. Davis Rear-end impacts: vehicle and occupant response J Manip Physiol Ther, 21 (1998), pp. 629-639
  • 38 E. Schuller, W. Eisenmerger, G. Beier Whiplash injury in low speed car accidents: assessment of biomechanical cervical spine loading and injury prevention in a forensic sample J Musculoskelet Pain, 8 (2000), pp. 55-67
  • 39 A. Tencer, S. Mirza, P. Cummings Do “whiplash” victims with neck pain differ from those with neck pain and other symptoms Annu Proc Assoc Adv Automot Med, 45 (2001), pp. 203-214
  • 40 M. Krafft, A. Kullgren, A. Ydenius, C. Tingvall Influence of crash pulse characteristics on whiplash assossiated disorders in rear impacts – crash recording in real-life impacts Traffic Inj Prev, 3 (2002), pp. 141-149
  • 41 P. Hoyes, B. Henderson A study and comparison of the effects of low speed change vehicle collisions on the human body Accid Anal Prev, 51 (2013), pp. 318-324 Article Download PDF
  • 42 C.H. Davis Injury threshold: whiplash associated disorders J Manip Physiol Ther, 23 (2000), pp. 420-427 Article Download PDF
  • 43 A. Croft, M. Freeman Correlating crash severity with injury risk, injury severity, and long-term symptoms in low velocity motor vehicle collisions Med Sci Monit, 11 (2005), pp. 316-321
  • 44 J. Kieser, M. Taylor, D. Carr Forensic biomechanics (1.ª ed.), Wiley-Blackwell ed., West Sussex (2013)
  • 45 M. Freeman Biomechanical, mechanical, and epidemiologic characteristics of low-speed rear-impact collisions American Academy of Forensic Sciences (AAFS) Conference (2015)
  • 46 F. Walz, M. Muser Biomechanical assessment of soft tissue cervical spine disorderes and expert opinion in low speed collisions Accid Anal Prev, 32 (2000), pp. 161-165 Article Download PDF
  • 47 D. Gabauer, H. Gabler Comparision of delta-v and occupant impact velocity crahs severity metrics using event data recorders 52ª AAAM Conference (2006)
  • 48 O. Keifer, P. Layson, B. Reckamp The effects of seated position o occupant kinematics in low-speed rear-end impacts. SAE paper no. 2005-01-1204 Society of Automotive Engineers (2005)
  • 49 A. Kullgren, M. Krafft, A. Lie, C. Tingvall The effect of whiplash protection systems in real-life crashes and their correlation to consumer crash test programmes J. Pike (Ed.), Neck injury biomechanics, SAE International, Warrendale (2009), pp. 117-123
  • 50 L. Voo, B. McGee, A. Merkle, M. Kleinberger, S. Kuppa Performance of seats with active head restraints in rear impacts J. Pike (Ed.), Neck injury biomechanics, SAE International, Warrendale (2009), pp. 549-556
  • 51 M. Xiao, P. Ivancic WHIPS seat and occupant motions during simulated rear crashes Traffic Inj Prev, 11 (2010), pp. 514-521
  • 52 B. Lankester, N. Garneti, M. Gargan, G. Bannister Factors predicting outcome alter whiplash injury in subjects pursuing litigation Eur Spine J, 15 (2006), pp. 902-907
  • 53 D. Walton, J. MacDermid, A. Giorgianni, J. Mascarenhas, S. West, C. Zammit Risk factors for persistent problems following acute whiplash injury: update of a systematic review and meta-analysis J Orthop Sports Phys Ther, 43 (2013), pp. 31-43
  • 54 L. Nordhoff Jr. Rear-end collisions: biomechanics and injuries L. Nordhoff Jr. (Ed.), Motor vehicle collision injuries. Biomechanics, diagnosis and management (2.ª ed.), Jones and Bartlett Publishers, Boston (2005), pp. 483-527
  • 55 H. Cappon, W. Hell, D. Lang, M. Svensson Whiplash injuries. Not only a problema in rear-end impact Enhanced Safety of Vehicles (ESV) Conference (2003)
Fuente de los datos: Dialnet