Swiss medical weekly
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Swiss medical weekly · Apr 1987
[Whiplash trauma of the cervical vertebrae in traffic: biomechanical and expert-opinion aspects].
The indirect injury mechanisms of the cervical spine should be subdivided into "non-contact injury" of the cervical spine, without head impact, by definition (hyperflexion or hyperextension), sometimes also called whiplash injury mechanism, and bending mechanism due to head contact, i.e. "contact injury" (hyperflexion, hyperextension, lateral bending, axial compression). The term "whiplash" is, in strict biomechanical terms, very often incorrect since it implies a biphasic motion (hyperextension and hyperflexion, or vice versa); in traffic collisions, however, its second phase is insignificant. The terms used for the injuries themselves should be taken from the classic morphology (fracture, luxation, distorsion etc.). ⋯ In the latter case the patient should not be treated as a malingerer. Moreover, if more than two vehicles are involved the reconstruction of the accident is greatly facilitated if the lesion can be proven to be a "contact" or "non-contact" injury (legal implications, insurance payments). The (rare) severe cervical spine injuries in seat belt wearers are not caused by the restraining effect of the belt but by bending and injuring of the neck due to head contact which often is not completely avoidable (justification of mandatory seat belt law).