Motor vehicle crashes continue to be the leading cause of mortality and acquired disability in children. Traumatic brain and spinal cord injuries are typically considered the most disabling of these injuries. However, little is known about the specific patterns of injuries that lead to various degrees of functional disability in children and the biomechanical mechanisms for these crash-related disabling injuries. The broad long-term objective of this line of research is to advance the understanding of the nature and causes of functional disability after pediatric injury in sufficient detail to inorm secondary prevention (improved engineering and injury countermeasures) strategies as well as tertiary prevention (improved acute and rehabilitative care) strategies. As a first step in achieving this goal, the current proposal will focus on motor vehicle crashes as a prototypic mechanism of disabling injury in children.
The aims of the project are: 1) To identify the injuries for children 7-18 years old that are associated with moderate to severe functional disability upon discharge from rehabilitation centers, 2) To identify the crash characteristics, direction of impac, occupant contact points, and adequacy of restraint system performance that contribute to the moderately to severely disabling pattern of injuries, and to 3) To create a 3-dimensional dynamic computational model in order to quantify the crash biomechanics, simulate the occupant kinematics, and identify a countermeasure that could mitigate the biomechanical mechanism of injury.

Public Health Relevance

Project Narrative Injuries from motor vehicle crashes are the leading cause of disability in children, but the mechanisms of disabling injuries are poorly understood. By determining biomechanical mechanisms of disabling injuries in children, improved strategies for secondary prevention (improved engineering and injury countermeasures) and tertiary prevention (improved acute and rehabilitative care) of these injuries can be developed.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Clinical Investigator Award (CIA) (K08)
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Study Section
Pediatrics Subcommittee (CHHD)
Program Officer
Quatrano, Louis A
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Children's Hospital of Philadelphia
United States
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Zonfrillo, Mark R; Janigian, Nicholas G; Maron, Bradley A (2016) Death or Severe Injury at the Ball Game. Curr Sports Med Rep 15:132-3
Zonfrillo, Mark R; Macy, Michelle L; Cook, Lawrence J et al. (2016) Anticipated resource utilization for injury versus non-injury pediatric visits to emergency departments. Inj Epidemiol 3:12
Zonfrillo, Mark R; Zaniletti, Isabella; Hall, Matthew et al. (2016) Socioeconomic Status and Hospitalization Costs for Children with Brain and Spinal Cord Injury. J Pediatr 169:250-5
Gaw, Christopher E; Zonfrillo, Mark R (2016) Emergency department visits for head trauma in the United States. BMC Emerg Med 16:5
Henry, M Katherine; Zonfrillo, Mark R; French, Benjamin et al. (2016) Hospital Variation in Cervical Spine Imaging of Young Children With Traumatic Brain Injury. Acad Pediatr 16:684-91
Macy, Michelle L; Zonfrillo, Mark R; Cook, Lawrence J et al. (2015) Patient- and Community-Level Sociodemographic Characteristics Associated with Emergency Department Visits for Childhood Injury. J Pediatr 167:711-8.e1-4
Zonfrillo, Mark R; Myers, Rachel K; Durbin, Dennis R et al. (2015) Validation of Parent-Reported Injuries to Their Children. Clin Pediatr (Phila) 54:983-6
Zonfrillo, Mark R; Kim, Konny H; Arbogast, Kristy B (2015) Emergency Department Visits and Head Computed Tomography Utilization for Concussion Patients From 2006 to 2011. Acad Emerg Med 22:872-7
Corwin, Daniel J; Wiebe, Douglas J; Zonfrillo, Mark R et al. (2015) Vestibular Deficits following Youth Concussion. J Pediatr 166:1221-5
Zonfrillo, Mark R; Ferguson, Rennie W; Walker, Lorrie (2015) Reasons for Child Passenger Nonrestraint in Motor Vehicles. Traffic Inj Prev 16 Suppl 2:S41-5

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