ISSN 2380-2995 (Online)
ISSN 2380-2987 (Print)


Ronald W. Lindsey, MD
Zbigniew Gugala, MD, PhD


Upper Extremity Injuries in Airbag-Equipped Vehicles: Are Newer Vehicles Safer?

Eric Waetjen, MD[1]; Jeremy S. Somerson, MD[2]; Gregory V. Gomez, MD[1]; Mark Bagg, MD[1]

[1] Department of Orthopaedic Surgery, University of Texas Health Science Center; San Antonio, TX, USA
[2] Department of Orthopaedic Surgery & Rehabilitation, University of Texas Medical Branch; Galveston, TX, USA

Corresponding Author:
Jeremy S. Somerson, MD
Orthopaedic Surgery & Rehabilitation
University of Texas Medical Branch
301 University Blvd
Galveston, TX 77555, USA



Introduction: Upper extremity injuries (UEIs) in motor vehicle collisions (MVCs) have increased attributable to airbag deployments. Since 2017, United States passenger vehicles are required to have new generation airbags. This research compares the rate of upper extremity injuries in pre- and post-2007 vehicles and analyzes associations with the occupant and impact characteristics.

Methods: The Crash Injury Research Network (CIREN) database was queried for MVCs for which an airbag was available for the years 2008 to 2010. Information on crash, occupant, airbag deployment, seatbelt usage, vehicle year, and UEIs was collected. Univariate analysis was used to identify associations between crash and vehicle occupant characteristics and the types of UEIs sustained.

Results: Between 2008 and 2010, 211 MVCs took place with airbags available. Airbags were more likely to deploy in vehicles with model year 2007 or later (p=0.015). No significant differences were noted in the UEI rate in pre-2007 vehicles (36%) compared to vehicles 2007 or later (31%; p=0.501). No delineation was made between front or side airbag deployment. Airbag deployment was associated with a 12-fold increased rate of upper extremity open fracture and a 3-fold increase of forearm fracture, while scapula fracture was 3.5-fold more likely in cases without airbag deployment.

Discussion: UEIs remain commonplace in the context of MVCs. Clinicians should remain vigilant for UEIs in cases of airbag deployment despite the presence of advanced airbag systems in newer vehicles, as they are associated with an increased risk of upper extremity fracture.

Level of Evidence: IV; Case series.

Keywords: Upper extremity injury; Motor vehicle collision; Airbag safety; Airbag injury.