engleski

Whiplash lnjuries nledical and legal problems

Whiplash injury is by its definition hyperextensive-flexory-rotatory injury most frequently occurring in trafic accidents when victim~s vehicule is hit from a backside. At the time of the impact, the vihicule is forcefully pushed forward. During the first 100 msec the body of the victim, together with the seat, is leaning foward, while head and neck remain in the position. After 200 msec the situation is reversed ; the body is returning to its previous position while head and neck move foward as for as physiologically possible. During the exposure to these forces, multiple neck injuries occur (lesions of muscles, ligaments, fasciae, intervertebrary discs, nerves, cartilages and joint surfaces and capsules). Recent results indicate that minimum speed of impact resulting in whiplash injury is above 15 km/h. Immediate symptoms are qenerally wild including local neckache, paresthesia dizziness and headache. Later, 24-48 hours following injury, temporary vision disturbancies and limb weakness couid develop. After the treatment is complated, many subjective symptoms including headache, dizziness and paresthesia of arms stifl persist in these patients. These symptoms cannot be objectified and result in a serious problems in the evaluation of permanent consequences of whiplash injuries. The investigation was carried out in 40 randomly selected whiplash injury victims without previous lesions of neck spine and in 40 equally selected patients with previously confirmed cervical degenerative changes. Thay all suffered from permanent whiplash injuries and applied for a reimbursment for nonmateriai damage to Zagreb Insurance company during 2001 . Analysis revealed that in 74 per cent of reimbursment requests, police records provided no data on injured persons. In 67 per cent of patients whipfash injury of I or II degree by QTF protocol was verified at the initial surgeonžs examination. These patients underwent continuous treatment for 6-7 month period, but lasting sequellae of whiplash injury persisted ; decreased motility of cervical spine, arm paresthesia, vasospasm of vertebral arteries, permanently narrowed visual field, all verified by objective methods including FSVK, EMNG of arms, TCD of vertebrobasilar arteries, visual field by Goldman and clinical examination of medical censor.

whiplash ; legal

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