Comparison of frontal and rear-end impacts for car occupants with whiplash-associated disorders : symptoms and clinical findings.

Rear-end impacts caused worse initial symptoms and specific clinical findings, not clearly distinguished from those occurring after frontal impacts. WAD III injuries, retro-orbital pain, and isolated contra-directional pro-retraction pain occurred more frequently after rear-end impacts, indicating the importance of shear loads and craniocervical junction vulnerability. Head inward rotation during rear-end impacts caused a more restricted mobility in the same direction at the primary examination than did outward rotation, indicating a possible influence from the shoulder part of the seat belt. The one-year outcome was mainly influenced by individual factors and less by the impact characteristics. For the covering abstract see ITRDE141807.