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Primarily treated and transferred patients where included.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The study group included 727 of 2030 (35.8%) children, who were severely injured (AIS 2\u2009+) in road traffic accidents, among them 268 (13.2%) as MVPs in the age groups: 0\u20131\u00a0years (42.5%), 2\u20133\u00a0years (26.1%) and 4\u20135\u00a0years (31.3%). The pattern of severe injury was head\/brain (56.0%), thoracic (42.2%), abdominal (13.1%), fractures (extremities and pelvis, 52.6%) and spine\/severe whiplash (19.8%). The 0\u20131-year-old MVPs showed the significantly highest proportion of brain injuries with Glasgow Coma Score (GCS)\u2009&lt;\u20098 and severe injury to the spine. The 2\u20133-year-olds showed the significantly highest proportion of fractures especially the lower extremity and highest proportion of cervical spine injuries of all spine injuries, while the 4\u20135-year-olds, the significantly highest proportion of abdominal injury and second highest proportion of cervical spine injury of all spine injuries. MVPs of the 0\u20131-year-old and 2\u20133-year-old groups showed a higher median Injury Severity Score (ISS) of 21.5 and 22.1 points than the older children (17.0 points). They also suffered an AIS-6-injury significantly more often (9 of 21) of spine (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). Especially the cervical spine was significantly more often involved. Passengers at the age of 0\u20131\u00a0years were treated with cardiopulmonary resuscitation (CPR) three times as often as older children in the prehospital setting and twice as often at admission in the Trauma Resuscitation Unit (TRU). Their survival rate was 7 out of 8 (0\u20131\u00a0years), 1 out of 6 (2\u20133\u00a0years) and 1 out of 4 (4\u20135\u00a0years).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Although the younger MVPs are restraint in a re-boarding position, severe injury to the spine and head occurred more often, while older children as front-faced positioned MVPs suffered from significantly higher rates of abdominal and more often severe facial injury. Our data show, that it is more important to properly restrain children in their adequate car seats (i-size-Norm) and additionally consider the age-related physiological and anatomical specific risks of injury as well as co-factors in road traffic accidents, than only prolonging the re-boarding position over the age of 15\u00a0months as a single method.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00068-022-01917-y","type":"journal-article","created":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T19:03:46Z","timestamp":1648839826000},"page":"3989-3996","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Prevention of severe injuries of child passengers in motor vehicle accidents: is re-boarding sufficient?"],"prefix":"10.1007","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8962-2356","authenticated-orcid":false,"given":"Christopher","family":"Spering","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerd","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e1szl\u00f3","family":"F\u00fczesi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertil","family":"Bouillon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hauke","family":"R\u00fcther","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Lehmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Lefering","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"and Section of Injury Prevention DGOU","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"and TraumaRegister DGU","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,4,1]]},"reference":[{"key":"1917_CR1","first-page":"407","volume":"44","author":"KB Arbogast","year":"2000","unstructured":"Arbogast KB, Moll EK, Morris SH, Anderko RL, Durbin DR, Winston FK. 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