Children in crashes: mechanisms of injury and restraint systems.
OBJECTIVE
To explore the levels of protection offered to children involved in motor vehicle collisions.


METHODS
A joint study by the Children's Hospital of Eastern Ontario (CHEO) and Transport Canada, Ottawa, conducted in 2 phases: retrospective from 1990 to 1997 and prospective from 1998 to 2000.


METHODS
CHEO, a university affiliated tertiary care centre.


METHODS
Children admitted to CHEO between 1990 and 2000 with spinal trauma due to motor vehical crashes (MVCs). Phase I of the study involved analysis, in a series of 45 children after MVAs, by location of spinal injury versus belt type. Phase 2 was a prospective study of 22 children injured in 15 MVAs.


METHODS
A biomechanical assessment of the vehicle and its influence on the injuries sustained.


METHODS
The nature and extent of the injuries sustained, and the vehicle dynamics and associated occupant kinematics.


RESULTS
The odds ratio of sustaining a spinal injury while wearing a 2-point belt versus a 3-point belt was 24 (95% confidence interval 2.0-2.45, p < 0.1), indicating a much higher incidence with a lap belt than a shoulder strap.


CONCLUSIONS
Proper seat-belt restraint reduces the morbidity in children involved in MVCs. Children under the age of 12 years should not be front-seat passengers until the sensitivity of air bags has been improved. Three-point pediatric seat belts should be available for family automobiles to reduce childhood trauma in MVCs.
Lapner
P C
PC
Department of Surgery, University of Ottawa, Ont.
McKay
M
M
Howard
A
A
Gardner
B
B
German
A
A
Letts
M
M
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D017278:Air Bags / Q000009:adverse effects; D001696:Biomechanical Phenomena; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D012622:Seat Belts / Q000009:adverse effects; D016103:Spinal Fractures / Q000209:etiology / Q000503:physiopathology; D014947:Wounds and Injuries / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control