title: Seat-belt injuries in children involved in motor vehicle crashes.
abstract: BACKGROUND
  The efficacy of seat belts in reducing deaths from motor vehicle crashes is well documented. A unique association of injuries has emerged in adults and children with the use of seat belts. The "seat-belt syndrome" refers to the spectrum of injuries associated with lap-belt restraints, particularly flexion-distraction injuries to the spine (Chance fractures).
  
  
  METHODS
  We describe the injuries sustained by 8 children, including 2 sets of twins, in 3 different motor vehicle crashes.
  
  
  RESULTS
  All children were rear seat passengers wearing lap or 3-point restraints. All had abdominal lap-belt ecchymosis and multiple abdominal injuries due to the common mechanism of seat-belt compression with hyperflexion and distraction during deceleration. Five of the children had lumbar spine fractures and 4 remained permanently paraplegic.
  
  
  CONCLUSIONS
  These incidents illustrate the need for acute awareness of the complete spectrum of intra-abdominal and spinal injuries in restrained pediatric passengers in motor vehicle crashes and for rear seat restraints that include shoulder belts with the ability to adjust them to fit smaller passengers, including older children.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Que. miriamsantschi@yahoo.com
authors.forename: Miriam
authors.initials: M
authors.lastname: Santschi
authors.forename: Vincent
authors.initials: V
authors.lastname: Echavé
authors.forename: Sophie
authors.initials: S
authors.lastname: Laflamme
authors.forename: Nathalie
authors.initials: N
authors.lastname: McFadden
authors.forename: Claude
authors.initials: C
authors.lastname: Cyr
mesh_terms: D000007:Abdominal Injuries / Q000209:etiology*; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D002648:Child; D003654:Deceleration; D004386:Duodenum / Q000293:injuries; D004438:Ecchymosis / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D009864:Ontario; D012622:Seat Belts / Q000009:adverse effects*; D013124:Spinal Injuries / Q000209:etiology; D014949:Wounds, Nonpenetrating / Q000209:etiology*