Seat-belt injuries in children involved in motor vehicle crashes.
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.
Santschi
Miriam
M
Department of Pediatrics, Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Que. miriamsantschi@yahoo.com
Echavé
Vincent
V
Laflamme
Sophie
S
McFadden
Nathalie
N
Cyr
Claude
C
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*