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Vertebral column injuries and lap-shoulder belts

In: Journal of Trauma, Vol. 38, No. 4, Apr. 1995, p. 547-556

Authors: F. Huelke, Andrew P. Morris, G. M. Mackay

Objective: To present cases of vertebral column fractures or fracture dislocations that occur to restrained front seat occupants where there is no evidence of body contact with interior car components based on both medical records and car inspection.

Materials and Methods: Reviewed were car crash injury cases investigated at the University of Michigan Transportation Research Institute and at the University of Birmingham (England) as well as the National Accident Severity Study files of the National Highway Traffic Safety Administration. Medical records and car inspections in the cases presented did not indicate any evidence of body contact with interior car structures.

Main Results: Vertebral fractures or fracture dislocations sustained by front seat occupants who were wearing lap-shoulder belts are rare, as evidenced by the relatively few cases identified in the literature and in the crash injury files reviewed.

Conclusions: Infrequently, in frontal crashes, vertebral fractures or fracture dislocations can occur to lap-shoulder belted front seat car occupants without head or torso impacts with interior car structures. Cervical spine injuries are due to neck flexion over the shoulder portion of the restraint. Thoracolumbar fractures can occur in the frontal crash even at low crash velocity.