The Seat Belt Syndrome

Garrett, John W.; Braunstein, Paul W.

doi:10.1097/00005373-196205000-00002

Cited by 318 publications

(123 citation statements)

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“…Frequent observation of severe parenchymal or vascular injuries requires a complete radiological examination by thoracic and abdomino-pelvic CT, to exclude seat-belt syndrome and seat-belt aorta [10,15].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of posterior tension band fixation in the thoracolumbar seat-belt type injuries of the young population

Ramieri

Domenicucci

Cellocco³

et al. 2009

Eur Spine J

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We report results in the surgical treatment of thoracolumbar flexion-distraction fractures, both associated or not with neurological impairment. Items in the present study include function, pain (back pain rating scale) and neurological recovery (Asia Score). A prospective series of 19 consecutive flexion-extension thoracolumbar injuries (T11-L2), occurred in young patients (20-33 years) due to motor vehicle crashes wearing the 3-point safety belts, includes 2 Chance and 17 seat-belt fractures, with different amount of vertebral dislocation and neurological impairment. Fractures have been evaluated according to the Magerl's classification. All patients were operated via posterior approach using hybrid instrumentation or short pedicular fixation to reduce dislocation and to obtain spinal fusion. Posterior decompression was performed in all patients with neurological deficit. Posterior instrumented arthodesis was performed by wide constructs that preferably include 2 levels above and below the dislocated vertebra. Most of them were instrumented using thoracic hooks and lumbar pedicular screws. One postoperative vascular complication was successfully treated by selective embolization. All neurological patients were submitted to a postoperative rehabilitation program. Posterior procedure allows proper reduction and realignment. In our experience, the use of laminar hooks one level above the dislocation seems to reduce the potential risk of neurological and /or vascular damage during the intraoperative maneuvers on the dislocated pedicles. At follow-up, fusion was achieved in all patients. The clinical condition was totally satisfactory due to the absence of significant pain, confirming mechanical stability of the implants. In terms of neurological outcomes, patients presenting as ASIA A-B or ASIA E, maintained their preoperative neurological condition. Surgical treatment, together with an early postoperative rehabilitation program, can be of paramount importance in neurological patients' quality of life.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of posterior tension band fixation in the thoracolumbar seat-belt type injuries of the young population

Ramieri

Domenicucci

Cellocco³

et al. 2009

Eur Spine J

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“…At the time, these injuries were typically seen in adults. [5] Over the past 4 decades, a large number of case reports and case series have confirmed a characteristic pattern of injuries which generally localize to the abdomen and lumbar spine. Infra-abdominal injuries: Gastrointestinal tract perforation, while rare as an outcome of blunt abdominal trauma, [45] is a characteristic injury resulting from SBS.…”

Section: Results a Seat Belt Syndromementioning

confidence: 96%

“…First described by Kulowski and Rost in 1956, [13] the term "seat belt syndrome" (SBS) was coined by Garrett and Braunstein in 1962 to describe a distinctive pattern of injuries, including abrasion or contusion of the abdominal wall, injury to the abdominal viscera, pelvic fracture, and fracture of the lumbar spine, associated with lap seat belts in serious crashes. [5] Garrett and…”

Section: Results a Seat Belt Syndromementioning

confidence: 99%

“…Cases of serious cervical and lumbar spinal cord injury, as well as intra-abdominal injuries (including perforation of hollow viscous and solid organ injuries) have been described over the past 10 years, resulting in the identification of a so-called "seat-belt syndrome" of injuries to children resulting from ill-fitting lap and lap-shoulder belts. [5][6][7][8][9][10] In addition, when the shoulder belt is used improperly behind the child's back or under the arm, the torso restraint is compromised, making it easier for a child to move forward in the event of a crash and contact structures in the vehicle with the head. Children aged 2 to 5 years restrained in vehicle seat belts are 4.2 times more likely to sustain a clinically significant (AIS >_ 2) head injury than children restrained in child safety seats or booster seats.…”

Section: IVmentioning

confidence: 99%

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The premature graduation of children from child restraints to vehicle safety belts

Winston¹,

Moll²,

Durbin³

et al. 2000

PsycEXTRA Dataset

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Belt-positioning booster seats are recommended for children between 40 and 80 pounds, however, usage is estimated at only 5% nationally. The goal of this project was to determine reasons for the premature graduation of children from child safety seats to vehicle seat belts and to suggest strategies for increasing booster seat use.The project utilized multiple methods, including a review of existing literature and programs regarding premature graduation and booster seat use; discussions with parents, children, and experts via telephone or focus groups; and facilitated brainstorming sessions. These qualitative methods were used to gain a broad understanding of the issues relating to the premature use of seat belts by young children and to suggest strategies to increase booster seat use.This research showed that the premature graduation of children from child safety seats to vehicle seat belts occurs for a variety of reasons. Most notably, a parent's perception of risk of their child being injured in a crash plays an important role -parents who used booster seats tended to have a higher risk perception than parents who used seat belts for their children. Parents' knowledge of best practice for child passenger safety and the potential consequences for not following these recommendations played a key role among the subjects studied in this research. Parents identified several potential barriers to optimal restraint for their young children including situational circumstances (e.g., extra adult or child in the vehicle), child behavior, child discomfort, the law, availability of the booster seat, cost, convenience/ ease of use, and perceptions of safer alternatives. This research also identified potential strategies to overcome barriers to booster seat use, and to promote continued booster seat use among parents who use them. ii Executive SummarySeat belts do not properly fit young children. The lap belt rides up around the child's waist and the shoulder belt crosses the face or neck, often causing the child to place the belt behind his/her back or under his/her arm. This reduces the effectiveness and compromises the torso restraint. As a result, the premature use of seat belts can cause significant injury in the event of a motor vehicle crash. In particular, young children restrained using seat belts are 3.5 times more likely to sustain a significant injury and 4.2 times more likely to sustain a significant head injury than children using child safety seats or booster seats (Wnston, et al., 2000). In addition, young children using seat belts are also at risk for seat belt syndrome, which can include serious injuries to the abdomen and/or spine.In order to help prevent these injuries, the National Highway Traffic Safety Administration recommends that children between 40 and 80 pounds be restrained using a belt positioning booster seat.' Unfortunately, however, belt positioning booster seat use is only about 5%nationally. The goal of this project was to determine reasons for the premature graduation of children from chi...

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“…The ''seat-belt syndrome'' was described for the first time by Garrett in 1962 in reporting the association of injuries of the thoracolumbar spinal column and of the internal organs of the abdomen [9,15]. In 1979, Dajee used the term ''seat-belt aorta'' to define particular types of abdominal aorta damage caused by the effects of the 2 or 3-point seat-belt during a high-impact vehicle collision [2,3,8,23].…”

Section: Discussionmentioning

confidence: 99%

Blunt abdominal aortic disruption (BAAD) in shear fracture of the adult thoraco-lumbar spine: case report and literature review

et al. 2011

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To present a rare case of association of abdominal aorta rupture and flexion-distraction fracture of thoracolumbar spine and to review the literature on this condition. In non-penetrating abdominal traumatic injuries with flexion-distraction fractures of the thoracolumbar spine, rupture of the abdominal aorta is an extremely rare occurrence but its outcome is potentially lethal. This association of skeletal and vascular lesions mainly affects young patients and involves the thoraco-lumbar junction and the portion of the aorta that lies in front of it. The authors analyze the pertinent literature and describe a case, operated in two sittings, of a traumatic lesion of the aorta attributable to a fracture of L1, focusing on mechanism of damage, diagnosis and surgical treatment. At 2-year follow-up examination, there were no neurological deficits. A review of the pertinent literature has shown that mortality can be reduced by a meticulous clinical and radiological work-up for a correct diagnosis followed by surgical repair of any damaged vessels. The possibility of performing a rapid diagnosis by means of total-body CT-scan plus CT-angiography allows repair of vascular damage, stabilization of the patient's hemodynamic conditions and, subsequently, surgical treatment of the vertebral fracture.

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The Seat Belt Syndrome

Cited by 318 publications

References 0 publications

Effectiveness of posterior tension band fixation in the thoracolumbar seat-belt type injuries of the young population

Effectiveness of posterior tension band fixation in the thoracolumbar seat-belt type injuries of the young population

The premature graduation of children from child restraints to vehicle safety belts

Blunt abdominal aortic disruption (BAAD) in shear fracture of the adult thoraco-lumbar spine: case report and literature review

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