• Miriam Santschi, Vincent Echavé, Sophie Laflamme, Nathalie McFadden, and Claude Cyr.
• Department of Pediatrics, Faculty of Medicine, Université de Sherbrooke, Sherbrooke, Que. miriamsantschi@yahoo.com
• Can J Surg. 2005 Oct 1;48(5):373-6.

BackgroundThe 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).MethodsWe describe the injuries sustained by 8 children, including 2 sets of twins, in 3 different motor vehicle crashes.ResultsAll 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.ConclusionsThese 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.

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