Chest Injuries Sustained in Severe Traffic Accidents by Seatbelt Wearers

Arajärvi, Eero; Santavirta, Seppo

doi:10.1097/00005373-198901000-00007

Cited by 58 publications

(22 citation statements)

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“…The shoulder-lap three-point restraint directly transmits force to the upper trunk, leading to chest wall injuries, splenic avulsion and diaphragmatic rupture/hernia as were seen in our patient 21 22. Occasionally, injuries to the carotids and proximal aorta, liver, heart, brachial plexus and cervical spine have also been reported 22.…”

Section: Discussionmentioning

confidence: 54%

Seat belt syndrome with unstable Chance fracture dislocation of the second lumbar vertebra without neurological deficits

2014

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The seat belt syndrome is a recognised complication of seat belt use in vehicles. Unstable Chance fractures of the spine without neurological deficits have been reported infrequently. We describe a young woman with completely disrupted Chance fracture of the second lumbar vertebra in association with left hemidiaphragmatic rupture/hernia, multiple bowel perforations, splenic capsular tear, left humeral shaft and multiple rib fractures. These injuries which resulted from high-speed vehicle collision and led to death of one of the occupants were readily detected by trauma series imaging. The patient was successfully treated by a dedicated multidisciplinary team which adopted a staged surgical approach and prioritisation of care. There were no manifested neurological or other deficits after 1 year of follow-up. To the authors' knowledge, this is the first report of such a case in Australasia. We discuss the challenging surgical management, highlighting the role of radiological imaging in such cases and provide a literature review.

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Section: Discussionmentioning

confidence: 54%

Seat belt syndrome with unstable Chance fracture dislocation of the second lumbar vertebra without neurological deficits

2014

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“…Similarly, the lateral angle / increased from rib 4 to rib 9, while decreasing again for rib 10. Both of these trends indicate that the rib centroidal path is primarily confined to a single plane for the upper ribs (2)(3)(4)(5), while the deviation from the plane (i.e., the degree to which the centroidal path cannot be accurately modeled as occurring within a single plane) progressively becomes more pronounced for the lower ribs (6)(7)(8)(9). In all cases, z max /x 0 was low; the largest z max /x 0 was 9.4%.…”

Section: Resultsmentioning

confidence: 99%

“…Rib fractures are a significant source of morbidity for trauma patients, especially from a motor vehicle collision [1][2][3]. A patient with six or more rib fractures is three times more likely to die within 24 hs of hospital admission than a similar occupant having a single rib fracture, and the presence of organ injuries increases these odds further [4].…”

Section: Introductionmentioning

confidence: 99%

Characterization of the Centroidal Geometry of Human Ribs

Kindig

Kent

2013

Journal of Biomechanical Engineering

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While a number of studies have quantified overall ribcage morphology (breadth, depth, kyphosis/lordosis) and rib cross-sectional geometry in humans, few studies have characterized the centroidal geometry of individual ribs. In this study, a novel model is introduced to describe the centroidal path of a rib (i.e., the sequence of centroids connecting adjacent cross-sections) in terms of several physically-meaningful and intuitive geometric parameters. Surface reconstructions of rib levels 2-10 from 16 adult male cadavers (aged 31-75 years) were first extracted from CT scans, and the centroidal path was calculated in 3D for each rib using a custom numerical method. The projection of the centroidal path onto the plane of best fit (i.e., the "in-plane" centroidal path) was then modeled using two geometric primitives (a circle and a semiellipse) connected to give C1 continuity. Two additional parameters were used to describe the deviation of the centroidal path from this plane; further, the radius of curvature was calculated at various points along the rib length. This model was fit to each of the 144 extracted ribs, and average trends in rib size and shape with rib level were reported. In general, upper ribs (levels 2-5) had centroidal paths which were closer to circular, while lower ribs (levels 6-10) tended to be more elliptical; further the centroidal curvature at the posterior extremity was less pronounced for lower ribs. Lower ribs also tended to exhibit larger deviations from the best-fit plane. The rib dimensions and trends with subject stature were found to be consistent with findings previously reported in the literature. This model addresses a critical need in the biomechanics literature for the accurate characterization of rib geometry, and can be extended to a larger population as a simple and accurate way to represent the centroidal shape of human ribs.

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“…Acquired hernias are further recognized as traumatic, spontaneous, or pathological. Most pulmonary hernias are traumatic although they have also been reported after cough [3,6], pleuroscopy [3], minimally invasive direct coronary artery bypass grafting [7], and seat belt injury associated with motor vehicle accident [8]. Spontaneous hernias occur with an abnormal rise in intrathoracic pressure associated with straining, cough, or heavy lifting [9].…”

Section: Discussionmentioning

confidence: 99%