Mechanisms of Abdominal Organ Injury in Seat Belt-Restrained Children

In seat belt-restrained child vehicle occupants, key elevated abdominal injury risk predictors have been identified through previous research; however, these cannot be used for prevention strategies suggestion through injury source or specific mechanism isolation. Cases of children who sustained, in a frontal crash, internal abdominal injuries while seat belt-restrained, were studied using standard crash investigation protocols using a large child-focused crash surveillance system. Also investigated was a second group of cases of similar crashes involving restrained children without abdominal injuries. To determine injury and associated kinematics mechanisms, each case's child, crash, and medical characteristics were analyzed in the context of known abdominal injury biomechanics. The most common injury mechanism was identified, through review of 21 abdominal injury cases, as belt loading directly over the injured organ. Three unique kinematic patterns varying by lap belt initial position and upper torso kinematics were identified. In these crashes, 90% of other child occupants and 60% of drivers sustained either minor or no injury. In all but one of the 16 cases involving no abdominal injury, all sustained head and face contact injury and external abdominal bruising. Key characteristics of crash mechanisms in which abdominal injuries were and were not sustained by belted children were reviewed by this evaluation. In low-severity crashes in which little injury was sustained by other occupants, abdominal injury resulted in children through direct abdominal belt compression manifested through shoulder belt misuse, poor child posture, or improper initial seat belt placement. Torso excursion control through consistent shoulder belt use was pointed to by these cases, and possible prevention strategies were suggested, included belt-positioning booster seats and lap belt pretensioners.

• Availability:
  • Find a library where document is available. Order URL: http://worldcat.org/issn/00225282
• Authors:
  • Arbogast, Kristy B
  • Kent, Richard W
  • Menon, Rajiv A
  • Ghati, Yoganand
  • Durbin, Dennis R
  • Rouhana, Stephen W
• Publication Date: 2007-6

Language

• English

Media Info

• Media Type: Print
• Edition: Supplement
• Features: Figures; References; Tables;
• Pagination: pp 1473-1480
• Serial:
  • Journal of Trauma, Injury, Infection and Critical Care
  • Volume: 62
  • Issue Number: 6
  • Publisher: Lippincott Williams & Wilkins
  • ISSN: 0022-5282

Subject/Index Terms

• TRT Terms: Abdomen; Biophysics; Child restraint systems; Children; Compression; Crash characteristics; Frontal crashes; Injury characteristics; Kinematics; Loads; Manual safety belts; Restraint systems; Risk analysis; Seat belts; Vehicle occupants
• Uncontrolled Terms: Abdominal injuries; Injury mechanism; Injury prevention; Predictors; Torso
• Subject Areas: Highways; Passenger Transportation; Safety and Human Factors; I83: Accidents and the Human Factor; I84: Personal Injuries;

Filing Info

• Accession Number: 01053918
• Record Type: Publication
• Files: TRIS
• Created Date: Jul 3 2007 1:56PM