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Pediatric seatbelt injuries: unusual Chance's fracture associated with intra-abdominal lesions in a child

European Spine Journal volume 13, pages 167–171 (2004)Cite this article

Abstract

The authors report the case of a 7-year-old child involved in a motor vehicle accident. She sustained an unusual flexion-distraction vertebral injury. This spinal injury was related to seatbelt use and was associated with intra-abdominal lesions. The spinal lesion consisted of a posterior ligamentous disruption with widening of the posterior intervertebral space at two adjacent lumbar levels. The purpose of this case report is to describe an atypical and perhaps often unrecognized spinal lesion and to explain our approach to diagnosis and treatment.

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References

  1. Agran PF, Dunkle DE, Winn DG (1987) Injuries to a sample of seat belted children evaluated in a hospital emergency room. J Trauma 27:58–64

    CAS  PubMed  Google Scholar 

  2. Anderson PA, Rivara FP, Maier RV, Drake C (1991) The epidemiology of seatbelt-associated injuries. J Trauma 31:60–67

    CAS  PubMed  Google Scholar 

  3. Aufdermaur HR (1974) Spinal injuries in juveniles. Necropsy findings in twelve cases. J Bone Joint Surg Br 56:513–519

    Google Scholar 

  4. Blasier RD, Lamont RL (1985) Chance fracture in a child: a case report with non-operative treatment. J Pediatr Orthop 5:92–93

    CAS  PubMed  Google Scholar 

  5. Chance GQ (1948) Note on a type of flexion fracture of the spine. Br J Radiol 21:452–453

    Google Scholar 

  6. Dennis R, Allard M, Atlas H, Farkouh E (1983) Changing trends with abdominal injury in seatbelt wearers. J Trauma 23:1007–1008

    PubMed  Google Scholar 

  7. Fuentes JM, Bloncourt J, Bourbotte G, et al (1984) La fracture de Chance. Neurochirurgie 30:113–118

    CAS  PubMed  Google Scholar 

  8. Gallagher DJ, Heinrich SD (1990) Pediatric Chance fracture. J Orthop Trauma 4:183–187

    CAS  PubMed  Google Scholar 

  9. Garrett JW, Braunstein PW (1962) The seat belt syndrome. J Trauma 2:200–204

    Google Scholar 

  10. Gertzbein SD, Court-Brown CM (1988) Flexion-distraction injuries of the lumbar spine. Clin Orthop 227:52–60

    CAS  PubMed  Google Scholar 

  11. Glassman SD, Johnson JR, Holt RT (1992) Seatbelt injuries in children. J Trauma 33:882–886

    CAS  PubMed  Google Scholar 

  12. Green DA, Green NE, Spengler DM, et al (1991) Flexion-distraction injuries to the lumbar spine associated with abdominal injuries. J Spinal Disord 4:312–318

    CAS  PubMed  Google Scholar 

  13. Gumley G, Taylor TKF, Ryan MD (1982) Distraction fractures of the lumbar spine. J Bone Joint Surg Br 64:520–525

    CAS  PubMed  Google Scholar 

  14. Holdsworth FW (1963) Fractures, dislocations, and fracture-dislocations of the spine. J Bone Joint Surg Br 45:6–20

    Google Scholar 

  15. Holdsworth FW (1970) Fractures, dislocations, and fracture-dislocations of the spine. J Bone Joint Surg Am 52:1534–1551

    CAS  PubMed  Google Scholar 

  16. Howland WJ, Curry JL, Buffington CB (1965) Fulcrum fractures of the lumbar spine. JAMA 193:240–241

    CAS  Google Scholar 

  17. Hubbard DD (1974) Injuries of the spine in children and adolescents. Clin Orthop 100:56–65

    CAS  PubMed  Google Scholar 

  18. Kaufer H, Hayes JT (1966) Lumbar fracture-dislocation: a study of twenty-one cases. J Bone Joint Surg Am 48:712–730

    Google Scholar 

  19. Le Gay DA, Petrie DP, Alexander D (1990) Flexion-distraction injuries of the lumbar spine and associated abdominal trauma. J Trauma 30:436–444

    PubMed  Google Scholar 

  20. Lesprit E, Pontailler JR, Vergnes P (2000) Fracture de Chance lombaire chez l'enfant associée à une lésion intra-abdominale. Acta Orthop Belg 66:190–193

    CAS  PubMed  Google Scholar 

  21. Leventhal HR (1960) Birth injuries of the spinal cord. J Pediatr 56:557–563

    Google Scholar 

  22. Miller JA, Smith TH (1991) Seatbelt induced Chance fracture in an infant. Case report and literature review. Pediatr Radiol 21:575–577

    CAS  PubMed  Google Scholar 

  23. Moskowitz A (1989) Lumbar seatbelt injury in a child: case report. J Trauma 29:1279–1282

    CAS  PubMed  Google Scholar 

  24. Palmer CE (1928) Center of gravity of the human body during the growth. Am J Phys Anthropol 11:423–455

    Google Scholar 

  25. Raney EM, Bennett JT (1992) Pediatric Chance fracture. Spine 17:1522–1524

    CAS  PubMed  Google Scholar 

  26. Reid AB, Letts RM, Black GB (1990) Pediatric Chance fractures: association with intra-abdominal injuries and seatbelt use. J Trauma 30:384–391

    CAS  PubMed  Google Scholar 

  27. Rennie W, Mitchell N (1973) Flexion distraction fractures of the thoracolumbar spine. J Bone Joint Surg Am 55:386–390

    CAS  PubMed  Google Scholar 

  28. Roaf R (1960) A study of the mechanics of spinal injuries. J Bone Joint Surg Br 42:810–823

    Google Scholar 

  29. Rockwood CA, Wilkins KE, Beaty JH (1996) Fractures in children, 4th edn. Lippincott, Philadelphia, pp 1062–1105

  30. Rumball K, Jarvis J (1992) Seat-belt injuries of the spine in young children. J Bone Joint Surg Br 74:571–574

    CAS  PubMed  Google Scholar 

  31. Smith WS, Kaufer H (1973) Patterns and mechanisms of lumbar injuries associated with lap seatbelts. J Bone Joint Surg Am 51:239–254

    Google Scholar 

  32. Taylor GA, Dunne Eggli K (1988) Lap-belt injuries of the lumbar spine in children: a pitfall in CT diagnosis. AJR 150:1355–1358

    CAS  Google Scholar 

  33. Tso EL, Beaver BL, Haller JA (1993) Abdominal injuries in restrained pediatric passengers. J Pediatr Surg 28:915–919

    CAS  PubMed  Google Scholar 

  34. Voss L, Cole PA, D'Amato C (1996) Pediatric Chance fractures from lapbelts: unique case report of three in one accident. J Orthop Trauma 10:421–428

    Article  CAS  Google Scholar 

  35. Woelfel G, Moore E, Cogbill T, et al (1984) Severe thoracic and abdominal injuries associated with lap-harness seatbelts. J Trauma 24:166–167

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Paediatric Orthopaedic Unit, Children's Hospital, University Hospital Geneva, Rue Willy Donzé 6, 1205 , Geneva, Switzerland

    D. Ceroni, M. Mousny & A. Kaelin

  2. Paediatric Surgery Unit, Children's Hospital, University Hospital Geneva, Switzerland

    A. Lironi

Authors
  1. D. Ceroni
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  2. M. Mousny
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  3. A. Lironi
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  4. A. Kaelin
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Correspondence to D. Ceroni.

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Ceroni, D., Mousny, M., Lironi, A. et al. Pediatric seatbelt injuries: unusual Chance's fracture associated with intra-abdominal lesions in a child. Eur Spine J 13, 167–171 (2004). https://doi.org/10.1007/s00586-003-0559-2

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  • DOI: https://doi.org/10.1007/s00586-003-0559-2

Keywords

  • Chance fracture
  • Flexion-distraction
  • Abdominal lesions
  • Seatbelt