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Lap belt iliac wing fracture: a predictor of bowel injury in children

Kathleen H Emery1

  • 1Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45227, USA. emerykh@chmcc.org

Pediatric Radiology
|November 26, 2002
PubMed

Insights

Lap belts in car crashes can cause serious bowel and spine injuries in children. Iliac wing fractures from lap belt use are linked to a high frequency of these severe abdominal injuries.

Area of Science:

  • Orthopedic Surgery
  • Pediatric Trauma
  • Abdominal Injury

Background:

  • Motor vehicle collisions are a significant cause of pediatric injury.
  • Lap belt restraints are standard safety devices, but can cause specific injuries.
  • Previous research links lap belts to bowel and lumbar spine trauma, particularly in children.

Observation:

  • Two pediatric patients involved in high-speed collisions presented with lap belt-related injuries.
  • Both patients sustained iliac wing fractures.
  • One patient experienced delayed diagnosis of bowel perforation, with free peritoneal fluid as the only CT finding.

Findings:

  • Lap belt use in pediatric motor vehicle collisions is associated with iliac wing fractures.
  • Pediatric patients with iliac wing fractures from lap belt use have a high frequency of associated bowel injuries.
  • Free peritoneal fluid on CT scans may be an indicator of bowel injury in these cases.

Implications:

  • Iliac wing fractures in children following motor vehicle accidents warrant a high suspicion for associated bowel injuries.
  • Radiologists and clinicians should be aware of the link between lap belt use, iliac wing fractures, and intra-abdominal injuries in pediatric trauma.
  • This highlights the importance of proper lap belt positioning in children to prevent severe injuries.

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