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Seatbelt injuries in children
S D Glassman1, J R Johnson, R T Holt
1Department of Orthopaedic Surgery, University of Louisville School of Medicine, Kentucky.
The Journal of Trauma
|December 1, 1992
Summary
Chance-type lumbar spine injuries in children are increasing due to seatbelt use. Bracing may be effective for less severe injuries, but significant deformities often require surgery.
Area of Science:
- Pediatric Orthopedics
- Spinal Trauma
- Biomechanics
Background:
- Chance-type flexion-distraction injuries are a subset of lumbar spine trauma.
- Increased use of lap seatbelts has led to a rise in these injuries among children.
- These injuries involve a significant ligamentous component and can lead to kyphotic deformity.
Purpose of the Study:
- To review treatment regimens and outcomes for pediatric Chance-type lumbar spine injuries.
- To identify factors predicting successful non-operative management (bracing).
- To inform appropriate treatment strategies for children with these injuries.
Main Methods:
- Retrospective review of twelve pediatric cases (<16 years old) with Chance-type lumbar spine injuries.
- Evaluation of initial treatment, modifications, and long-term outcomes (6 months to 9 years).
- Analysis of initial kyphotic deformity and maximum measured deformity in relation to treatment success.
Main Results:
- Seven patients with significant ligamentous injury were initially braced.
- Successful bracing was associated with initial kyphotic deformity <20 degrees and maximum deformity <25 degrees.
- Brace treatment failure occurred in all cases with initial deformity >20 degrees, progressing to >30 degrees before surgery.
Conclusions:
- A specific pediatric treatment approach for Chance-type lumbar spine injuries is warranted.
- Bracing can be effective for select pediatric cases with less severe initial deformity.
- Significant initial kyphotic deformity (>20 degrees) in children suggests a higher likelihood of treatment failure with bracing and need for surgical intervention.