[Seat belt syndrome]

The increasingly common use of seat belts in the standard features of cars has markedly reduced the seriousness of lesions due to motor vehicle accidents but, at the same time, has caused the appearance of a specific pattern of injuries strictly related to the type of restraint. Thus, the seat belt syndrome consists of soft-tissues, skeletal and visceral injuries associated with the use of the passenger restraint system. After describing the site of injuries, we report the most common features of traumatic lesions, also comparing the consequences of the three possible occurrences: unrestrained, with two- and three- point restraints. With lap seat belts, which are the less complex, injuries most frequently involve the abdomen and vertebrae while with the three-point variety of seat belts the chest and shoulder girdle are involved. No matter what the type of restraint, skin abrasions are nearly always observed, and associated with internal injuries in 30% of cases. From the analysis of distribution, type and seriousness of injuries we can summarize that: a) the use of passenger restraint systems has surely reduced mortality and morbidity associated with motor vehicle accidents; b) the seat belt will never be able to avoid traumatic events because strong forces act and strike in a very short time on small areas of textile fabric; c) seat belts can be still considered the easiest, most reliable and cost-effective preventive method.