Seat belt syndrome with unstable Chance fracture dislocation of the second lumbar vertebra without neurological deficits.

Abstract

The seat belt syndrome is a recognised complication of seat belt use in vehicles. Unstable Chance fractures of the spine without neurological deficits have been reported infrequently. We describe a young woman with completely disrupted Chance fracture of the second lumbar vertebra in association with left hemidiaphragmatic rupture/hernia, multiple bowel perforations, splenic capsular tear, left humeral shaft and multiple rib fractures. These injuries which resulted from high-speed vehicle collision and led to death of one of the occupants were readily detected by trauma series imaging. The patient was successfully treated by a dedicated multidisciplinary team which adopted a staged surgical approach and prioritisation of care. There were no manifested neurological or other deficits after 1 year of follow-up. To the authors' knowledge, this is the first report of such a case in Australasia. We discuss the challenging surgical management, highlighting the role of radiological imaging in such cases and provide a literature review.

• Authors: David O Onu, Andrew W Hunn, Robert D Bohmer
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2014 (Jan 08 2014) ISSN: 1757-790X [Electronic] England
• PMID: 24403388 (Publication Type: Case Reports, Journal Article)

Topics

• Accidents, Traffic
• Adult
• Cooperative Behavior
• Female
• Fractures, Comminuted (diagnosis, surgery)
• Humans
• Image Processing, Computer-Assisted
• Imaging, Three-Dimensional
• Intensive Care Units
• Interdisciplinary Communication
• Joint Dislocations (diagnosis, surgery)
• Lumbar Vertebrae (injuries, pathology, surgery)
• Magnetic Resonance Imaging
• Multiple Trauma (diagnosis, surgery)
• Neurologic Examination
• Patient Care Team
• Postoperative Care (methods)
• Postoperative Complications (diagnosis)
• Seat Belts (adverse effects)
• Spinal Fractures (diagnosis, surgery)
• Spinal Fusion (methods)
• Syndrome
• Tomography, X-Ray Computed