Gordon Zachary L, Gillespie Robert J, Ponsky Todd A, Barksdale Edward M, Thompson George H
Division of Pediatric Orthopaedic Surgery and Pediatric General Surgery, Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Cleveland, OH 44106, USA.
J Pediatr Orthop. 2009 Dec;29(8):856-9. doi: 10.1097/BPO.0b013e3181c119b2.
Pediatric Chance fractures are uncommon injuries. They are the result of a flexion-distraction force applied to the spine, and most commonly occur from motor vehicle accidents in which passengers are wearing lap seat belts as opposed to 3-point restraints with a chest strap. Neurologic injuries are rarely associated with Chance fractures in children, but accompanying intraabdominal injuries are often found and carry a potential for significant morbidity. We present 3 siblings in a minivan who were involved in a high-speed motor vehicle accident and as a result of wearing their 3-point restraints improperly, suffered Chance fractures. None had neurologic dysfunction, but 2 had serious intra-abdominal injuries requiring surgical repair. All 3 Chance fractures were treated with cast immobilization. This case report shows the importance of wearing 3-point restraints properly while traveling in a motor vehicle.
