Lumbar compression fractures secondary to lap-belt use in children.

The correlation between flexion-distraction injuries and lap-belt use has been well documented. Over a 10-year period, we identified seven children admitted to Children's National Medical Center, Washington, DC, with compression fractures of the lumbar spine secondary to lap-belt use. Four were rear seat passengers, and three were in the front seat. The average age was 7 years. Four of the seven (57%) suffered associated abdominal injuries. One died of an associated head injury. We hypothesize that the mechanism of injury in these cases was similar to that in flexion-distraction injuries. The increased elasticity in the posterior ligamentous complex in children may be responsible for the occurrence of these compression fractures rather than the expected flexion-distraction-type injuries.