FULCRUM FRACTURES OF THE LUMBAR SPINE. TRANSVERSE FRACTURE INDUCED BY AN IMPROPERLY PLACED SEAT BELT.

THE USE OF the lap-type safety belt has been shown by numerous studies to be effective in the reduction of major and fatal automobile injuries.1-4When the belt is properly and firmly fixed across the pelvis, a firm restraint from trauma is imposed. When the belt is loosely worn or intentionally placed higher on the abdomen, an entirely different force is created. There have been several reports of severe intra-abdominal injury due to high placement of the seat belt. Kulowski and Rost5described a case of intermittent partial obstruction of the ileum due to adhesions at the site of a previous mesenteric tear, presumably caused by a seat belt injury. Tolins6described one instance of small-bowel perforation. Garrett and Braunstein,4in their comprehensive study, report one case of ruptured pancreas and duodenum. Cocke and Meyer7have reported a well-documented case of splenic rupture due to