Seat belt sign trauma ppt4/5/2024 This results in a fracture of posterior elements of the spine, usually at thoracolumbar level. This fracture is caused by a flexion-distraction mechanism with forced flexion of the spine across a fixed fulcrum. Also, a unique vertebral fracture is associated with 2-point seatbelts: the Chance fracture. Solid viscus organs are especially afflicted in patients with a mal-positioned lap belt. Severe injuries to the head, spine and gastrointestinal tract are highly associated with 2-point or lap belt seatbelts. The combination of injuries is associated with the type of seatbelt used. The likelihood of intra-abdominal injury in patients with a ‘seatbelt sign’ is increased up to 4-20 percent. In the ‘seatbelt syndrome’ this bruising is accompanied by intra-abdominal injury. The ‘seatbelt sign’ was described by Doersch and Dozier in 1968 and is a bruising pattern across the torso that follows the course of the seatbelt after a high velocity MVC. These patterns are described as the ‘seatbelt sign’ and ‘seatbelt syndrome’. However, distinctive patterns of injuries after high velocity MVC’s have emerged. When the seatbelts were introduced in cars, morbidity and mortality rates following motor vehicle crashes (MVC) have dropped considerably. If there is a disruption primary repair is a good option. When a laparotomy is not indicated, the abdominal wall must be assessed for disruption. In both cases of the severe abdominal wall disruption, primary repair without mesh in the acute phase was successful. Closure of blunt traumatic abdominal wall disruption can be done primarily with sutures or addition of a mesh. CT-scanning is an accurate method to detect disruptions. However, it is a diagnosis that may not be missed as patients have a higher risk of morbidity and mortality. A disruption of the abdominal wall is a rare complication. These disruptions were primarily closed and during six months of follow-up no complications occurred. Both patients had an abdominal wall disruption along the seatbelt sign. Both presented with an acute abdomen and a seatbelt sign upon which the decision was made to perform emergency laparotomies. Two patients were brought in after a high velocity Motor Vehicle Collision. We present two cases of severe abdominal wall disruption caused by a seatbelt injury and treated with primary repair. Injuries may consist of traumatic abdominal wall disruption. However, two patterns of injuries, the ‘seatbelt sign’ and ‘seatbelt syndrome’ have emerged. With the introduction of the use of seatbelts in cars, mortality following motor vehicle crashes has decreased significantly.
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