A REVIEW OF CERVICAL FRACTURES AND FRACTURE-DISLOCATIONS WITHOUT HEADIMPACTS SUSTAINED BY RESTRAINED OCCUPANTS

Crash injury reduction via lap-shoulder belt use has been well documen ted. Like any other interior car component, lap-shoulder belts may be related to injury in certain crashes. Relatively unknown is the fact t hat cervical fractures or fracture-dislocations to restrained front se at occupants occur where no head contact was evidenced by both medical records and car inspection. A review of the available literature on c ar crash injuries revealed more than 100 such cases. A review of the N ational Accident Severity Study (NASS) 80-88 file was also conducted, revealing more examples. Case capsule descriptions from the authors' f iles are also detailed along with examples of such injuries in infants and children in child restraints. However, cervical fractures or frac ture dislocations are rare, as evidenced by the relatively few cases i dentified in the literature, in the author's files, and by an analysis of NASS 80-90 data that revealed a cervical spine injury frequency of only .4% at the AIS-3 level (Huelke, Morris, and Mackay 1992).