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Posted on 01-07-2014

Seat Belt Induced Injuries in Baltimore Auto Accidents

Believe it or not, wearing a seat belt can actually cause injuries if you are involved in a Baltimore auto accident. Don't get me wrong- this is not a license to unbuckle and drive without a seat belt harness. Seat belts were invented to prevent catastrophic injury and ejection from a vehicle and should be worn any time an occupant gets behind the wheel. Interestingly, the forces that restrain an occupant and prevent ejection can be the cause of other lesser seen injuries in the cases of Baltimore auto accidents.

One of the most important indicators to the possible presences of these seat belt injuries is what is referred to as "seat belt sign." This is the presence of an abrasion (redness, scraping) located over the abdomen, pelvic region, neck, or breasts (or anywhere a seat belt is worn).

In children the presence of seat belt sign may indicate a SCIWORA injury. This stands for Spinal Cord Injury Without Radiographic Abnormality. Admittedly, I have never seen it in my 5 years of clinic practice to date. During the deceleration phase of the rear-end whiplash injury internal organs can sometimes get compressed between the seat belt and the spine causing organ damage and even dislocation of spinal segments. This can cause severe compression to the spinal cord that can be missed on standard radiographic (x-ray) examination. Presence of a seat belt sign in children should warrant further abdominal MRI in children and may prompt an MRI to rule out SCIWORA.

In addition to the lap belt causing injury, the shoulder harness can injure an occupant as well, depending on where it contacts the neck of an occupant. This is also especially true when the webbing lays across a child/young adult's neck rather than their chest. This is seen when the webbing is not adjusted to an occupants height appropriately. It can cause seat belt sign on the neck which can indicate damage to the vascular structures of the neck. Most notably, it can cause compression and tearing of the carotid and/or vertebral arteries. Careful evaluation may include doppler ultrasound to the affected structures or MRA evaluation. The discussion of MRA evaluation is beyond the scope of this blog post. Please contact me if you want more information.

Finally, women are especially susceptible to seat belt sign following a Baltimore auto accident as well. Due to the anatomy of their breasts, they can develop seat belt sign across their breasts. In some cases this can cause break down of fatty tissue in the breast region, known as traumatic fat necrosis. This can lead to a change in the shape and look of their breast tissue. There has been some research indicating that this can lead to breast cancer, although research in that category is not conclusive at this time. Additionally, women who have artificially augmented their bosoms can suffer from a traumatic capsulotomy where their augmented breasts begin to display asymmetry following a whiplash injury or where their breast implants actually get punctured as a result of a motor vehicle collision in Baltimore.

Once again, these seat belt signs are certainly not very common and even when present, do not necessarily indicate internal damage as described above. I always tell patients that they know their body better than I do and that if they suspect there may be internal damage that they should talk to their providers about having more thorough examinations be performed.

If you, or anyone you know, has suffered from an auto accident in Baltimore and have seat belt sign or other forms of whiplash, please contact Mid-Atlantic Spinal Rehab & Chiropractic at (443) 842-5500. We would be glad to help!

The preceding information was found in the book "Whiplash and Mild Traumatic Brain Injuries" by Dr. Arthur C. Croft (pages 202-203.)

Dr. Gulitz

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