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Clinical Notes
April 10, 1967

Seat-Belt Fractures of the Spine and Sternum

Author Affiliations

From the Department of Radiology, Johns Hopkins Hospital, Baltimore.

JAMA. 1967;200(2):167-168. doi:10.1001/jama.1967.03120150123033

IN A RECENT ISSUE of the Journal, Howland et al1 reviewed automobile crash injuries attributed to improperly positioned, lap-type seat belts and reported the first case of an unusual transverse fracture of a lumbar vertebra sustained by acute flexion of the torso over the lap belt. A similar "fulcrum fracture" of the lumbar spine is described in case 1 below.

The implication has been that seat-belt injuries may be prevented by proper positioning of the laptype belt or by the use of the "bandolier" or shoulder-type belt. That the latter type of safety harness also is capable of producing skeletal injury is indicated by case 2.

Report of Cases 

Case 1.—  A 21-year-old woman was admitted to the emergency room immediately after injury in an automobile accident. The patient had been a passenger in a small, foreign sports car which had struck the rear of a semitrailer truck while