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July 19, 1965

Fulcrum Fractures of the Lumbar Spine: Transverse Fracture Induced by an Improperly Placed Seat Belt

Author Affiliations

From the Department of Radiology, Ohio Valley General Hospital (Drs. Howland and Curry), and the Department of Orthopedic Surgery, Wheeling Clinic (Dr. Buffington), Wheeling, WVa.

JAMA. 1965;193(3):240-241. doi:10.1001/jama.1965.03090030062025

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.1-4 When 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 Rost5 described 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. Tolins6 described one instance of small-bowel perforation. Garrett and Braunstein,4 in their comprehensive study, report one case of ruptured pancreas and duodenum. Cocke and Meyer7 have reported a well-documented case of splenic rupture due to