Citation

Onu DO, Hunn AW, Bohmer RD. BMJ Case Rep. 2014; 2014: e2013-202412.

Affiliation

Department of Neurosurgery, Royal Hobart Hospital, Hobart, Tasmania, Australia.

Copyright

(Copyright © 2014, BMJ Publishing Group)

DOI

10.1136/bcr-2013-202412

PMID

24403388

Abstract

The seat belt syndrome is a recognised complication of seat belt use in vehicles. Unstable Chance fractures of the spine without neurological deficits have been reported infrequently. We describe a young woman with completely disrupted Chance fracture of the second lumbar vertebra in association with left hemidiaphragmatic rupture/hernia, multiple bowel perforations, splenic capsular tear, left humeral shaft and multiple rib fractures. These injuries which resulted from high-speed vehicle collision and led to death of one of the occupants were readily detected by trauma series imaging. The patient was successfully treated by a dedicated multidisciplinary team which adopted a staged surgical approach and prioritisation of care. There were no manifested neurological or other deficits after 1 year of follow-up. To the authors' knowledge, this is the first report of such a case in Australasia. We discuss the challenging surgical management, highlighting the role of radiological imaging in such cases and provide a literature review.

Language: en