Safety belt abdominal trauma associated with anthropometric characteristics of an injured person—a case report

• Main Authors: Pavel Timonov, Methodi Goshev, Ilinka Brainova-Michich, Alexandar Alexandrov, Dimitar Nikolov, Antoaneta Fasova
• Format: Article
• Language: English
• Published: SpringerOpen 2018-09-01
• Series: Egyptian Journal of Forensic Sciences
• Subjects: Safety belt trauma; Chance fracture; Abdominal aorta; Spinal fracture
• Online Access: http://link.springer.com/article/10.1186/s41935-018-0085-3

Abstract Background The aim of this report is to present a case of a blunt abdominal trauma with vascular and spinal involvements of an overweight man, caused by the front seat safety belt. Case presentation It took place as a result of the car bonnet collision with a roadside pillar. During the primary inspection of the crash site, it was found that the car had collided with a roadside pillar. The driver was found dead in the driver’s seat with the seat belt on. The lower part of the belt was in the inguinal region and the upper part was high on the chest, separated by the bulky midriff. The autopsy revealed a transverse fracture of the body of tenth thoracic vertebra, complicated by a torn abdominal aorta, and severe bleeding into the abdominal cavity, which was the cause of the death. The complications of the abdominal trauma result from the atypical position of the seat belt holding the upper and lower part of the body to the seat at two very distant levels, while between them the bulky, heavy midriff continued to move forward, carrying with it the vertebral column and surrounding anatomical structures. On the other hand, the forceful contact between the abdominal wall and the instrumental panel of the car generates pressure which transmits force through the adjacent organs to the aortic wall. The specific anthropometric features of the victim had an impact on the mechanism of death. The improper position of the seat belt relative to the body affected the severity of abdominal injuries, instead of protecting from them. Conclusions The driver’s body disproportion, combined with the restraining effect of the seat belt, could increase the risk of a fatal outcome. It is incorrect to think that if the victim had not worn a seat belt, he would have survived. The safest seatbelt type for occupants with a similar anthropometric data would be the 4-point seat belt system, which is used in children’s car seats. This type of safety belt is crossed over the chest and abdomen and holds the entire trunk better at dynamic loads in all directions.