This fracture has a strong relation with hollow viscus injury associated with lap belt injuries [48]. A seatbelt

caused a chronic intermittent intestinal obstruction due to adhesions seven years following trauma [49]. Thoracic duct rupture and chylothorax as a complication of a seatbelt was reported after sudden increase in intra-abdominal pressure [50]. Similarly pancreatic transection at the neck may occur [51]. Intra-peritoneal rupture of distended urinary bladder may occur when the horizontal strap of the seatbelt increases the intra-vesical pressure [52]. Blunt traumatic aortic rupture [53], sternal fractures [41], clavicle fractures [32] and shoulder dislocations [54] were also reported as a complication Selisistat cell line of seatbelts. Cervical spinal injuries were noticed to be higher in restrained children DMXAA than non-restrained children [19, 32, 55]. Figure 2 A 30-year-old male driver with an abdominal seat belt sign (A) who had a laparotomy (B). The patient had abdominal this website tenderness and guarding. Abdominal CT scan has shown free intraperitoneal fluid without solid organ injury. Laparotomy has shown multiple mesenteric tears. Figure 3 Seatbelt syndrome is defined as a seatbelt sign associated with lumbar spine fracture and bowel perforation. Seatbelt compliance and road traffic collision deaths We

have studied the correlation between seatbelt use and road traffic deaths. A linear regression analysis was made between the overall seatbelt compliance and road traffic death rates in high income countries. Data for the high-income countries (defined as having a GNI $11 456 per capita or more) were retrieved from the WHO, road traffic injury prevention discussion paper (39 countries) [56]. More data were

retrieved from MEDLINE, Google and Google scholar searching tools and data from another seven countries were added (Kuwait [57], New Zealand [58], Qatar [59], Saudia Arabia [11], Sweden [60], UAE [61], and USA [62]. We used data of high income countries which have overall seatbelt compliance for all occupants including the drivers, front seat passengers and back seat passengers. Data for estimated road traffic death rate per 100 000 populations for year 2007 were collected from the WHO road traffic injury prevention global status report on road Thalidomide safety [63]. The linear regression was done on data for 46 high-income countries. There was a very highly significant negative correlation between the seatbelt compliance and road traffic death rates (F = 65.5, p < 0.00001, R = – 0.77, Adjusted R square = 0.58) (Figure 4). Figure 4 Linear regression between the seatbelt compliance and road traffic death rates in 46 high-income countries. The negative correlation was highly significant (R = – 0.77, F = 65.5, p < 0.00001). The above strong negative correlation between the seatbelt compliance and mortality rate can be explained by several factors.