PEDIATRICS Vol. 84 No. 2 August 1989, pp. 348-354
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Cervical Spine Fractures Sustained by Young Children in Forward-Facing Car Seats

Susan Fuchs MD1, Martha J. Barthel RN, MSN1, Ann Marie Flannery MD1, and Katherine K. Christoffel MD, MPH1

1 The Department of Pediatrics, University of Pittsburgh School of Medicine; Emergency Department, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Departments of Neurosurgery and Pediatrics, Northwestern University School of Medicine; Children's Memorial Hospital, Chicago, Illinois; and the Section of Neurosurgery, Medical College of Georgia, Atlanta, Georgia

Child passenger safety restraint laws have reduced the number of children killed or injured in motor vehicle accidents in the past few years. However, the increased used of child safety seats has brought with it an increase in the misuse of these devices. High cervical spine injuries sustained by five children less than 2 years of age while in forward-facing car seats are described. In the cases of three children, the car safety seat use was correct. Misuse of car seats and anatomic and biomechanical factors in the cervical spines of infants and young children appear to have contributed to the occurrence of these previously rare injuries. Like seat belts, car safety seats are now a factor in child passenger injury characteristics, and therefore, car safety seat design merits reevaluation. In light of this development, public and parent education by health care professionals concerning the correct use of car safety seats is necessary.

Key Words: cervical spine fractures • infant car seats; child safety seats • child passenger safety • motor vehicle injury • passenger injury

Submitted on October 4, 1988
Accepted on January 12, 1989




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