Pediatric restraint use in motor vehicle collisions -: Reduction of deaths without contribution to injury

Hypothesis: Restraint use for children in automobiles is mandated in every state, but injury patterns are unknown. Although use of pediatric retraints is associated with reducing morbidity and mortality, the injury distribution for specific anatomic sites may be altered in restrained vs unrestrained children. Design: Review of trauma registry data, medical records, and autopsy findings. Setting: Urban level I trauma center and tertiary care children's hospital. Patients: All children aged 6 years or younger who were in motor vehicle collisions from June I, 1990, through March 31, 1997. Main Outcome Measures: Age, weight, restraint use and type, collision data, Injury Severity Score (TSS), injury type, and outcome. Results: We included 600 children. The restrained group showed a reduction in severe injuries for every anatomic sire and had a lower mean ISS, fewer injuries, and more uninjured children. The restrained group also had a reduction in the incidence of hollow- and solid-organ abdominal injuries. Conclusions: Age-appropriate restraint devices decrease mortality and reduce the incidence of significant injury in motor vehicle collisions for all anatomic sites in young children. In contrast to injuries attributed to restraint use in adults, specific restraint-related injury patterns were not seen in children.