Between January 2013 - January 2020, 28 children were admitted to Starship Children’s Hospital following a serious road traffic crash.

In total, there were five paediatric lap belt injuries of the abdominal aorta.

Ages ranged between three and 12 years of age, with a median age of eight years of age.
60 per cent of patients were documented to have sustained abdominal wall ecchymoses. 
All five patients sustained a hollow viscus injury, with three patients suffering a hollow viscus peroration.
All five patients sustained lumbar spine fractures, with four patients suffering Chance fractures.

Dr Dhru Ramson, a Royal Australasian College of Surgeons (RACS) Trainee at Auckland’s Starship Children’s Hospital said car accidents are responsible for a large number of child deaths In New Zealand.

“Age-appropriate seating restraints have been shown to offer a safety benefit,” Dr Ramson said.

“Lap belts have been heavily implicated in contributing to injury with a 50 per cent reduction in fatalities from automobile collisions following the introduction of the three-point harness.

“Child restraint practises in Aotearoa New Zealand have been demonstrated to fall short of best practise recommendations.  

“In our retrospective study, all five patients who sustained lap belt injuries of the abdominal aorta had a triad of gastrointestinal injury, lumbar spine fracture and abdominal aortic injury. 

“Our single centre audit demonstrates lap belts continue to cause significant injury, which could be reduced by the use of three-point restraints and age-appropriate restraints. 

“We recommend the phasing out of lap belts and increased utilisation of age-appropriate restraints.  

“Anecdotally, paediatric lap belt injuries of the abdominal aorta occur in later model vehicles.

“They don’t happen very often, but when they do, they are catastrophic, which is alarming, because the severity of this type of injury can be reduced with appropriate safety measures, including a three-point restraint.

“I encourage the Hipkins Government to consider legislation which prohibits the use of lap belt restraints in all vehicles on New Zealand roads.”

Dr Ramson’s research was unveiled at the the Royal Australasian College of Surgeons Annual Scientific Congress in Adelaide (1-5 May).

The Congress is the largest multi-disciplinary surgical meeting held in the southern hemisphere and brings together some of the top surgical and medical minds from across Aotearoa New Zealand, Australia, and the rest of the world.

For more information about the Royal Australasian College of Surgeons Annual Scientific Congress, please visit:


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