Seatbelt injury is most commonly associated with which fracture?

• A. Wedge Fracture
• B. Burst Fracture
• C. Chance Fracture
• D. Compression Fracture

Answer: (C)

Seatbelt injuries cause a flexion-distraction injury at the thoracolumbar junction. The lap belt fixes the pelvis while the upper body is thrown forward, producing a horizontal fracture through the posterior elements and often the vertebral body—the classic Chance fracture. This mechanism explains why it’s linked to seatbelt use in high-energy crashes and why it differs from other fracture types: wedge fractures come from anterior compression, burst fractures from high-energy axial loading with fragment retropulsion, and simple compression fractures involve mainly the anterior column without the distraction pattern. So, the pattern best matching a seatbelt injury is a Chance fracture.