Injuries: road traffic and seat belt injuries: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Injuries: road traffic and seat belt injuries

Sample item

A driver wearing a lap-and-shoulder belt in a head-on collision has a linear bruise across the abdomen and develops peritonitis. What injury pattern should be sought?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Mesenteric and bowel injury with Chance fracture of the lumbar spine

The seat belt sign reflects compression and flexion forces, which commonly cause mesenteric tears, bowel perforation and a flexion-distraction (Chance) fracture of the lumbar vertebrae. Ring fracture and calcaneal fractures are typical of falls from height, and a bumper fracture of the leg is seen in pedestrians.

Option by option

  • A. Bilateral calcaneal fractures

    Calcaneal fractures are classical in jumps landing on the feet.

  • B. Bumper fracture of the tibia

    Bumper fracture is a pedestrian injury and not related to belts.

  • C. Fracture of the ring around the foramen magnum

    Ring fracture of the skull base is seen in falls onto the feet or buttocks.

  • D. Mesenteric and bowel injury with Chance fracture of the lumbar spine (correct)

    Seat belt sign strongly predicts hollow viscus, mesenteric and lumbar spine injury.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is D, Mesenteric and bowel injury with Chance fracture of the lumbar spine. The seat belt sign reflects compression and flexion forces, which commonly cause mesenteric tears, bowel perforation and a flexion-distraction (Chance) fracture of the lumbar vertebrae.

Why is "Bilateral calcaneal fractures" not the answer?

Calcaneal fractures are classical in jumps landing on the feet.

Why is "Bumper fracture of the tibia" not the answer?

Bumper fracture is a pedestrian injury and not related to belts.

Why is "Fracture of the ring around the foramen magnum" not the answer?

Ring fracture of the skull base is seen in falls onto the feet or buttocks.

What concept does this question test?

It tests Injuries: road traffic and seat belt injuries in Forensic Medicine. Ring fracture and calcaneal fractures are typical of falls from height, and a bumper fracture of the leg is seen in pedestrians.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Injuries: road traffic and seat belt injuries?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.