Breast injuries from buckling-up
by Jared Reed
The three-point seatbelt has meant many thousands of lives have been spared in car accidents, but crush injuries to the breast are emerging as a new pattern of injury, reconstructive surgeons in Melbourne say.
The term ‘seat belt syndrome’ has been coined to refer to injuries caused by the lap-diagonal car restraint, and can include fractures, hollow organ perforations, mesenteric tears, and injuries to the breast ranging from mild bruising to subcutaneous avulsion from the chest wall.
In Melbourne, a pregnant woman in her late thirties was injured in an accident from a seatbelt, and a reduction in breast swelling over several months gradually revealed a deep cleft running across the nipple-areola area, so that the breast was almost completely inverted.
Her breast was saved by doctors who had to re-contour the distorted clefted right breast into the conventional convex mound. Other cases reported include a pregnant woman whose breast was split into two halves with avulsion of ducts from the nipple - requiring a drain to be inserted for the milk for 11 weeks.
There is likely to be an increase in injuries due to seatbelt legislation becoming more widespread, say the authors.
“The consequences of such injury can be severe in their functional, psychosocial and aesthetic impact,” they write in ANZ Journal of Surgery (80; 71-74).
“The challenge for the plastic surgeon is that each case is likely to be different and will require empirical designs based on estimation of nipple and breast segment blood supply, existing skin scars and the mobility of the remaining breast.”
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9 February 2010
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