Abstract
Restrained occupants are frequently protected from severe head and chest injuries which are common among unrestrained occupants. Consequently, the injuries which remain may be undetected. Injuries to the spleen, liver, kidneys, and digestive system are typically not diagnosed at the scene. This paper reports on an observed pattern of liver lacerations suffered by drivers wearing shoulder belts, without the lap belt fastened. Eight cases of drivers protected by shoulder belts but without the lap belt fastened met the criteria for the study. All eight suffered liver lacerations. In three of the cases, the injuries were not immediately detected.