Abstract
Thirty-five occupants fatally injured (despite the use of seat belts) in head-on collisions suffered severe injuries to the craniocervical junction (ring fractures of the base of the skull, fractures of the upper cervical vertebrae, or disruptions between the cervical vertebrae) if there was extensive trauma against the head or if submarining under shoulder belts took place. If three-point belts were used, few or no neck injuries were observed if there was only a slight impact between the head and some part of the car, and there was no instability of the cervical spine due to pathologic changes.
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