Chance fracture: Difference between revisions
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==== | ==Background== | ||
*Unstable | |||
*Most common at T12-L2 due to spinal curvature and mechanism | |||
*May be misdiagnosed as anterior compression fracture, which is usually stable | |||
==Clinical Features== | |||
*Common mechanism: seat belt serves as axis of rotation with failure of middle and posterior columns | *Common mechanism: seat belt serves as axis of rotation with failure of middle and posterior columns | ||
*Seat Belt Injury: lap belt worn above the pelvic bones without a shoulder harness | *Seat Belt Injury: lap belt worn above the pelvic bones without a shoulder harness | ||
*Mechanism: minor anterior vertebral compression with failure of the middle and posterior columns | *Mechanism: minor anterior vertebral compression with failure of the middle and posterior columns | ||
*Intra-abdominal injuries more commonly associated than neuro deficits | *Intra-abdominal injuries more commonly associated than neuro deficits | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Evaluation== | ==Evaluation== | ||
===Workup=== | ===Workup=== | ||
*Obtain sagittally reconstructed CT if suspect lap-belt mechanism or flexion-distraction | |||
===Diagnosis=== | ===Diagnosis=== | ||
*Pure bony injury from posterior to anterior through: | |||
**Spinous process | |||
**Pedicles | |||
**Vertebral body | |||
==Management== | ==Management== | ||
Revision as of 12:44, 24 October 2020
Background
- Unstable
- Most common at T12-L2 due to spinal curvature and mechanism
- May be misdiagnosed as anterior compression fracture, which is usually stable
Clinical Features
- Common mechanism: seat belt serves as axis of rotation with failure of middle and posterior columns
- Seat Belt Injury: lap belt worn above the pelvic bones without a shoulder harness
- Mechanism: minor anterior vertebral compression with failure of the middle and posterior columns
- Intra-abdominal injuries more commonly associated than neuro deficits
Differential Diagnosis
Evaluation
Workup
- Obtain sagittally reconstructed CT if suspect lap-belt mechanism or flexion-distraction
Diagnosis
- Pure bony injury from posterior to anterior through:
- Spinous process
- Pedicles
- Vertebral body