Chance fracture

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[edit] Discussion of Chance fracture

  • Chance fracture represents a pure bony injury extending from posterior to anterior through the spinous process, pedicles, and vertebral body, respectively.
  • This fracture most commonly is found in the upper lumbar spine, but it may be observed in the midlumbar region in children.
  • Associated intraabdominal injuries (i.e. pancreatic injury, duodenal injury) can result in increased morbidity and mortality. Associated intra-abdominal injuries appear to be more common in the pediatric age group with incidence approaching 50%.
  • Unrecognized, Chance injuries may result in progressive kyphosis with resulting pain and deformity.

  • The most common history is that of a back seat passenger restrained by a lap seatbelt and involved in a motor vehicle accident or that of a person who has fallen from a height.

  • Treatment:
    • These fractures generally can be reduced by placing the patient on a Risser table with hyperextension applied to the thoracolumbar junction prior to applying a fiberglass or plaster cast.
    • If immobilization is impractical (large body habitus) or the patient has polytrauma, surgical management may be indicated.

[edit] Imaging Findings for Chance fracture

  • A demonstrable fracture line may be detected extending through the spinous process, pedicles, and vertebral body.

[edit] Images

Patient #1: MVA. CT images demonstrate a chance fracture

[edit] See Also

[edit] External Links

[edit] References for Chance fracture