Chance fracture: Difference between revisions
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==Evaluation== | ==Evaluation== | ||
[[File:PchancefracCT.png|thumb|Chance fracture of T10 and fracture of T9 due to a seatbelt during an MVC.]] | |||
===Workup=== | ===Workup=== | ||
*Obtain sagittally reconstructed CT if suspect lap-belt mechanism or flexion-distraction | *Obtain sagittally reconstructed CT if suspect lap-belt mechanism or flexion-distraction | ||
Revision as of 12:46, 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