Chance fracture

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Chance fracture (Flexion-distraction injuries)

  • Common mechanism: seat belt serves as axis of rotation with failure of middle and posterior columns
  • Most common at T12-L2 due to spinal curvature and mechanism
  • Pure bony injury from posterior to anterior through:
    • Spinous process
    • Pedicles
    • Vertebral body
  • Unstable
  • 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
  • May be misdiagnosed as anterior compression fracture, which is usually stable
  • Intra-abdominal injuries more commonly associated than neuro deficits
  • Obtain sagittally reconstructed CT if suspect lap-belt mechanism or flexion-distraction

Background

Clinical Features

Differential Diagnosis

Evaluation

Workup

Diagnosis

Management

Disposition

See Also

External Links

References