L-Spine

Chance Fracture

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Chance Fracture, Chance Flexion Distraction Fracture of Vertebra, Chance Vertebral Fracture, Seat Belt Fracture

  • Pathophysiology
  1. High velocity Traumatic Injury (e.g. MVA with Lap belt only)
  2. Causes flexion and distraction of the thoracolumbar spine
  3. Unstable, transverse Fracture through the anterior, middle and posterior Vertebral body
  • Associated Conditions
  1. Spinal cord injury
  2. Traumatic Aortic Disruption
  3. Liver Laceration
  4. Splenic Rupture
  5. Mesentary or Small Bowel injury (if Seat Belt Sign present)
  • Signs
  1. Point tenderness over thoracolumbar Vertebrae (L1 region)
  2. Seat Belt Sign
  • Management
  1. Spine surgery is typically required
  • Resources
  • References
  1. Herbert, Orman and Hollander in Herbert (2018) EM:Rap 18(4): 13