Chance fracture
Template:Infobox medical condition (new) A Chance fracture is a type of vertebral fracture that results from excessive flexion of the spine.[1][2] Symptoms may include abdominal bruising (seat belt sign), or less commonly paralysis of the legs.[3][4] In around half of cases there is an associated abdominal injury such as a splenic rupture, small bowel injury, pancreatic injury, or mesenteric tear.[5][6] Injury to the bowel may not be apparent on the first day.[7]
The cause is classically a head-on motor vehicle collision in which the affected person is wearing only a lap belt.[8] Being hit in the abdomen with an object like a tree or a fall may also result in this fracture pattern.[9][4] It often involves disruption of all three columns of the vertebral body (anterior, middle, and posterior).[10][11] The most common area affected is the lower thoracic and upper lumbar spine.[11] A CT scan is recommended as part of the diagnostic work-up to detect any potential abdominal injuries.[6] The fracture is often unstable.[12]
Treatment may be conservative with the use of a brace or via surgery.[12] The fracture is currently rare.[10] It was first described by G. Q. Chance, a radiologist from Manchester, UK, in 1948.[5][13] The fracture was more common in the 1950s and 1960s before shoulder harnesses became common.[5][6]
Mechanism
In some Chance fractures there is a transverse break through the bony spinous process while in others there is a tear of the supraspinous ligament, ligamentum flavum, interspinous ligament, and posterior longitudinal ligament.[4]
Diagnosis
On plain X-ray, a Chance fracture may be suspected if two spinous processes are excessively far apart.[4]
A CT scan of the chest, abdomen, and pelvis is recommended as part of the diagnostic work-up to detect any potential abdominal injuries.[6][4] MRI may also be useful.[4] The fracture is often unstable.[12]
History
It was first described by G. Q. Chance, an Irish radiologist in Manchester, UK, in 1948.[5][13] The fracture was more common in the 1950s and 1960s before shoulder harnesses became common.[5][6]
References
<templatestyles src="Reflist/styles.css" />
- ↑ Script error: No such module "citation/CS1".
- ↑ Script error: No such module "Citation/CS1".
- ↑ Script error: No such module "Citation/CS1".
- ↑ a b c d e f Script error: No such module "citation/CS1".
- ↑ a b c d e Script error: No such module "citation/CS1".
- ↑ a b c d e Script error: No such module "citation/CS1".
- ↑ Script error: No such module "citation/CS1".
- ↑ Script error: No such module "citation/CS1".
- ↑ Script error: No such module "citation/CS1".
- ↑ a b Script error: No such module "citation/CS1".
- ↑ a b Script error: No such module "citation/CS1".
- ↑ a b c Script error: No such module "citation/CS1".
- ↑ a b Script error: No such module "Citation/CS1".
Script error: No such module "Check for unknown parameters".
External links
Template:Medical resources Script error: No such module "Navbox".