Chance fracture
Vertebral fracture from flexion, often from lap-belt injuries.
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A Chance fracture is a type of vertebral fracture resulting from excessive flexion of the spine, classically caused by head-on motor vehicle collisions in which the occupant wears only a lap belt. It often involves disruption of all three columns of the vertebral body and is associated with abdominal injuries in about half of cases. The fracture is typically unstable and most commonly affects the lower thoracic and upper lumbar spine.
Background
The Chance fracture was first described in 1948 by G. Q. Chance, a radiologist working in Manchester, UK. The fracture was more common in the 1950s and 1960s before shoulder harnesses became common in vehicles. The mechanism of injury involves excessive flexion of the spine. In some cases 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.
The fracture is often unstable. Diagnosis may be suspected on plain X-ray if two spinous processes are excessively far apart. A CT scan of the chest, abdomen, and pelvis is recommended to detect potential abdominal injuries. MRI may also be useful. Treatment may be conservative with a brace or via surgery.
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Sources
Compiled from Wikipedia and the sources listed below. Text from Wikipedia is available under CC BY-SA 4.0; this entry is adapted from it.
- Wikipedia: Chance fracture (CC BY-SA 4.0).
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