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Clay-shoveler fracture

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Lifting 35 kg barbell over head. Dropped onto cervical spine, developed acute neck pain

Patient Data

Age: 25 years
Gender: Female

Cervical spine

x-ray

Displaced fracture (arrow) through the C6 spinous process.

Cervical spine

ct

Inferiorly displaced fracture through the spinous process consistent with direct impact injury.

Case Discussion

This fracture is usually to hyperflexion with avulsion of the ligamentous attachments to the spinous process. In this case, the fracture has been caused by direct impact force form the barbell! In both cases treatment is symptomatic.

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