Chalk stick fracture

Chalk stick, also known as carrot stick fractures, are fractures of the fused spine, classically seen in ankylosing spondylitis.

Some authors define the chalk stick fracture as a fracture through a Pagetoid long bone (see Paget disease) 3.

They usually occur through the disco-vertebral junction in the lower cervical or upper thoracic spine.

When several contiguous segments of the spine are fused, the fused column acts as a lever arm. This places greater than normal stresses on the spine. These fractures often occur following minimal trauma due to the altered biomechanics of the spine.

Chalk stick fractures are most commonly encountered in ankylosing spondylitis but may also been seen in the fused spines in patients with 2:

Non surgical management in a orthotic maybe suitable for patients with stable fracture patterns and no neurological defects. It should be noted that patients managed non operatively need aggressive follow up to ensure the fracture is adequately aligned till union is achieved and patient compliance with treatment 4

Long term follow up is also necessary to ensure they do not develop worsening kyphotic deformity. If these patients do develop malalignment syndromes surgical management is recommended 4.

Patients with any neurological deficit or unstable fracture patterns need surgical fixation to decompress the spinal cord and stabilize the fracture. In cervical fractures a Halo Brace can also be considered to manage these patients 4.  

Not surprisingly, it is named because of the resemblance of the fracture to breaking a chalk stick or a carrot.

Fractures
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Article information

rID: 41742
Tag: refs
Synonyms or Alternate Spellings:
  • Chalk fracture
  • Carrot stick fracture

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Cases and figures

  • Figure 1: broken chalk stick
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  • Case 1
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  • Case 4
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  • sagittal MPR
    Case 5
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  • Case 6
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  • Chalk stick fract...
    Case 7
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  • Case 8
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  • Case 9
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