Clay-shoveler fractures are fractures of the spinous process of a lower cervical vertebra.
Often these injuries are unrecognised at the time and only found incidentally years later when the cervical spine is imaged for other reasons.
Acutely they tend to be associated with 1:
- motor vehicle accidents
- sudden muscle contraction
- direct blows to the spine
The fracture is seen on lateral radiographs as an oblique lucency through the spinous process, usually of C7. There is usually significant displacement.
History and etymology
Originally described in Australia, in (no prizes for guessing) clay shovelers. Why clay rather than dirt or sand? The reason is due to the stickiness of clay. As a clay shovelers tossed the shovel upward, the clay sometimes stuck to it which produced a sudden flexion force on the neck and back muscles, resulting in the fracture.
- 1. Lee P, Hunter TB, Taljanovic M. Musculoskeletal colloquialisms: how did we come up with these names? Radiographics. 24 (4): 1009-27. doi:10.1148/rg.244045015 - Pubmed citation
- 2. Yamaguchi KT, Myung KS, Alonso MA et-al. Clay-shoveler's fracture equivalent in children. Spine. 2012;37 (26): E1672-5. doi:10.1097/BRS.0b013e318273e191 - Pubmed citation
- 3. Solaroğlu I, Kaptanoğlu E, Okutan O et-al. Multiple isolated spinous process fracture (Clay-shoveler's fracture) of cervical spine: a case report. Ulus Travma Acil Cerrahi Derg. 2007;13 (2): 162-4. Pubmed citation
- fractures by location
- cervical spine fracture classification systems
- thoracolumbar spinal fracture classification systems
- three column concept of spinal fractures (Denis classification)
- classification of sacral fractures
- facet dislocation