Clay-shoveler fracture

Last revised by Dr Yahya Baba on 26 Feb 2021

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.

Originally described in Australia, among clay shovelers. The reason is due to the stickiness of clay. As clay shovelers lift the shovel upwards to toss the clay from deep ditches, the clay tends to stick to the shovel. This results in sudden forces on the neck and back muscles leading to the avulsion fracture.

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Cases and figures

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  • Case 6
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  • Case 4
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  • Case 5: old un-united
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  • Case 6: C6 and C7
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  • Case 7
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  • Case 8
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  • Case 9
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  • Case 10
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