Extension tear drop fracture

Extension tear drop fracture typically occurs due to forced extension of the neck with resulting avulsion of the anteroinferior corner of the vertebral body. Extension teardrop fractures are stable in flexion, and unstable in extension as the anterior longitudinal ligament is disrupted. Extension teardrop is not considered as severe as flexion teardrop fractures.

They occur due to forced extension of the neck (i.e. is a hyperextension injury) with resulting avulsion of the anteroinferior corner of the vertebral body.

In older patients the C2 vertebral body is commonly affected due to degenerative ankylosis of lower levels. Associated cervical spine fractures are common. 

  • anterior-inferior corner fracture 3
    • avulsion fracture from the attachment of the anterior longitudinal ligament to the inferior corner of the vertebral body, usually a thin fracture fragment
    • the fragment is triangular in a shape reminiscent of a teardrop
    • vertical height of fragment is equal to or greater than width
    • anterior disc space widening
  • additional fractures are common and thus, CT scan is indicated in all cases

There are several other tear drops, please see the disambiguation article here.

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Article information

rID: 1303
Section: Gamuts
Tags: refs, cases, spine
Synonyms or Alternate Spellings:
  • Extension teardrop fracture
  • Hyperextension teardrop fracture
  • Hyper extension teardrop fractures
  • Extension teardrop fractures
  • Extension tear drop fracture

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Cases and figures

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    Figure 1: illustration
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    Case 1: C3 extension teardrop fracture
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    Case 2: C2 extension teardrop fracture
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    Case 3: C2 extension teardrop fracture
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    Case 4: C3 extension tear drop fracture
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    Case 5
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    Case 6
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