Wedge fracture

Dr Ian Bickle and Dr Henry Knipe et al.

Wedge fractures are hyperflexion injuries to the vertebral body resulting from axial loading. Most commonly affecting the anterior aspect, wedge fractures are considered a single-column (i.e. stable) fracture. 

Less commonly wedge fractures refer to a subtype of tibial plateau fractures. This article addresses vertebral wedge fractures. 

Most common type (~50%) of thoracolumbar spine fractures 4

Typically, these fractures are insufficiency fractures secondary to ostoporosis, although some are pathological secondary to a focal bone lesion. A small proportion are due to trauma in patients with normal underlying bone 2.

Radiographs, CT, and MRI may show cortical disruption with impaction of the antero-superior endplate. The antero-inferior endplate and posterior vertebral body remain unaffected. This results in the characteristic "wedged" appearance 3,4

  • burst fracture: fracture of anterior and posterior vertebral body (i.e. two-column injury) 4
  • care should be taken to assess for posterior ligamentous injury, indicative of potential instability
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Article information

rID: 35522
Synonyms or Alternate Spellings:
  • Wedge fractures
  • Vertebral body wedge fractures
  • Wedge compression fractures
  • Vertebral body wedge fracture
  • Wedge compression fracture

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Cases and figures

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    Figure 1: acute vs old
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    Case 1
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    Case 2
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    LAT
    Case 3
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    Case 4: multiple fractures
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