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
- 1. Parizel PM, van der Zijden T, Gaudino S et-al. Trauma of the spine and spinal cord: imaging strategies. Eur Spine J. 2010;19 Suppl 1 (S1): S8-17. doi:10.1007/s00586-009-1123-5 - Free text at pubmed - Pubmed citation
- 2. Old JL, Calvert M. Vertebral compression fractures in the elderly. Am Fam Physician. 2004;69 (1): 111-6. Pubmed citation
- 3. O'Brien WT. Top 3 Differentials in Radiology. Thieme. (2009) ISBN:1604062266. Read it at Google Books - Find it at Amazon
- 4. Pope TL. Harris & Harris' Radiology of Emergency Medicine. Lippincott Williams & Wilkins. (2012) ISBN:145110720X. Read it at Google Books - Find it at Amazon
- 5. Imhof H, Halpern B. Spinal Imaging (Direct Diagnosis in Radiology). TIS. ISBN:B005NA3E0K. Read it at Google Books - Find it at Amazon
- 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