Chance fracture

Case contributed by Edward Oates , 17 Jul 2015
Diagnosis certain
Changed by Edward Oates, 19 Jul 2015

Updates to Case Attributes

Status changed from draft to pending review.
Presentation was changed:
Single vehicle MBA @ ~120kmh120kmh on a remote dirt road in desert scrublands. The patient had ridden into a hidden drainage ditch, and was catapulted (into)into and over the handlebars. GCS 15 at time of retrieval, with bilateral lower limb neurological defecit. Road retrieval with sedation and analgesia, without ventilatory support. Major trauma response initiated at small remote receiving hospital.
Body was changed:

An extreme example of a chance fracture, with profound destruction of the involved and neighbouring vertebral bodies, and retropulsion of bony fragments into the paraspinal musculature and subcutaneous soft tissue.

This is one of those cases where the final resting place of the bony fragments really tells a story of the forces and dynamics involved during the mechanism of injury. An understanding of the basic mechanisms of a chance fracture (flexion-distraction) is required to help understand how these fragments got where they did.

Compare this fracture with the less severe, and more textbook example demonstrated here: http://radiopaedia.org/cases/chance-fracture-1 Comparisonin the linked study below. Comparison with case allows a better understanding of how such bony destruction can occurevolves through the mechanism of injury.

http://radiopaedia.org/cases/chance-fracture-1

Such a severe injury, with destructive compromise of the spinal canal was naturally associated with non recoverable traumatic cord injury (cord transection) .

  • -<p>An extreme example of a chance fracture, with profound destruction of the involved and neighbouring vertebral bodies, and retropulsion of bony fragments into the paraspinal musculature and subcutaneous soft tissue.</p><p>This is one of those cases where the final resting place of the bony fragments really tells a story of the forces and dynamics involved during the mechanism of injury. An understanding of the basic mechanisms of a chance fracture (flexion-distraction) is required to help understand how these fragments got where they did.</p><p>Compare this fracture with the less severe, and more textbook example demonstrated here: http://radiopaedia.org/cases/chance-fracture-1 Comparison with case allows a better understanding of how such bony destruction can occur.</p><p>Such a severe injury, with destructive compromise of the spinal canal was naturally associated with non recoverable traumatic cord injury (cord transection) .</p>
  • +<p>An extreme example of a chance fracture, with profound destruction of the involved and neighbouring vertebral bodies, and retropulsion of bony fragments into the paraspinal musculature and subcutaneous soft tissue.</p><p>This is one of those cases where the final resting place of the bony fragments really tells a story of the forces and dynamics involved during the mechanism of injury. An understanding of the basic mechanisms of a chance fracture (flexion-distraction) is required to help understand how these fragments got where they did.</p><p>Compare this fracture with the less severe, and more textbook example demonstrated in the linked study below. Comparison with case allows a better understanding of how such bony destruction evolves through the mechanism of injury.</p><p>http://radiopaedia.org/cases/chance-fracture-1</p><p>Such a severe injury, with destructive compromise of the spinal canal was naturally associated with non recoverable traumatic cord injury (cord transection) .</p>

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