High speed road traffic collision.
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Chance fracture L2 extending through the vertebral body, pedicles, laminae, left transverse process and spinous process, with widening of the posterior fracture lines.
Chronic bilateral L5 pars interarticularis defects resulting in grade I anterolisthesis of L5 on S1. Paravertebral soft tissues are within normal limits.
Chance fracture are unstable flexion-extension injuries, involving all three columns. They most commonly occur at the thoracolumbar junction and have a high association with intra-abdominal injuries (both solid and hollow viscera). Luckily, this patient did not suffer any intra-abdominal injuries.