Unstable thoracic spine fracture dislocation

Case contributed by Liz Silverstone


Pedestrian run over by truck. Emergency splenectomy.

Patient Data

Age: 25 years
Gender: Female

Portable supine chest X-ray in resus


Displaced fracture of the left clavicle.
Fracture of the posterior left 7th rib.
Abnormal spacing of left ribs, 6 - 9.
Soft-tissue emphysema in the left chest wall.
T9/T10 fracture dislocation.
Bilateral chest drains and ETT appear satisfactory.

Fracture-dislocation of the thoracic spine (3-column injury) with pneumorachis, rib fractures and dislocations, lung contusions.

Post splenectomy. Multiple thoracoabdominal injuries.

Coronal reformat clarifies the chest radiograph appearances. Thoracic spine fracture/dislocation and rib deformities due to multiple fractures and dislocations.

Case Discussion

Multi-trauma with numerous injuries, which can be detected by systematic analysis of the chest radiograph. 

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