Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 4/2016

01-04-2016 | Orthopaedic Surgery

Chance fracture in an older patient with positive sagittal imbalance and previous lumbar arthrodesis: what can be done?

Authors: Pawel Zwolak, Markus Kröber

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 4/2016

Login to get access

Abstract

The Chance fracture occurs frequently in school-aged patients’ population and is related to flexion-distraction injury in motor vehicle accidents. It is so called seat-belt syndrome because the seatbelt lies over the abdomen. After sudden deceleration bends the child around the lap belt causing injuries to the abdomen, and the spine (e.g., Chance fracture). The Chance fracture after a low energy fall in elderly patient’s population has rarely been reported. We present an 82 years old patient who suffered unrecognized Chance fracture after a low energy fall. The management of this patient with positive sagittal imbalance and previous arthrodesis consisted of decompression, Smith-Petersen osteotomy and posterior pedicle screw instrumentation.
Literature
1.
2.
Howland WJ, Curry JL, Buffington CB (1965) Fulcrum fractures of the lumbar spine. JAMA 193:240–241CrossRefPubMed
3.
Gertzbein SD, Court-Brown CM (1988) Flexion-distraction injuries of the lumbar spine. Clin Orthop 227:52–60PubMed
4.
Argan PF, Dunkle DE, Winn DG (1987) Injuries to a sample of seat belted children evaluated in a hospital emergency room. J Trauma 27:58–64CrossRef
5.
Bernstein MP, Mirvis SE, Shanmuganathan K (2006) Chance-type fractures of the thoracolumbar spine: imaging analysis in 53 patients. AJR 187:859–868CrossRefPubMed
6.
Okamoto K, Doita M, Yoshikawa M, Manabe M, Sha N, Yoshiya S (2005) Lumbar chance fracture in an adult snowboarder: unusual mechanism of a chance fracture. Spine (Phila Pa 1976) 30:56–59CrossRef
7.
8.
Boham M, O’Connell K (2014) Unusual mechanism of injury resulting in a thoracic chance fracture in a rodeo athlete: a case report. J Athl Train 49:274–279CrossRefPubMedPubMedCentral
9.
Hu X, Lieberman IH (2012) Proximal instrumented vertebral body chance fracture after pedicle screw instrumentation in a thoracic kyphosis patient with osteoporosis. J Spinal Disord Tech 28:31–36CrossRef
10.
Vaccaro AR, Oner C, Kepler CK, Dvorak M, Schnake K, Bellabarba C, Reinhold M, Aarabi B, Kandziora F, Chapman J, Shanmuganathan R, Fehlings M, Vialle L (2013) AOSpine Spinal Cord Injury and Trauma Knowledge Forum. AOSpine thoracolumbar spine injury classification system: fracture description, neurological status, and key modifiers. Spine (Phila Pa 1976) 38:2028–2037CrossRef
11.
Chapman JR, Agel J, Jurkovich GJ, Bellabarba C (2008) Thoracolumbar flexion-distraction injuries associated morbidity and neurological outcomes. Spine (Phila Pa 1976) 33:648–657CrossRef
12.
Weiss KS, Harris MB, Neitzschman HR (1997) Radiology case of the month: unfortunate chance. Chance fracture at L3. J La State Med Soc 149:317–318PubMed
13.
Bernstein MP, Mirvis SE, Shanmuganathan K (2006) Chance-type fractures of the thoracolumbar spine: imaging analysis in 53 patients. AJR Am J Roentgenol 187:859–868CrossRefPubMed
14.
Groves CJ, Cassar-Pullicino VN, Tins BJ, Tyrrell PN, Mc-Call IW (2005) Chance-type flexion-distraction injuries in the thoracolumbar spine: MR imaging characteristics. Radiology 236:601–608CrossRefPubMed
15.
Krompinger WJ, Fredrickson BE, Mino DE et al (1986) Conservative treatment of fractures of the thoracic and lumbar spine. Orthop Clin North Am 17:161–170PubMed
16.
Parker JW, Lane JR, Karaikovic EE, Gaines RW (2000) Successful short-segment instrumentation and fusion for thoracolumbar spine fractures: a consecutive 4½-year series. Spine (Phila Pa 1976) 25:1157–1170CrossRef
17.
Schizas C, Kosmopoulos V (2007) Percutaneous surgical treatment of Chance fractures using cannulated pedicle screws: report of two cases. J Neurosurg Spine 7:71–74CrossRefPubMed
18.
Schwender JD, Holly LT, Rouben DP, Foley KT (2005) Minimally invasive transforaminal lumbar interbody fusion (TLIF). Technical feasibility and initial results. J Spinal Disord Tech 18(Suppl):1–6CrossRef
19.
20.
DeWald CJ, Stanley T (2006) Instrumentation-related complications of multilevel fusions for adult spinal deformity patients over age 65: surgical considerations and treatment options in patients with poor bone quality. Spine (Phila Pa 1976) 31:144–151CrossRef
21.
Sarzier JS, Evans AJ, Cahill DW (2002) Increased pedicle screw pullout strength with vertebroplasty augmentation in osteoporotic spines. J Neurosurg 96:309–312PubMed
Metadata
Title
Chance fracture in an older patient with positive sagittal imbalance and previous lumbar arthrodesis: what can be done?
Authors
Pawel Zwolak
Markus Kröber
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 4/2016
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-016-2411-2

Other articles of this Issue 4/2016

Archives of Orthopaedic and Trauma Surgery 4/2016 Go to the issue

Arthroscopy and Sports Medicine

A new classification system of patellar instability and patellar maltracking

Orthopaedic Surgery

Patient characteristics and outcomes of a hip fracture and concomitant fracture compared with hip fracture alone: results from a United Kingdom teaching hospital

Orthopaedic Surgery

Tibiocalcaneal arthrodesis as a limb salvage procedure for complex hindfoot deformities

Arthroscopy and Sports Medicine

Strength does not influence knee function in the ACL-deficient knee but is a correlate of knee function in the and ACL-reconstructed knee

Trauma Surgery

The influence of the operation technique and implant used in the treatment of periprosthetic hip and interprosthetic femur fractures: a systematic literature review of 1571 cases

Handsurgery

Patient rated outcomes study into the surgical interventions available for the rheumatoid hand and wrist