Chance Fracture

  • Etiology: lap belt injury causing hyperflexion without axial loading, unstable flexion-distraction injury of thoracic-lumbar junction
  • Imaging: 3 column fracture – anterior compression, middle + posterior dislocation
  • MRI: posterior longitudinal ligament / interspinous ligament injuries with relatively intact anterior longitudinal ligament
  • Clinical: 40% have intraabdominal injuries – laceration or contusion of pancreas / duodenum / jejunum / mesentery, associated with fracture of rib / sternum / clavicle, soft tissue injury to rectus abdominis / peritoneum / diaphragm, aortic injury

Cases of Chance Fracture