A Chance fracture is a type of vertebral fracture that results from excessive flexion of the Vertebral column.[ Injury to the bowel may not be apparent on the first day.]
The cause is classically a head-on motor vehicle collision in which the affected person is wearing only a lap belt.[ It often involves disruption of all three columns of the vertebral body (anterior, middle, and posterior).][ The most common area affected is the lower thoracic spine and upper lumbar spine.][ The fracture is often unstable frature.]
Treatment may be conservative with the use of a orthotics or via surgery.[ The fracture is currently rare.][ It was first described by G. Q. Chance, a radiologist from Manchester, UK, in 1948.]
Mechanism
In some Chance fractures there is a transverse break through the bony spinous process while in others there is a tear of the supraspinous ligament, ligamentum flavum, interspinous ligament, and posterior longitudinal ligament.[
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Diagnosis
On plain X-ray, a Chance fracture may be suspected if two spinous processes are excessively far apart.[
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A CT scan of the chest, abdomen, and pelvis is recommended as part of the diagnostic work-up to detect any potential abdominal injuries.[ MRI may also be useful.][ The fracture is often unstable frature.][
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History
It was first described by G. Q. Chance, an Irish radiologist in Manchester, UK, in 1948.[ The fracture was more common in the 1950s and 1960s before shoulder harnesses became common.][
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