Discussion of Chance fracture
- Chance fracture represents a pure bony injury extending from posterior to anterior through the spinous process, pedicles, and vertebral body, respectively.
- This fracture most commonly is found in the upper lumbar spine, but it may be observed in the midlumbar region in children.
- Associated intraabdominal injuries (i.e. pancreatic injury, duodenal injury) can result in increased morbidity and mortality. Associated intra-abdominal injuries appear to be more common in the pediatric age group with incidence approaching 50%.
- Unrecognized, Chance injuries may result in progressive kyphosis with resulting pain and deformity.
- The most common history is that of a back seat passenger restrained by a lap seatbelt and involved in a motor vehicle accident or that of a person who has fallen from a height.
- These fractures generally can be reduced by placing the patient on a Risser table with hyperextension applied to the thoracolumbar junction prior to applying a fiberglass or plaster cast.
- If immobilization is impractical (large body habitus) or the patient has polytrauma, surgical management may be indicated.
 Imaging Findings for Chance fracture
- A demonstrable fracture line may be detected extending through the spinous process, pedicles, and vertebral body.
Patient #1: MVA. CT images demonstrate a chance fracture
 See Also
 External Links
 References for Chance fracture
- E-medicine Chance fracture article