Management of a high thoracic chance fracture

  • Anouar Bourghli
  • Ibrahim Obeid
  • Louis Boissiere
  • Jean-Marc Vital
  • Zafer Tabboush
  • Mohammed Al Sarawan
Grand Rounds

AbstractOpen image in new window

Purpose

Chance fracture of the high thoracic spine is rare, and its impact on the adjacent cervical spine can be important.

Methods

We present the case of a 16-year-old male, who fell down from a 2 m height, in an unknown context as he has a mental retardation, and no witness saw the accident. Initial CT scan revealed a comminuted depressed fracture of the right parietal bone, associated with a chance fracture at the level of T3 with a kyphosis and bilateral lung contusion.

Results

The patient underwent neurosurgical treatment for elevation and reconstruction of the parietal fracture; he also underwent, 2 days later, a posterior spinal correction and fusion with T1-to-T5 instrumentation. The patient returned to normal walking on day 7 with a satisfactory clinical and radiological result at 1 year.

Conclusion

Literature is sparse on the treatment of high thoracic chance fractures. The current case shows that early surgical management should prevent a secondary kyphotic deformity that may need a more aggressive treatment at a later stage.

Keywords

Chance fracture High thoracic Kyphosis Sagittal alignment Posterior approach 

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Anouar Bourghli
    • 1
  • Ibrahim Obeid
    • 2
  • Louis Boissiere
    • 2
  • Jean-Marc Vital
    • 2
  • Zafer Tabboush
    • 1
  • Mohammed Al Sarawan
    • 1
  1. 1.Orthopedic and Spinal Surgery DepartmentKingdom HospitalRiyadhSaudi Arabia
  2. 2.Orthopedic Spinal Surgery Unit 1Bordeaux Pellegrin HospitalBordeauxFrance

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