Skip to main content

Advertisement

Log in

Chance Fracture of the Upper Thoracic Spine in a Child

  • Case Report
  • Published:
European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

We report on a three-year-old girl who fell accidentally from the fourth floor. She suffered multiple trauma, including severe head injury, unstable T2–T3 Chance fracture, pneumothorax with lung contusion and serial rib fractures on the left side, liver laceration, splenic injury and fracture of the sacral bone on the right side. The progressive intracranial pressure was released by trepanation and bifrontal craniectomy. The abdominal injuries were treated conservatively. After stabilization of the intracranial situation, dorsal spondylodesis from T2 to T4 was performed employing the cannulated NEON system (Ulrich®) with CT-controlled positioning of guide wires. One year on, the implants have been removed and the patient has good function, with only a small atactic dysfunction as residuum. To our knowledge, this is the first report of a pediatric Chance fracture located in the upper thoracic spine following a fall from great height that describes how this treatment approach led to a very favorable outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Chance GQ. Note on a type of flexion fracture of the spine. Br J Radiol 1948;21:a452–3.

    Article  Google Scholar 

  2. Howland WJ, Curry JL, Buffington CB. Fulcrum fractures of the lumbar spine. Transverse fracture induced by an improperly placed seat belt. JAMA 1965;193:240–1.

    PubMed  CAS  Google Scholar 

  3. Woltmann A, Beisse R, Eckardt H, Potulski M, Bühren V. Combined abdominal and spine injuries after high energy flexion — distraction trauma. Eur J Trauma Emerg Surg 2007;5:482–7.

    Article  Google Scholar 

  4. Reid AB, Letts RM, Black GB. Pediatric Chance fractures: association with intra-abdominal injuries and seatbelt use. J Trauma 1990;30:384–91.

    Article  PubMed  CAS  Google Scholar 

  5. Subotic U, Holland-Cunz S, Bardenheuer M, Loff S, Wessel LM. Chance fracture — a rare injury in pediatric patients? Eur J Pediatr Surg 2007;17:207–9.

    Article  PubMed  CAS  Google Scholar 

  6. Frank J, Marzi I, Mutschler W. Schockraummanagement des Polytraumas. Zentralbl Chir 1996;121:943–9.

    PubMed  CAS  Google Scholar 

  7. Stahel PF, Heyde CE, Ertel W. Current concepts of polytrauma management. Eur J Trauma 2005;31:200–11.

    Article  Google Scholar 

  8. Magerl F, Aebi M, Gertzbein SD, Harms J, Nazarian S. A comprehensive classification of thoracic and lumbar injuries. Eur Spine J 1994;3:184–201.

    Article  PubMed  CAS  Google Scholar 

  9. Hubbard DD. Injuries of the spine in children and adolescents. Clin Orthop Relat Res 1974;56–65.

  10. Laurer H, Maier B, El Saman A, Lehnert M, Wyen H, Marzi I. Distribution of spinal and associated injuries in multiple trauma patients. Eur J Trauma Emerg Surg 2007;5:476–81.

    Article  Google Scholar 

  11. Blasier RD, LaMont RL. Chance fracture in a child: a case report with nonoperative treatment. J Pediatr Orthop 1985;5:92–93.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Anna L. Sander MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sander, A.L., Laurer, H., El Saman, A. et al. Chance Fracture of the Upper Thoracic Spine in a Child. Eur J Trauma Emerg Surg 35, 318–321 (2009). https://doi.org/10.1007/s00068-008-8088-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00068-008-8088-7

Key Words

Navigation