Chance Fracture

A chance fracture is a flexion-distraction injury to the spine that involves all

three columns. Bony chance fractures can often managed nonoperatively, while
ligamentous disruption of the posterior column often necessitates operative
stabilization.

Overview

• The posterior ligamentous complex (PLC) is comprised of:

° Supraspinous ligament
° Interspinous ligament
° Ligamentum flavum
° Facet joint capsules
• Bony chance fractures have potential to heal, while soft tissue 3 column injuries
(e.g.: ligamentous, trans-discal) are unlikely to heal
• 10–15 % of chance fractures are associated with neurologic deficits

History

• Do you have other sites of pain along your spine?

• Do you have any weakness, numbness, or tingling?
• Do you have abdominal pain?
• Do you have any bowel or bladder difficulty or incontinence?

© Springer International Publishing Switzerland 2017 83

M.C. Makhni et al. (eds.), Orthopedic Emergencies,
DOI 10.1007/978-3-319-31524-9_23