2.  54 yo obese male involved
in single car mvc. Pt
driving older model 1964
Ford truck that struck a
tree. Pt restrained with lap
belt. Pt reports brief
LOC, low back pain, and
abdominal pain. Pt unable
to ambulate on scene 2/2
pain.
 T 97.9 P 80 BP 160/78




O2 98% RA RR 16
Gen: WDWN, NAD
HEENT: NCAT, PERRL,
EOMI
Back: severe
thoracolumbar midline
pain w/out edema, step
offs, or bony abnormality
Neuro: A&O x 3, CNII-XII
intact; 5/5 strength
throughout, no focal
sensory or motor deficits
apprecitaed

3. http://www.radiologyassistant.nl/

4. • Description
• a pure bony injury extending
from posterior to anterior
through the spinous process,
pedicles, and vertebral body,
respectively.
• Upper lumbar spine in
adults, midlumbar region in
children.
• Associated intra-abdominal
injuries are common,
especially in the pediatric age
group (50%).
• Mechanism
• flexion-distraction
• Unstable
www.LearningRadiology.com
http://emedicine.medscape.com/article/1263663-overview

5.  Spine consult
 patients w/ partial vertebral body involvement (half
bony injury and half ligamentous injury) may be
candidates for non operative treatment if alignment is
acceptable
 Non-operative tx = hyperextension orthosis
 Surgical fixation
http://www.wheelessonline.com/ortho/chance_fracture_of_the_spine

6.  Obtain CT chest/abdomen/pelvis to evaluate for intra-
abdominal injury in the presence of Chance fracture