Missed lumbar transverse process fractures in a high school football player

Evaluation of Overlooked Fractures - Dislocations and Trauma Series

“…Bu kırıkların major travmalı hastalarda sadece düz grafilerle tanıda % 11 oranında atlandığı bilinmektedir. [5,6] Atletlerde görülebileceği unutulmamalıdır.…”

Isolated transverse process fracture of the lumbar vertebrae

“…[1–3] Fractures of the transverse processes of the lumbar vertebrae may result from direct blunt trauma (as in motor vehicle accidents), violent lateral flexion-extension forces (as in sports particularly football), avulsion of the psoas muscle or Malgaigne fractures of the pelvis. [134] Fractures of the transverse processes of the lumbar vertebrae usually occur as the result of major forces and a statistically significant association between transverse process fractures and abdominal injury has been reported. [5] Although transverse fracture of the lumbar vertebra can be a marker of associated visceral injuries including trauma to the abdominal viscera, retroperitoneum, spine, long bones and cranium,[35] the fractures of the transverse processes of the lumbar spine can occur in the absence of other vertebral and visceral damage.…”

Utilization of mechanical diagnosis and therapy (MDT) for the treatment of lumbar pain in the presence of known lumbar transverse process fractures: a case study

“…2 The healing time for a transverse process fracture has been reported as ranging between a few weeks to 3 months. [4][5][6] Since patients with isolated fractures of the thoracic or lumbar transverse processes may have pain and functional deficits, it seems logical that referral to physical therapy services may be indicated.…”

“…Suggested treatments for those with healing transverse process fractures include rest, ice, analgesic medications, strengthening of abdominal and lumbar musculature, trunk flexibility exercises, and the use of bracing or corsets. 5,6 The treatment approach used in this case was mechanical diagnosis and therapy (MDT) or the McKenzie method; it is a system of assessment, classification, management, and prevention of spinal and extremity joint symptoms. Mechanical diagnosis and therapy uses the symptomatic and mechanical responses to repeated end range movements and sustained postures to classify patients into one of three mechanical syndromes: derangement, dysfunction, or postural.…”

“…This last session occurred 12 weeks post injury, which coincides with the time frame that would be expected for healing of the transverse process fractures. [4][5][6] It is not possible to know with certainty if the patient's symptomatic and functional improvements were solely a response to the reduction of the lumbar derangement syndrome versus a result of natural bone healing, or possibly a combination of both. Post treatment imaging would have provided further information regarding the status of healing at the fracture sites, but additional imaging was not indicated as the patient was ultimately managing well from a symptomatic and functional perspective.…”