Pediatric seatbelt injuries: unusual Chance's fracture associated with intra-abdominal lesions in a child

Abstract

The authors report the case of a 7-year-old child involved in a motor vehicle accident. She sustained an unusual flexion-distraction vertebral injury. This spinal injury was related to seatbelt use and was associated with intra-abdominal lesions. The spinal lesion consisted of a posterior ligamentous disruption with widening of the posterior intervertebral space at two adjacent lumbar levels. The purpose of this case report is to describe an atypical and perhaps often unrecognized spinal lesion and to explain our approach to diagnosis and treatment.

Classification of Chance Fracture in Children Using Magnetic Resonance Imaging

“…In addition, the use of MRI in flexion distraction fractures has rarely been reported. Ceroni et al 12 There are great differences in the anatomy of adult and children due to the presence of growth structures and more elastic soft tissues. In children, the disc can be deformed more significantly than in adults due to a high water content in the nucleus pulposus and a more elastic collagen fiber.…”

“…Most of them are case reports [11][12][13][14][15][16][17][18] or short series. 6,10,19 -21 To our knowledge, the present study represents the largest series of children with flexion distraction fracture in the medical literature.…”

Open reduction and internal fixation of a lumbar Chance fracture in a child using Songer cable and lamina plates

“…8,9,11 Published reports on the management of pediatric Chance fractures consist of case reports and small patient series. 1,4,7,14 The original treatment recommended by Chance was reduction in hyperextension and immobilization in a cast. Most investigators have reported good results using such conservative management.…”

Flexion-distraction Injuries in Children and Adolescents

“…Of these studies, 1 had a sample size greater than 20 patients, 7 four had between 10 and 20 patients, 4,[8][9][10] five had between 4 and 9 patients, 1,5,11-13 and 15 were case series or case reports with 3 or fewer patients. 3,[14][15][16][17][18][19][20][21][22][23][24][25][26][27] Demographic Data. Patient age was available for 115 patients in these studies and ranged from 2 to 17 years.…”