Case Report: Unusual Mechanism of Chance Fracture in an Adult Male

Manoj Todkar, MS, DNB, MRCS


April 25, 2005

Case Report

A 30-year-old man fell from a height of 20 feet. He sustained close fracture of both calcanei, an open fracture of the left tibia, and complained of pain in his lumbar area.

Palpation revealed tenderness in the lumbar region. His neurologic examination was normal. Radiographs (Figure) and CT scans (not shown) revealed a transverse fracture at L2, which demonstrated split posterior elements and progressed anteriorly into the vertebral body. To treat this fracture, L1-L3 fusion was carried out using a metal cage, and posterior instrumentation was employed using pedicular screws. An external fixator was applied for the open fracture of the tibia; the calcaneus fracture was fixed internally on one side and treated conservatively on the other side.

Radiograph demonstrates a transverse fracture at the level of L2.


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