Thoracic burst fracture

Background

Unstable (usually)

Mechanism: axial loading with flexion compromising anterior and middle column
Retropulsion of bone causes damage to the spinal canal and neurologic deficits that often cause stable neurologic deterioration.
Can occur with or without injury to posterior elements (posterior involvement increases risk for neuro deficits)
Be certain not to mistakenly call a burst fracture a wedge fracture

Vertebral fractures and dislocations types

Vertebral anatomy.

Differential Diagnosis

Thoracic Trauma

Airway/Pulmonary
Cardiac/Vascular
- Cardiac injury
  - Blunt cardiac injury
    - Cardiac contusion
    - Commotio cordis
  - Penetrating cardiac injury
  - Cardiac tamponade
- Traumatic aortic transection
Musculoskeletal
Other

Workup

Obtain CT if unsure (vs. wedge)

Management

Consult Orthopedics or Neurosurgery (Institution dependent)
Depending on neurologic symptoms and features of the fracture- can be managed nonoperatively

See Also

Thoracic and lumbar spine trauma
Vertebral burst fractures

References

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