Skeletal fracture demographics in spinal cord-injured patients.
BACKGROUND
The demographics of skeletal fractures found in patients presenting with a spinal cord injury to a modern level-one trauma center have not been reported.


METHODS
A retrospective review was performed of 1290 patients presenting between January 1997 and December 1999 with an acute vertebral fracture and spinal cord or cauda equina injury to determine the incidence, fracture type, and mechanism of all fractures of the extremities and pelvis.


RESULTS
Overall, 128 (10% of 1290) of these patients sustained 203 associated skeletal fractures including 16 open fractures (8% of 203). The most common associated fractures involved the radius, tibia, femur, humerus, fibula, and ulna. Some 48% of the injuries was due to motor vehicle accidents, 41% to falls, 6% to recreational injuries or assaults, and 5% to gunshot wounds. Twenty-four patients (1.8% of 1290) were found to have more than one vertebral fracture and sustained a high rate of associated fractures (42 fractures), averaging 1.8 fractures per patient.


CONCLUSIONS
This study underscores the frequent association between vertebral fractures and fractures of the appendicular skeleton and pelvis and reinforces the need to maintain a high index of suspicion when evaluating neurologically injured patients due to the potential for symptom masking of acute nonspinal fracture.
Anderson
Stuart D
SD
Department of Orthopaedic Surgery, University of Virginia, School of Medicine, 400 Ray C. Hunt Drive, Suite 330, Charlottesville, VA 22903, USA.
Anderson
D Greg
DG
Vaccaro
Alexander R
AR
D000293:Adolescent; D000328:Adult; D000368:Aged; D050723:Fractures, Bone / Q000150:complications / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D011128:Polyradiculopathy / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000209:etiology; D016103:Spinal Fractures / Q000150:complications / Q000453:epidemiology*