The association between Chance fractures and intra-abdominal injuries revisited: a multicenter review.
The association between Chance fractures and intra-abdominal injuries is reported to be as high as 89 per cent. Because prior studies were small series or case reports, we conducted a multicenter review to learn the true association between Chance fractures and intra-abdominal injuries as well as diagnostic trends. Trauma registry data, medical records, and radiology reports from 7 trauma centers were used to characterize 79 trauma patients with Chance fractures. Initial methods of abdominal assessment were computed tomography (CT) scan (79%), clinical examination (16%), and diagnostic peritoneal lavage (DPL) (5%). Twenty-six (33%) patients had intraabdominal injuries of which hollow viscus injuries predominated (22%). Twenty patients (25%) underwent laparotomy. The presence of an abdominal wall contusion and automobile restraint use were highly predictive of intra-abdominal injury and the need for laparotomy. The association between a Chance fracture and intra-abdominal injury is not as high as previously reported. CT scan has become the primary modality to assess the abdominal cavity of patients with Chance fractures, whereas the role of DPL has diminished.
Texas Tech Univesity Health Sciences Center at El Paso, El Paso, Texas 79905-2700, USA.
Alan H
AH
Tyroch
Emmett L
EL
McGuire
Susan F
SF
McLean
Rosemary A
RA
Kozar
Keith A
KA
Gates
Krista L
KL
Kaups
Charles
C
Cook
Sarah M
SM
Cowgill
John A
JA
Griswold
Larry A
LA
Sue
Michael L
ML
Craun
Jan
J
Price
D000007:Abdominal Injuries / Q000150:complications / Q000453:epidemiology*; D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D016103:Spinal Fractures / Q000150:complications / Q000453:epidemiology*; D013904:Thoracic Vertebrae; D014057:Tomography, X-Ray Computed; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries