Outcome analysis of chance fractures of the skeletally immature spine.
METHODS
Observational.


OBJECTIVE
The authors present a detailed description of 25 skeletally immature patients with Chance fractures with a mean follow-up of 6.4 years.


BACKGROUND
Since the legislation mandating seat belt usage in Canada was first introduced, the fatality rate of automobile collisions has decreased significantly. However, seat belts do not result in the complete elimination of injury. Fractures of the lumbar spine due to seat belts are well recognized in adolescents and adults but there are few reports in young children.


METHODS
Radiographic images and patient records were analyzed for information on patient demographics and injury details.


RESULTS
Treatment involved either posterior instrumentation (n = 16) or a conservative approach using casting or bracing (n = 9). Concomitant injuries were documented. A deformity index was developed as a simple value to take into account the severity of both anterior loss of vertebral height and posterior distraction.


CONCLUSIONS
The deformity index was significantly higher in patients with a concomitants abdominal injury and significantly higher in patients managed operatively. Functional outcome scores were completed on 14 of the patients. Patients scored within the reported norms on the SF-36 version 2 but scored poorly on the pain and disability component of the AAOS lumbar specific questionnaire. These outcomes indicate a need for using an injury specific score to accurately quantify disability.
Mulpuri
Kishore
K
Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada. kmulpuri@cw.bc.ca
Jawadi
Ayman
A
Perdios
Angeliki
A
Choit
Rachel L
RL
Tredwell
Stephen J
SJ
Reilly
Christopher W
CW
D000007:Abdominal Injuries; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000209:etiology; D008159:Lumbar Vertebrae / Q000254:growth & development / Q000293:injuries*; D008297:Male; D011788:Quality of Life; D011859:Radiography; D012622:Seat Belts / Q000009:adverse effects*; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D011795:Surveys and Questionnaires; D015599:Trauma Severity Indices; D016896:Treatment Outcome