[Clinical study thoracolumbar Chance fractures: a report of 21 cases].
OBJECTIVE
To discuss the mechanism, clinical characteristics, diagnosis and treatment of thoracolumbar Chance fractures.


METHODS
Among all the 21 patients, 13 patients were male and 8 patients were female, ranging in age from 23 to 57 years, with an average of 32 years. The injury was at the level of T11 in 3 patients, at the level of T12 in 9 patients, at the level of L1 in 8 patients and at the level of L2 in 1 patient. According to Denis classification, 10 patients were type A, 2 type B, 5 type C, and 4 type D. All the patients were treated with pedicle screw internal fixation and posterior lateral fusion at the level of injury.


RESULTS
Twenty-one patients had been followed up for an average of 18 months (13 to 28 months). According to ASIA neurologic grading system, 4 cases in grade C or D recovered to grade E postoperatively and one case in grade B was not improved. Postoperative X-ray showed good reduction and fixation in all cases and no looseness or breakage in the fixation system. The results of postoperative back pain and function assessment were mostly satisfactory.


CONCLUSIONS
Thoracolumbar Chance fractures are due to flexion-distraction injuries and regarded as unstable, which are uncommon and usually not present with a neurologic deficit. Reduction and stabilization with posterior pedicle screw internal fixation is suggested in patients with thoracolumbar Chance fractures.
Wang
Yun
Y
Section I, Department of Orthopaedics, Ningbo NO.2 Hospital, Ningbo 315010, Zhejiang, China. wang_yun4910@126.com
Zhang
Qian-fa
QF
Pang
Qing-jiang
QJ
Ge
Zhi-bin
ZB
D000328:Adult; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries*