title: Chance Fracture of the Upper Thoracic Spine in a Child.
abstract: We report on a three-year-old girl who fell accidentally from the fourth floor. She suffered multiple trauma, including severe head injury, unstable T2-T3 Chance fracture, pneumothorax with lung contusion and serial rib fractures on the left side, liver laceration, splenic injury and fracture of the sacral bone on the right side. The progressive intracranial pressure was released by trepanation and bifrontal craniectomy. The abdominal injuries were treated conservatively. After stabilization of the intracranial situation, dorsal spondylodesis from T2 to T4 was performed employing the cannulated NEON system (Ulrich(®)) with CT-controlled positioning of guide wires. One year on, the implants have been removed and the patient has good function, with only a small atactic dysfunction as residuum. To our knowledge, this is the first report of a pediatric Chance fracture located in the upper thoracic spine following a fall from great height that describes how this treatment approach led to a very favorable outcome.
authors.affiliation: Department of Trauma, Hand, and Reconstructive Surgery, University Hospital of the Johann Wolfgang Goethe-University, Frankfurt/Main, Germany. AnnaLena.Sander@kgu.de.|Department of Trauma, Hand, and Reconstructive Surgery, University Hospital of the Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany. AnnaLena.Sander@kgu.de.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Sander
authors.affiliation: Department of Trauma, Hand, and Reconstructive Surgery, University Hospital of the Johann Wolfgang Goethe-University, Frankfurt/Main, Germany.
authors.forename: Helmut
authors.initials: H
authors.lastname: Laurer
authors.affiliation: Department of Trauma, Hand, and Reconstructive Surgery, University Hospital of the Johann Wolfgang Goethe-University, Frankfurt/Main, Germany.
authors.forename: André
authors.initials: A
authors.lastname: El Saman
authors.affiliation: Department of Trauma, Hand, and Reconstructive Surgery, University Hospital of the Johann Wolfgang Goethe-University, Frankfurt/Main, Germany.
authors.forename: Carola
authors.initials: C
authors.lastname: Ploss
authors.affiliation: Department of Radiology, University Hospital of the Johann Wolfgang Goethe-University, Frankfurt/Main, Germany.
authors.forename: Martin G
authors.initials: MG
authors.lastname: Mack
authors.affiliation: Department of Trauma, Hand, and Reconstructive Surgery, University Hospital of the Johann Wolfgang Goethe-University, Frankfurt/Main, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Maier
authors.affiliation: Department of Trauma, Hand, and Reconstructive Surgery, University Hospital of the Johann Wolfgang Goethe-University, Frankfurt/Main, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Marzi
keywords: Multiple trauma; Pediatric Chance fracture; Upper thoracic spine
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