The Clay Shoveler's Fracture: A Case Report and Review of the Literature.
BACKGROUND
A clay-shoveler's fracture is a very rarely occurring stress-type avulsion fracture of the lower cervical or upper thoracic spinous processes owing its name to the clay shovelers of past times. Currently, this type of injury is mainly encountered in individuals practicing sports involving rotational movements of the upper spine.


METHODS
We present a case of a man sustaining a clay-shoveler's injury during his work in a horse-riding school. Treatment consisted of a period of rest and analgesics, followed by mobilization as was tolerated. We give a brief historical account of clay shoveler's fractures. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Clay-shoveler's fractures are frequently overlooked due to their rareness; however, they have specific clinical features that should alert an attending physician to set the correct diagnosis. This report describes a typical case of a clay-shoveler's fracture, relates to the historical entity of clay-shoveler's fractures, and summarizes existing literature on this topic.
Department of Orthopaedic Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Jantine
J
Posthuma de Boer
Department of Orthopaedic Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Alexander F Y
AF
van Wulfften Palthe
Department of Orthopaedic Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Agnita
A
Stadhouder
Department of Traumatology, VU University Medical Center, Amsterdam, The Netherlands.
Frank W
FW
Bloemers
D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D060051:Occupational Injuries / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D016103:Spinal Fractures / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*
clay-shoveler's fracture; spine; spinous process; stress fracture