Also known
as the seat belt injury or Chance fracture.
The seat belt fracture is a transverse fracture through a vertebral
body
and neural arch (see figures). The mechanism of injury is flexion and distraction. Although it was originally described
as a pure osseous lesion, the fracture may also occur through the
disc and the ligaments. It is usually associated with motor vehicle
accidents
in which the
injured passenger is wearing a seatbelt, frequently just a lap seatbelt. It was described by British
radiologist George Chance. Seat belt fracture generally occurs at the thoracolumbar junction. Although it
involves all three columns of the
spine, it can be treated with orthoses when it was a pure osseous
lesion. In case of external stabilization is not feasible (due to
severe obesity, concomitant systemic trauma, etc) it requires spinal
stabilization to restore the posterior tension band.
