A passenger wearing a lap belt alone survives a frontal car crash. Radiographs reveal a horizontal fracture through the vertebral body and pedicles of L2 with posterior element disruption, without cord injury. This fracture is characteristically associated with:

• A Axial loading of the spine from a fall from height
• B Rotational shear from a rollover accident
• C Hyperextension injury from a rear-end collision
• D Flexion-distraction force from a lap type seat belt ✓

Explanation

The Chance fracture is a horizontal (transverse) fracture through the vertebral body, pedicles and posterior elements, caused by the flexion-distraction force exerted by a lap belt in a frontal collision. It is classically associated with intra-abdominal visceral injury, especially mesenteric and bowel tears, because the belt compresses the abdomen. Axial loading produces burst fractures, and hyperextension produces hangman type injuries, so those mechanisms do not fit.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.