A 60-year-old man with ankylosing spondylitis sustains a minor fall and develops severe neck pain with new-onset quadriparesis. Imaging reveals a fracture through the fused C5-C6 motion segment extending through all three columns. This fracture pattern is best described as which type?
- A Three-column fracture (or fracture-dislocation through ankylosed segment) ✓
- B Chance fracture
- C Teardrop fracture
- D Clay-shoveler's fracture
Correct answer: A. Three-column fracture (or fracture-dislocation through ankylosed segment)
Explanation
In ankylosing spondylitis, the spine becomes a rigid brittle column. Even minor trauma causes unstable three-column fractures through the ankylosed segment, often at the disc space. These are highly unstable and carry high neurological risk. Clay-shoveler's is an avulsion of the spinous process. Chance is a flexion-distraction injury through a single motion segment. Teardrop is a flexion injury of the anterior inferior vertebral body.
Reference: Rockwood and Green's Fractures in Adults, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.