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Classification of chance fracture in children using magnetic resonance imaging.

Spine 2007 January 16
STUDY DESIGN: MRI study of pediatric Chance fracture.

OBJECTIVE: To evaluate bone and soft tissue lesions in pediatric Chance fracture.

SUMMARY OF BACKGROUND DATA: Several descriptions and classifications have been already developed for Chance fracture, but mainly for adult. Furthermore, they are all based only on radiographic studies.

METHODS: MRI and radiographs of 18 children with Chance fracture were analyzed before treatment.

RESULTS: On MRI, in all cases, no abnormal signs were noted on the intervertebral disc. Six patients had a bone fracture going through the pedicle and the vertebral body. Twelve patients had a physeal injury located on the superior or on the inferior vertebral endplate. Three types of lesions could be identified according to the location of the lesion in relation to the pedicle.

CONCLUSION: MRI is useful in the diagnosis of pediatric Chance fracture. It allows physeal injury to be clearly identified from disc injury.

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