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Mechanism of Chance Frx


- Discussion:
    - typical mechanism of injury is head on motor vehicle collision while wearing a seat belt;
    - force exerted on spine is pure distraction owing to fulcrum that is anterior to vertebral body;
          - this is imposed by the lap seat belt as the pt acutely flexed forward;
          - this causes the vertebral elements to be pulled apart;
          - hence, tension failure occurs, initially in Posterior column, then in the Middle column, and finally in the Anterior column;
    - if the fulcrum of is within the body, or in Middle column, there will be compression of the Anterior column;
         - these fractures will tend to go into late kyphosis & therefore require early fixation