Citation

Pérez Suárez E, Carceller F, García Salido A, Serrano A, Casado J. Arch. Argent. Pediatr. 2011; 109(1): 13-16.

Vernacular Title

Fractura de Chance no identificada por tomografía computada convencional: Presentación de un caso.

Affiliation

Servicio de Cuidados Intensivos Pediátricos, Hospital Infantil Universitario Niño Jesús, Madrid, Spain. eperez221981@hotmail.com

Copyright

(Copyright © 2011, Sociedad Argentina de Pediatria)

DOI

10.1590/S0325-00752011000100018

PMID

21283937

Abstract

INTRODUCTION: Bending-disruption fractures of the vertebral body are called Chance fracture. In some cases these fractures may not be noticeable with a CT scan. CLINICAL CASE: A 9 years-old boy suffered a frontal collision while traveling in the back seat of a car. The child was secured by the safetybelt, without a child car seat or elevator adapted to his height. He had abdominal skin lesions in the physical exploration compatible with a belt mark. Conventional thoraco- abdominal CT scan did not show any vertebral fracture. As the clinical suspicion persisted, lateral plain radiography of the lumbar column was performed showing a Chance fracture in L2, confirmed by MRI.

CONCLUSION: Chance fracture is typically seen in children under 12 years less than 135 cm height and with injuries associated with the belt after a traffic accident. This type of fractures may go unnoticed in a conventional CT scan so clinical suspicion must lead us to further work-up. The MRI is the gold standard for the diagnosis. This case remarks the importance of the use of homologated elevated seat devices in older children.

Language: es