@article{ref1,
title="Fractures of the thoracolumbar spine sustained by soldiers in vehicles attacked by improvised explosive devices",
journal="Spine",
year="2009",
author="Ragel, Brian T. and Allred, C. Dain and Brevard, Sidney B. and Davis, Richard T. and Frank, Edmund H.",
volume="34",
number="22",
pages="2400-2405",
abstract="STUDY DESIGN: Retrospective analysis. OBJECTIVE: To analyze the types of orthopedic spine fractures sustained by North Atlantic Treaty Organization soldiers when vehicles are attacked by improvised explosive devices (IEDs), with specific focus on the flexion-distraction type thoracolumbar fracture (Chance fracture). SUMMARY OF BACKGROUND DATA: Operation Enduring Freedom is the North Atlantic Treaty Organization's effort in Afghanistan. IED attacks on armored vehicles are common and account for high proportion of soldiers' deaths and injuries. METHODS: Retrospective record review was accomplished on soldiers admitted to a military hospital with orthopedic spine fractures after IED attacks on vehicles from January 1, 2008 to May 15, 2008. Thoracolumbar fractures were classified using the McAfee classification system. RESULTS: Twelve male patients with 16 thoracolumbar fractures were identified (3 patients with multiple fractures). The 16 thoracolumbar fractures included 6 flexion-distraction fractures in 5 patients (38%, 6/16: two T12, two L1, one L3, and one L4), 7 compression fractures in 5 patients (44%, 5/16; one T7, one T8, two L1, one L2, one L3, and one L4), and 3 burst fractures (19%, 3/16; two L1 and one L2). CONCLUSION: The incidence of flexion-distraction thoracolumbar (Chance) fractures has been reported to be between 1.0% and 2.5% in most spine fracture series. In this small study, Chance fractures represented 38% of all tho-racolumbar fractures sustained after IED attack on armored vehicles. The blast pattern associated with IED explosion may be responsible for the high rate of these injuries in vehicle occupants.<p /> <p>Language: en</p>",
language="en",
issn="0362-2436",
doi="10.1097/BRS.0b013e3181b7e585",
url="http://dx.doi.org/10.1097/BRS.0b013e3181b7e585"
}