Open reduction and internal fixation of a lumbar Chance fracture in a child using Songer cable and lamina plates

Abstract

Chance-type fractures of the spine have been associated with seat-belt injuries in the pediatric population. Nonoperative management is appropriate in most cases of Chance fractures, but surgical intervention is occasionally warranted to deter progression of kyphosis and neurological deterioration. Internal fixation using pedicle screws has been widely used in the surgical repair of this injury. The authors report on a 6-year-old girl who suffered an L-2 Chance fracture with facet disruption, kyphosis, and significant posterior ligamentous injury. She underwent open reduction and internal fixation using Songer cable wiring augmented with bilateral lamina plating. At the 18-week follow-up, she continued to be free of any neurological deficits and her alignment was stable on plain radiographs of flexion-extension. The authors have therefore described a feasible option in the surgical management of Chance-type fractures in the pediatric spine.