Clay shoveler’s fracture involves
Correct Answer: Spinous process
Description: Ans. a (Spinous process) (Ref. Grainger & Allison's Diagnostic Radiology, 4th Ed. 1823)CLAY SHOVELLER'S FRACTUREIt is an avulsion of the spinous process of C6, C7 or T1 caused either by rotation of the upper trunk when the cervical spine is relatively fixed or, less commonly, as the result of a direct blow.Educational points:The atlas--Cl# The most common is an isolated fracture of the posterior or neural arch of the atlas. This injury is neurologically benign and mechanically stables.# Jefferson fracture is characterized by disruption of the anterior and posterior arches of the atlas. The Jefferson fracture results from a force delivered to the top of the skull. . CT is the best means of visualizing the fracture sites. Characteristically, a Jefferson fracture is identified by a bilateral offset of the lateral masses of Cl relative to C2 on the frontal projection.The axis--C2# Hangman's fracture (traumatic spondylolysis of the axis) represents of the neural arch of C2 that are produced by a hyperextension force such as that commonly experienced when the head or face hits the windshield or steering wheel. This may result in bilateral fractures of the neural arch anterior to the inferior facets. (This is same fracture as caused by judicial hanging, & referred to as a hangman's fracture).# Dens fractures have been classified into Types 1, 2, and 3. Type 1 is an avulsion fracture of the superolateral portion of the tip of the dens by the intact alar ligament. Type 2 is a transverse fracture at the base of the dens. Type 3 is a fracture, not of the dens, but of the superior portion of the axis body with extension through one or both of its superior articular facets. Types 1 and 2 are also known as 'high' and Type 3 as Tow' dens fractures.# Dens are often missed on routine x-ray, hence Odontoid view (Open-mouth) & CT best at delineating it.
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Orthopaedics
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