Thoracic burst fracture

Background

• Unstable
• Can occur with or without injury to posterior elements (posterior involvement increases risk for neuro deficits)
• Be certain not to mistakenly call a burst fracture a wedge fracture

Differential Diagnosis

Thoracic Trauma

• Airway/Pulmonary
  • Bronchial injury
  • Diaphragm injury
  • Hemothorax
  • Pulmonary contusion
  • Tracheal injury
  • Trachobronchial injury
  • Traumatic pneumothorax
    • Tension pneumothorax
• Cardiac/Vascular
  • Cardiac contusion
  • Cardiac trauma
  • Cardiac tamponade
  • Commotio cordis
    • Traumatic aortic transection
• Musculoskeletal
  • Clavicle fracture
    • Clavicle fracture (peds)
  • Flail chest
  • Rib fracture
  • Scapula fracture
  • Scapulothoracic dissociation
  • Sternoclavicular dislocation
  • Sternum fracture
• Other
  • Esophageal injury or Perforation
  • Pneumomediastinum
  • Traumatic asphyxia

Workup

• Obtain CT if unsure (vs. wedge)

See Also

• Thoracic and lumbar spine trauma
• Vertebral burst fractures

References

Authors

Ross Donaldson, Neil Young, Daniel Ostermayer