Mechanisms of mid-thoracic spine fracture/dislocation due to falls during horse racing: A report of two cases

Mechanisms of mid-thoracic spine fracture/dislocation due to falls during horse racing: A report of two cases

We reported two cases of jockeys who sustained fracture/dislocation of the mid-thoracic spine due to traumatic falls during horse racing. We examined the injury mechanism based upon the patients’ diagnostic images and video footage of races, in which the accidents occurred. Admission imaging of pati...

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Autor principal: Paul C. Ivancic
Formato: article
Lenguaje:EN
Publicado: Elsevier 2021
Materias:
Fracture/dislocation
Thoracic spine
Injury mechanism
Biomechanics
Horse racing
Medicine (General)
R5-920
Acceso en línea:https://doaj.org/article/8961420920394084a860417cce6749f9
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spelling oai:doaj.org-article:8961420920394084a860417cce6749f92021-11-18T04:43:44ZMechanisms of mid-thoracic spine fracture/dislocation due to falls during horse racing: A report of two cases1008-127510.1016/j.cjtee.2021.07.003https://doaj.org/article/8961420920394084a860417cce6749f92021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1008127521001140https://doaj.org/toc/1008-1275We reported two cases of jockeys who sustained fracture/dislocation of the mid-thoracic spine due to traumatic falls during horse racing. We examined the injury mechanism based upon the patients’ diagnostic images and video footage of races, in which the accidents occurred. Admission imaging of patient 1 (a 42 years old male) revealed T5 burst fracture with bony retropulsion of 7 mm causing complete paralysis below T5/6. There existed 22° focal kyphosis at T5/6, anterolisthesis of T5 relative to T6, T5/6 disc herniation, cord edema and epidural hemorrhage from T4 through T6, and cord injury from C3 through C6. Admission imaging of patient 2 (a 23 years old male) revealed T4/5 fracture/dislocation causing incomplete paralysis below spinal level. There existed compression fractures at T5, T6, and T7; 4 mm anterior subluxation of T4 on T5; diffuse cord swelling from T3 through T5; comminuted fracture of the C1 right lateral mass; right frontal traumatic subarachnoid hemorrhage; and extensive diffuse axonal injury. The injuries were caused by high energy flexion-compression of the mid-thoracic spine with a flexed posture upon impact. Our results suggest that substantially greater cord compression occurred transiently during trauma as compared to that documented from admission imaging. Video footage of the accidents indicated that the spine buckled and failed due to abrupt pocketing and deceleration of the head, neck and shoulders upon impact with the ground combined with continued forward and downward momentum of the torso and lower extremities. While a similar mechanism is well known to cause fracture/dislocation of the cervical spine, it is less common and less understood for mid-thoracic spine injuries. Our study provides insight into the etiology of fracture/dislocation patterns of the mid-thoracic spine due to falls during horse racing.Paul C. IvancicElsevierarticleFracture/dislocationThoracic spineInjury mechanismBiomechanicsHorse racingMedicine (General)R5-920ENChinese Journal of Traumatology, Vol 24, Iss 6, Pp 397-400 (2021)
institution DOAJ
collection DOAJ
language EN
topic Fracture/dislocation
Thoracic spine
Injury mechanism
Biomechanics
Horse racing
Medicine (General)
R5-920
spellingShingle Fracture/dislocation
Thoracic spine
Injury mechanism
Biomechanics
Horse racing
Medicine (General)
R5-920
Paul C. Ivancic
Mechanisms of mid-thoracic spine fracture/dislocation due to falls during horse racing: A report of two cases
description We reported two cases of jockeys who sustained fracture/dislocation of the mid-thoracic spine due to traumatic falls during horse racing. We examined the injury mechanism based upon the patients’ diagnostic images and video footage of races, in which the accidents occurred. Admission imaging of patient 1 (a 42 years old male) revealed T5 burst fracture with bony retropulsion of 7 mm causing complete paralysis below T5/6. There existed 22° focal kyphosis at T5/6, anterolisthesis of T5 relative to T6, T5/6 disc herniation, cord edema and epidural hemorrhage from T4 through T6, and cord injury from C3 through C6. Admission imaging of patient 2 (a 23 years old male) revealed T4/5 fracture/dislocation causing incomplete paralysis below spinal level. There existed compression fractures at T5, T6, and T7; 4 mm anterior subluxation of T4 on T5; diffuse cord swelling from T3 through T5; comminuted fracture of the C1 right lateral mass; right frontal traumatic subarachnoid hemorrhage; and extensive diffuse axonal injury. The injuries were caused by high energy flexion-compression of the mid-thoracic spine with a flexed posture upon impact. Our results suggest that substantially greater cord compression occurred transiently during trauma as compared to that documented from admission imaging. Video footage of the accidents indicated that the spine buckled and failed due to abrupt pocketing and deceleration of the head, neck and shoulders upon impact with the ground combined with continued forward and downward momentum of the torso and lower extremities. While a similar mechanism is well known to cause fracture/dislocation of the cervical spine, it is less common and less understood for mid-thoracic spine injuries. Our study provides insight into the etiology of fracture/dislocation patterns of the mid-thoracic spine due to falls during horse racing.
format article
author Paul C. Ivancic
author_facet Paul C. Ivancic
author_sort Paul C. Ivancic
title Mechanisms of mid-thoracic spine fracture/dislocation due to falls during horse racing: A report of two cases
title_short Mechanisms of mid-thoracic spine fracture/dislocation due to falls during horse racing: A report of two cases
title_full Mechanisms of mid-thoracic spine fracture/dislocation due to falls during horse racing: A report of two cases
title_fullStr Mechanisms of mid-thoracic spine fracture/dislocation due to falls during horse racing: A report of two cases
title_full_unstemmed Mechanisms of mid-thoracic spine fracture/dislocation due to falls during horse racing: A report of two cases
title_sort mechanisms of mid-thoracic spine fracture/dislocation due to falls during horse racing: a report of two cases
publisher Elsevier
publishDate 2021
url https://doaj.org/article/8961420920394084a860417cce6749f9
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