Musculoskeletal Teaching FileMusculoskeletal Teaching File
Flexion Teardrop Fracture
History: 34 year old male brought to the emergency room following a motor vehicle collision.
Lateral cervical spine: Flexion teardrop fracture of C5 vertebral body with associated soft tissue swelling.
CT spine: Oblique fracture through the anterior inferior margin of the C5 vertebral body with retrolisthesis of C5 over C6.
Discussion
As its name implies, a flexion teardrop fracture involves severe flexion of the cervical spine which results in a fracture-dislocation of a cervical vertebrae. Complete disruption of the soft tissues at the level of trauma along with subluxation or dislocation of the interfacetal joints and fracture of the anteroinferior corner of the involved vertebral body characterize this injury (1). The posterior ligament complex, posterior longitudinal ligament, the anterior longitudinal ligament, and the intervertebral disk are all disrupted. The clinical sequelae of the injury involves acute cervical cord syndrome consisting of complete quadriplegia and loss of touch, pain, and temperature sensations. Posterior column sensations of position, motion and vibration remain intact. Damage to the spinal cord results from the severe hyperkyphosis at the level of injury. Needless to say, this is the most devastating of all cervical spine injuries (2).
References
Resnick D and Niwayama G. Diagnosis of Bone and Joint Disorders. Volume 5. Second Edition. Philadelphia: W.B. Saunders. 1988: 2937-8
Harris J, Harris W, Novelline R. The Radiology of Emergency Imaging. Third Edition. Baltimore: Williams and Wilkins. 1993: 117.
Case prepared by Anjum Shariff, M.D. and Anthony L. Alcantara, M.D.
Related case from University of North Carolina Radiology Teaching File