- Discussion:
- typical mechanism of injury is head on motor vehicle collision while wearing a seat belt;
- force exerted on spine is pure distraction owing to fulcrum that is anterior to vertebral body;
- this is imposed by the lap seat belt as the pt acutely flexed forward;
- this causes the vertebral elements to be pulled apart;
- hence, tension failure occurs, initially in Posterior column, then in the Middle column, and finally in the Anterior column;
- if the fulcrum of is within the body, or in Middle column, there will be compression of the Anterior column;
- these fractures will tend to go into late kyphosis & therefore require early fixation