Chance fracture
Encyclopedia
A Chance fracture is a flexion
Flexion
In anatomy, flexion is a position that is made possible by the joint angle decreasing. The skeletal and muscular systems work together to move the joint into a "flexed" position. For example the elbow is flexed when the hand is brought closer to the shoulder...

 injury of the spine, first described by GQ Chance in 1948. It consists of a compression injury to the anterior portion of the vertebral body and a transverse fracture through the posterior elements of the vertebra and the posterior portion of the vertebral body. It is caused by violent forward flexion, causing distraction injury to the posterior elements.

The most common site at which Chance fractures occur is the thoracolumbar junction (T12-L2) and midlumbar region in pediatric population. This fracture initially became known as a "seat belt injury" due to its association with the sudden forward flexion that occurs when one is involved in a head-on automobile collision while being restrained by a lap belt. With the advent of both lap and shoulder belts in the 1980s, Chance fractures have become less common especially now that lap belts are almost phased out.

Up to 50% of Chance fractures have associated intraabdominal injuries. Injuries associated with Chance fractures include fractures of the pancreas
Pancreas
The pancreas is a gland organ in the digestive and endocrine system of vertebrates. It is both an endocrine gland producing several important hormones, including insulin, glucagon, and somatostatin, as well as a digestive organ, secreting pancreatic juice containing digestive enzymes that assist...

; contusions or lacerations of the duodenum
Duodenum
The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms anterior intestine or proximal intestine may be used instead of duodenum...

; and mesenteric contusions or lacerations.
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