Multiple Contiguous Avulsion Fractures of Thoracic Spinous Processes: A Clay Shoveler′s Variant

Ali Bakhsh and Himanshu Sharma

Department of Orthopedics, The Peninsula College of Medicine and Dentistry, UK

^*Correspondance to: Ali Bakhsh 

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Abstract:

Avulsion fracture of the spinous process, also known as a clay-shoveler’s fracture, is usually seen at a single level or dual adjacent spinal levels in the lower cervical or cervicothoracic junction. We report a 49-year old lady presented late with multiple contiguous clay-shoveler’s fracture between T4 and T8 on MRI scan with negative initial plain radiography. Thoracic spine x-rays might miss the avulsion fractures. With persistent pain and crepitus in the cervicothoracic spine following sudden forced hyper-flexion & rotational trauma, further imaging in the form of MRI scan with or without CT scan is recommended. Disproportionate pain in the initial post-injury period should raise a high index of suspicion. Prolonged recovery period of 6-9 months should be provided to the patients for preferred conservative treatment.

Keywords:

Spinous process; Fracture; Avulsion

Cite the Article:

Bakhsh A, Sharma H. Multiple Contiguous Avulsion Fractures of Thoracic Spinous Processes: A Clay Shoveler′s Variant. Ann Clin Case Rep. 2016; 1: 1076.