Presentation
Tripped and fell
Patient Data
There is an extension teardrop fracture at the anteroinferior aspect of the vertebral body of C2. The fragment involves about thirty percent of the end plate surface and is displaced anteriorly by two to three millimeters. There is an undisplaced fracture component involving the right and left foramen tranversarium. The posterior elements are intact.
Case Discussion
An extension tear drop fracture is caused by the traction of the anterior longitudinal ligament, the fibers of which insert into the inferior portion of the anterior cortex of the vertebral body.
C2 is the most common level for an extension tear drop. It is characterized by a small triangular-shaped fracture fragment from the anteroinferior corner of a vertebral body. The vertical height of the separate fragment is equal to, or exceeds, its horizontal width in the sagittal plane. The middle and posterior columns are intact with a variable degree of prevertebral soft tissue swelling.
Extension teardrop is not considered as severe as flexion teardrop fractures and it does not typically produce direct neurologic injury.
Case co-author: Rehana Jaffer, MD, FRCPC