Tyroch Alan H, McGuire Emmett L, McLean Susan F, Kozar Rosemary A, Gates Keith A, Kaups Krista L, Cook Charles, Cowgill Sarah M, Griswold John A, Sue Larry A, Craun Michael L, Price Jan
Texas Tech Univesity Health Sciences Center at El Paso, El Paso, Texas 79905-2700, USA.
Am Surg. 2005 May;71(5):434-8.
The association between Chance fractures and intra-abdominal injuries is reported to be as high as 89 per cent. Because prior studies were small series or case reports, we conducted a multicenter review to learn the true association between Chance fractures and intra-abdominal injuries as well as diagnostic trends. Trauma registry data, medical records, and radiology reports from 7 trauma centers were used to characterize 79 trauma patients with Chance fractures. Initial methods of abdominal assessment were computed tomography (CT) scan (79%), clinical examination (16%), and diagnostic peritoneal lavage (DPL) (5%). Twenty-six (33%) patients had intraabdominal injuries of which hollow viscus injuries predominated (22%). Twenty patients (25%) underwent laparotomy. The presence of an abdominal wall contusion and automobile restraint use were highly predictive of intra-abdominal injury and the need for laparotomy. The association between a Chance fracture and intra-abdominal injury is not as high as previously reported. CT scan has become the primary modality to assess the abdominal cavity of patients with Chance fractures, whereas the role of DPL has diminished.
