Daffner R H, Deeb Z L, Rothfus W E
Skeletal Radiol. 1987;16(4):280-4. doi: 10.1007/BF00361469.
Motorcyclists who are involved in accidents generally suffer severe multiple injuries, some of which are not readily apparent on initial examination. One such subtle injury is fracture, with or without dislocation, in the upper thoracic spine. The severe spinal cord damage produced by the injury is often overshadowed by cerebral or cervical injury. Proper diagnosis is further hampered by the fact that the upper thoracic region is difficult to examine radiographically on plain films, particularly when using portable equipment. Of a group of 14 motorcyclists having 26 fractures and/or dislocations in the thoracic region, 12 had 24 injuries between T3 and T8. These 24 injuries represented 56% of the fractures and/or dislocations encountered in a larger study of trauma to the thoracic vertebral column. All of these were flexion injuries, suffered when the individual was thrown from the motorcycle and struck a large, solid object. In three cases, the diagnosis was delayed as much as 48 h because proper films were not obtained initially. Because of the serious consequences of delayed treatment, we recommend that all motorcyclists who have sustained severe trauma be examined by overpenetrated film of the upper thoracic region.
发生事故的摩托车手通常会受到严重的多处损伤，其中一些在初次检查时并不明显。一种这样的隐匿性损伤是上胸椎骨折，伴或不伴脱位。该损伤导致的严重脊髓损伤常常被脑部或颈部损伤所掩盖。上胸部区域在普通X线片上难以进行影像学检查，尤其是使用便携式设备时，这一事实进一步阻碍了正确的诊断。在一组14名在胸部区域有26处骨折和/或脱位的摩托车手中，12人在T3至T8之间有24处损伤。在一项对胸椎创伤的更大规模研究中，这24处损伤占所遇到的骨折和/或脱位的56%。所有这些都是屈曲损伤，是个体从摩托车上被抛出并撞到一个大的固体物体时所遭受的。在3例病例中，由于最初未获得合适的X线片，诊断延迟了长达48小时。由于延迟治疗的严重后果，我们建议对所有遭受严重创伤的摩托车手进行上胸部区域的过度穿透X线片检查。
