Lee Hohyoung, Yoon Euisun, Choi Gyeonggyu, Lee Sungho
Department of Orthopaedic and Trauma Surgery, Cheju Halla General Hospital, Jeju, Republic of Korea.
Trauma Case Rep. 2023 Aug 14;47:100903. doi: 10.1016/j.tcr.2023.100903. eCollection 2023 Oct.
We present a case of a 28-year-old beginner golfer who sustained multiple episodes of isolated spinous process fractures of the lower cervical and upper thoracic vertebrae (clay-shoveler's fracture) and its ten-year follow-up. The patient is complaining of intermittent mild dull pain and discomfort in the posterior aspect of the cervicothoracic junction even after 10 years from initial injury. Radiologic evaluation revealed non-union of avulsed fragments and the patient's symptoms are possibly associated with non-union. Nevertheless, he recovered to full activity with no limitations in activities of daily living.
In case of non-union of previous fractures, it seems to affect biomechanical stability of surrounding muscles and ligaments of the spinous processes and increase stress in motion on spinous processes of adjacent vertebrae during vigorous activity. It is associated with additional fractures of adjacent vertebrae.
我们报告一例28岁的初练高尔夫球者，其下颈椎和上胸椎棘突发生多次孤立性骨折（铲土工骨折），并对其进行了为期十年的随访。即使在初次受伤十年后，患者仍主诉颈胸交界处后方间歇性轻度钝痛和不适。影像学评估显示撕脱碎片未愈合，患者的症状可能与未愈合有关。尽管如此，他恢复到了完全活动状态，日常生活活动没有限制。
既往骨折未愈合似乎会影响棘突周围肌肉和韧带的生物力学稳定性，并在剧烈活动时增加相邻椎体棘突运动时的应力。它与相邻椎体的额外骨折有关。
