What is a Wedge Fracture?
When people are thinking about bone fractures, fractures of the spine are some of the most worrisome. This is because the spinal cord is contained within the vertebrae of the spine. These traumatic injuries have the potential to damage the spinal cord which can lead to a loss of motor and sensory function in certain areas of the body. A wedge fracture results from a crush fracture in the front of the vertebrae, giving it a wedge shape on imaging.
People acquire a wedge fracture of the spine from any mechanism that leads to compression of the vertebrae. For example, someone could fall out of a tree and compress their spine, leading to compression fractures or wedge fractures throughout their spinal cord. In an auto accident, someone could impact their head on the steering wheel. This force is then transmitted down the rest of the spine, leading to the development of a wedge fracture.
Treatment of a Wedge Fracture
Whether someone sustained their wedge fracture falling out of a free or in a pedestrian injury, the treatment process typically begins in the same way. The first step is to properly diagnose and localize the fracture using a combination of clinical symptoms and imaging, such as an x-ray, CT scan, or a MRI. Once the fracture has been located, the injury is typically immobilized using some sort of a brace. This will help protect the peripheral nerves and will give the bones time to heal before moving again.
Certain Complications are Possible
Whenever someone injuries their spine, there are a few comorbidities that they must be aware of. When the spine has been fractured, there is a risk of osteoporosis, or low bone density, later in life. In addition, the nerves that run down the spine are also at risk. Damage to these nerves could lead to chronic pain down the road.
Structures at Risk
The structure that is most at risk for these injuries is the spinal cord. An injury to the spinal cord could lead to significant complications for a patient, with the most severe being paralysis. A patient could also lose other functions, including swallowing and talking, depending on the nerves that are damaged.
The differential diagnosis of a wedge fracture has several other options, including:
- Herniated disc
- Muscle spasm
- Nerve impingement
- Transverse process fracture
- Cauda Equina Syndrome
The prognosis will depend on the severity of the wedge fracture; however, most people recover without any incidents. If nerves have been damaged, the prognosis could be more guarded in nature.
Surgery is Rare
Surgery for these fractures is unusual. If the patient has neurological symptoms, failed initial treatment, or has a severe angle of fracture in their back, surgery could be needed to put the spine back in place.
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