Transverse process fractures: a clinical series and coronal injury of the spine

Abstract

Background: Transverse process fractures in trauma patients frequently are diagnosed using computed tomography and result in severe pain and limitation of motion. However, there is no accepted standard of care. Thus, these fractures can be treated with excessive measures or inadequately treated. In this study, diagnosis and treatment of transverse process fractures are examined. Methods: The mechanisms of trauma, findings, and associated organ injuries of 50 patients with transverse process fractures and no other spinal injuries treated between 2013 and 2015 were recorded. The same treatment protocol was applied to each patient. The results of the treatments were examined retrospectively and recorded. Results: Deformation and edema of the fascia and muscles around the transverse process fractures were detected by computed tomography and magnetic resonance imaging. The average pain intensity of the patients before treatment was 8.8 of 10 on a visual analog scale and 5.2 of 10 after treatment with nonsteroidal anti-inflammatory drugs, muscle relaxants, flexible support corsets, and mobilization. Patients hospitalized for additional pathologies were primarily treated in thoracic surgery wards (11 of 15 patients). Transverse process fractures were caused by backward falls or blows to the back in 49 patients. Conclusions: Transverse process fractures can be treated quickly and effectively with the recommended protocol after excluding any accompanying organ injuries or other spinal injuries. Transverse process fractures most often occur during backward falls or blows to the back, commonly low-energy injuries. This trauma mechanism can be described as a "coronal injury of the spine."