Fractures and Dislocations: Teardrop Flexion

Flexion Teardrop:  Unstable

This is often a most severe C-spine injury (Completely unstable)  It results from severe flexion force with axial loading.

Clinically, there is  “Acute Anterior Cord Syndrome”:  

• Quadriplegia

• Loss of anterior column senses (pain, temp, touch)

• Retention of posterior column senses.

This is different from an extension teardrop fracture (stable avulsive injury)

 You sill see a large, triangular fragment off the Anterior/Inferior aspect of the vertebral body and fanning of the spinous processes. This indicates complete disruption of all ligaments and disk at the level of injury. The involved vertebral body is usually subluxed posteriorly.

     
Flexion Teardrop Fractures of C2 (left) and C5 (right)

    
Flexion Teardrop Fracture of C4 (left) and CT image of fracture (right)

This section written by:

LCDR Ron Boucher, MC, USN
LT Hugh McSwain, MC, USN

With some assistance from:

CDR Michael Puckett, MC, USN
ENS Robert Post, MC, USNR