Differences in Thoracolumbar Burst Fractures by Falls from Height with Associated Foot and Ankle Fractures

ABSTRACT

STUDY DESIGN: This is a retrospective clinical study. OBJECTIVES: To know how the associated foot or ankle fracture influences the fracture pattern in the thoracolumbar burst fractures caused by falls from height. SUMMARY OF LITERATURE REVIEW There were few studies on how the foot or ankle fracture influences the thoracolumbar fracture caused by falls from height. MATERIALS AND METHODS: We reviewed 46 subjects, who underwent surgery due to burst fracture of the thoracic or lumbar region, caused by fall accidents, from May 2004 to October 2008. Among them, we defined 19 cases that had associated foot or ankle fractures as group A, and the other 27 cases as group B. We analyzed the differences of radiological and clinical findings, and functional outcomes between the two groups. RESULTS: The falling heights were higher in group A than in group B (P<0.01). Thoracolumbar junction (T11-L2) was the most common location involved in both groups, but group A had more fractures on the lower lumbar region (L3-5), relatively (p=0.03). Kyphotic deformity was more severe in group B (p=0.01) but there were no significant differences in the wedge angle, amount of canal compromise, compression rate of anterior column between both groups (p=0.08, 0.46, 0.76). More segments were fused in group B (P=0.04). Neurologic deficit was more common in group B (p=0.03), but there were many complications related with foot or ankle fractures in group A (38%).There was no significant difference in the final clinical outcome between both groups (Pain scale p= 0.48, Work scale p=1.00). CONCLUSIONS: In patients who had burst fractures in the thoracic or lumbar region associated with foot or ankle fractures, there was a tendency to increase the incidence of lower lumbar fracture, relatively. The neurologic deficits were less common in this group of patients, but there was no difference in the functional outcome.