Abstract
Purpose of study:
The presence of an L5 transverse process fracture is reported in many texts to be a marker of pelvis fracture instability. There is paucity of literature to support this view. Available studies have been performed on patients who were already known to have a pelvis fracture. No study has attempted to document the presence of this lesion in the absence of a pelvis fracture.
Primary aim: To identify the correlation between the presence of a L5 transverse process fracture and an unstable pelvic ring injury.
Secondary aim: To establish whether a L5 transverse process fracture can occur in the absence of a pelvis fracture.
Methods:
We conducted a retrospective review of all CT scans performed in patients who presented to a Level 1 Trauma Unit for blunt abdomino-pelvic trauma between January 1, 2012 and August 28, 2013. A total of 203 patients met our inclusion criteria.
Results:
Fifty four of these 203 patients (26%) sustained a pelvis fracture. Of these 54 patients 26 (48%) had an unstable fracture pattern according to the AO classification.
Five of these 26 patients (19%) had an associated L5 transverse process fracture. Seven (12%) had an L5 transverse process fracture associated with a stable fracture pattern.
Three patients (1.4%) had an isolated L5 transverse process fracture in the absence of a pelvis fracture.
Conclusion:
This study confirms the association between the presence of a L5 transverse process fracture and an unstable pelvis fracture pattern. This injury is rarely seen in the absence of a pelvis fracture so its presence should alert the treating clinicians to the existence of a pelvis fracture.
