• Kent T Yamaguchi, Karen S Myung, Manuel Aparicio Alonso, and David L Skaggs.
• Children's Hospital Los Angeles, Children's Orthopaedic Center, Los Angeles, CA 90027, USA.
• Spine. 2012 Dec 15;37(26):E1672-5.

Study DesignCase report and literature review.ObjectiveThis article reports 2 cases of clay-shoveler's fracture equivalent in children presenting acutely after participation in sports.Summary Of Background DataThe clay-shoveler's fracture in adults is an avulsion fracture of the lower cervical or upper thoracic spinous process. To our knowledge, this is the first report in English literature on soft-tissue avulsion injury of the spinous process in children presenting with history and symptoms similar to clay-shoveler's fractures.MethodsRetrospective review of 2 cases.ResultsA 14-year-old baseball player and a 16-year-old wrestler experienced acute posterior neck pain after participation in sports. Both patients presented with a history and physical examination suggestive of clay-shoveler's fracture but showed no evidence of injury on radiographs. Subsequent magnetic resonance images demonstrated an acute soft-tissue avulsion of the spinous process at C7 in 1 patient and T2 in the other. With nonoperative therapy, both patients returned to sports by 4 months, with occasional, intermittent discomfort a year after injury, which did not limit any activities.ConclusionIn adolescents, if the history and physical examination are consistent with a clay-shoveler's fracture, but radiographs are normal, magnetic resonance imaging may be indicated to diagnose a soft-tissue avulsion.

20 keywords...

hide…