Percutaneous pedicle screw instrumentation for temporary internal bracing of nondisplaced bony chance fractures

Objective and Importance: Although many patients with unstable Chance fractures can heal in an external brace, others will require internal stabilization. Short-segment minimally invasive internal bracing of a Chance fracture offers the rigidity and patient compliance of internal bracing with minimal tissue disruption. This technique has not yet been described. Clinical Presentation: A healthy 16-year-old female and 21-year-old male sustained classic nondisplaced Chance fractures. They were both neurologically intact. Technique: An image-guided Jamshidi needle was used to percutaneously place K-wires to direct percutaneous pedicle screws. Freehand percutaneous passing of rods to connect the pedicle screw heads on each side created a short-segment construct. Conclusions: Minimally invasive internal bracing of nondisplaced bony Chance fractures is an option for selected neurologically intact patients unable to tolerate external bracing.