Flexion Teardrop Fracture Displacement
Yes, flexion teardrop fractures of the cervical spine are characteristically displaced, with posterior displacement (retrolisthesis) of the vertebral body into the spinal canal being a defining feature of this highly unstable injury pattern. 1
Key Characteristics of Displacement
Flexion teardrop fractures are among the most unstable cervical spine injuries, with retrolisthesis of the vertebral body being a hallmark feature that carries high risk for neurological compromise. 1 The injury mechanism involves flexion-compression forces that create:
- Posterior displacement of the fractured vertebral body into the spinal canal, which is the primary reason for the high incidence of neurological deficits associated with this fracture pattern 2, 1
- A triangular-shaped fragment at the anteroinferior corner of the vertebral body that gives the fracture its characteristic "teardrop" appearance 1
- Significant ligamentous disruption accompanying the bony injury, contributing to the instability 3
Clinical Significance of Displacement
The posterior displacement has critical implications:
- High incidence of neurological complications due to spinal canal compromise from the posteriorly displaced vertebral body 2
- Complete or incomplete tetraplegia is common, with studies showing 3 of 8 patients presenting with complete tetraplegia and 4 with incomplete tetraplegia in surgical series 2
- Ten of 21 patients with flexion-type injuries had neurological deficits in one retrospective review 4
Radiographic Assessment
The displacement can be quantified on imaging:
- CT scanning is essential for evaluating the extent of vertebral body displacement and the sagittal plane fracture pattern 2
- Posterior displacement measurements should be documented, with successful surgical reduction achieving residual displacement of less than 1 mm 2
- CT is the reference standard for identifying cervical spine fractures with near 100% sensitivity and specificity 5
Critical Distinction from Extension-Type
Extension-type teardrop fractures (primarily affecting C2) are fundamentally different—these are stable injuries without significant displacement that can be managed conservatively. 4, 1 Do not confuse these with flexion-type injuries, as the treatment and prognosis are completely different.