Saturday, April 24, 2010

Clay-Shoveler's Fracture


The clay-shoveler's fracture is a lower cervical spinous fracture commonly occuring at C7 but can occur anywhere between C6 to T3. It is a result of hyperflexsion of the neck that is often experienced when shoveling snow. The term Clay-Shoveler's fracture, originated in Western Australia that was coined after relief works that fracture the same area of their lower cervical spine while shoveling clay. Most of these previously unemployed men were out of shape while trying to shovel clay out of a 15 ft deep ditch with long handled shovels. The clay stuck to their shovels while thrusting them upward. Coincidently, all of the men reported that at the peak of the upward motion they felt a sharp stabbing pain and heard a crack right between their shoulders. The medical explaination of this accident is that the force from the muscles in the back (trapezius and rhomboid muscles), pulled and fractured the spinous process of the seventh cervical vertebra. This partially explains how the Clay-Shoveler's fracture usually happens to laborers who perform activities that involve lifting objects rapidly with arms extended. Examples are of these activities are shoveling snow, soil or grubble up and over the head backwards, using a pickax or even something simple like picking roots!


SYMPTOMS: burning, knife-like pain at the level of the factured spine between the upper shoulder blades. Repeat activity with the muscles of the upper back can increase the sharp-like pain.


DIAGNOSIS: can be diagnosed by x-ray examination


The pain can sudside in days to weeks on it's own but can gradually return in activites that involve prolong extending of the arms like something as simple as computer work.


TREATMENT: most patients require no treatment. A massage, physical therapy or pain medication can relieve pain. For long-lasting pain, surgical removal of the tip from the broken spine will cure the problem.








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