Clay Shoveler's Fracture in the Absence of Trauma: The Impact of Cervical Spine Lordosis: Case Report and Literature Review

Nadeem Siraj 1, Asad Riaz 2, *, Zakir Hussain 2, Abdul Muhymin Alam Khattak 2, Waqar Hussain 3, Asghar Khan 4, Bissma Laraib 2, Muhammad Moen 2, Irfan Ullah Mashwani 5, Khan Ifrah Shahid 6, Zainab Saeed 7 and Saad Qadeer 8

1 Department of Orthopedics Surgery, Lady Reading Hospital, Peshawar, Pakistan.
2 Department of General Surgery, Ayub Teaching Hospital, Abbottabad, Pakistan.
3 Medical Officer at Medical Emergency Resilience Foundation (MERF) NGO, Peshawar, Pakistan.
4 Department of  Orthopedics Surgery, Ayub Teaching Hospital, Abbottabad, Pakistan.
5 Department of General Medicine, Shahid Hussain Orthopedic and General Hospital, Lower Dir, Pakistan.
6 Department of Physiology, Abbottabad International Medical College, Abbottabad.Pakistan
7 Department Opthamology, Liaqat National Hospital, Karachi, Pakistan.
8 Department of General Medicine, Ayub Teaching Hospital, Abbottabad, Pakistan
 
Case Study
World Journal of Advanced Research and Reviews, 2024, 23(02), 1389–1394
Article DOI: 10.30574/wjarr.2024.23.2.2412
 
 
Publication history: 
Received on 30 June 2024; revised on 10 August 2024; accepted on 13 August 2024
 
Abstract: 
Introduction: Clay shoveler's fracture is a rare avulsion fracture of the spinous processes in the lower cervical and upper thoracic vertebrae, typically occurring in laborers or athletes. We present a unique case of clay shoveler's fracture in a patient with cervical spine lordosis and no history of trauma.
Case Presentation: A 23-year-old female presented with neck pain and tenderness over the C7 spinous process. Radiographs revealed an avulsion fracture of the C7 spinous process and increased cervical lordosis.
Discussion: The atypical presentation of clay shoveler's fracture in association with cervical lordosis highlights the importance of considering underlying spinal pathologies in diagnosis and treatment. Altered biomechanics and stress distribution may predispose to fractures with minor trauma.
Conclusion: This case emphasizes the need for clinicians to evaluate cervical spine alignment and associated abnormalities in patients with clay shoveler's fracture without a clear history of trauma, to provide valuable insights into the underlying mechanism of injury and guide effective management.
 
Keywords: 
Clay Shoveler's Fracture; Avulsion Fracture; Spinous Process; C7 Vertebra; Cervical Spine Lordosis; Altered Biomechanics; Stress Distribution; Conservative Management; Neck Pain; Tenderness; Radiographs; Atypical Presentation; Spinal Pathology; Cervical Alignment
 
Full text article in PDF: 
Share this