J Korean Fract Soc.  2018 Apr;31(2):57-60. 10.12671/jkfs.2018.31.2.57.

Clay-Shoveler's Fracture in an 18-Year-Old Cheerleader: A Case Report

• Hwang IY
• Park SJ
• Cha JR

• KMID: 2409761
• DOI: http://doi.org/10.12671/jkfs.2018.31.2.57

Abstract

Clay-Shoveler's fracture refers to a fracture that is solely developed on the spinous process of the cervical spine or the thoracic vertebrae. This fracture rarely occurs during sporting activities. In this case, an 18-year-old female developed the fracture on the spinous process of the 7th cervical spine and 1st thoracic vertebrae due to the repetitive practice of cheerleading. The patient's pain was improved by wearing a support device and taking an anti-inflammatory analgesic drug and muscle relaxant. Her case is being followed-up at the outpatient department.

Keyword

Lower cervical vertebra fracture; Clay-Shoveler's fracture; Cheerleader; Spinous process; Stress fracture

MeSH Terms

Adolescent*
Female
Fractures, Stress
Humans
Outpatients
Spine
Sports
Thoracic Vertebrae

Figure

• 

  Fig. 1 (A) Double shadow sign (ghost sign) of processus spinosus on the 7th cervical vertebral and 1st thoracic vertebrae on the front and back of the cervical vertebral can be observed (arrows). (B) On the front of the cervical vertebral is the distal processus spinosus's infraplacement by the vertical fracture on the same part (arrows).

• 

  Fig. 2 On T2-weighted sagittal magnetic resonance imaging of the cervical vertebral, high signal intensity was observed on the interspinal ligament from the 6/7 cervical vertebral to the 1/2 thoracic vertebra, which could be considered as a sprain or rupture. Edema was shown around neck muscles, but spinal cord compression didn't appear (arrows).

Reference

1. Bagnulo A. Cheerleading injuries: a narrative review of the literature. J Can Chiropr Assoc. 2012; 56:292–298.

2. Debuch L. Die Schipperkrankheit und ihre Behandlung. Arch Orthop Trauma Surg. 1936; 37:223–231.

3. Venable JR, Flake RE, Kilian DJ. Stress fracture of the spinous process. JAMA. 1964; 190:881–885.

4. Herrick RT. Clay-shoveler's fracture in power-lifting. Am J Sports Med. 1981; 9:29–30.

5. Hestroni I, Mann G, Dolev E, Morgenstern D, Nyska M. Clay Shoveler's fracture in a volleyball player. Phys Sportsmed. 2005; 33:38–42.

6. Kang DH, Lee SH. Multiple spinous process fractures of the thoracic vertebrae (Clay-Shoveler's fracture) in a beginning golfer: a case report. Spine. 2009; 34:E534–E537.

7. Hwang JC, Chung DW. Isolated spinous process fracture of the 7th cervical vertebrae in a novice golfer: a case report. J Korean Orthop Soc Sports Med. 2012; 11:96–98.