https://youtube.com/shorts/oEYzqhXT3W4
Key Morphologic Features That Influence Healing and Progression
Summary
1. Fracture Orientation
- More vertical fracture lines correspond to lower shear forces and greater mechanical stability.
- Horizontal orientation increases rotational stress and is associated with higher risk of worsening.
2. Inferior-Level Superior Articular Facet Length
- A longer facet provides broader mechanical support beneath the pars and correlates with improved healing.
- A short facet reduces understructure support and predisposes to instability.
3. Fracture Dimensions
- Smaller craniocaudal, anteroposterior, and mediolateral dimensions reflect a more localized injury and predict better stability.
- Larger fractures indicate greater structural compromise.
4. Fracture Gap
- Narrow fracture gaps behave more stably and show higher chances of consolidation.
- Wider gaps correlate with mechanical instability and delayed or nonunion patterns.
5. Typical Location
- Most fractures occur in the upper one-third of the pars, approximately 30–40 percent from the superior edge, aligning with the region of highest extension–rotation stress.
Conclusion
Computed tomography clearly demonstrates that stability in pars fractures is driven by four major geometric factors: vertical orientation, long inferior-level facet, smaller fracture dimensions, and narrow gap. These features collectively predict more reliable healing and reduced risk of progression.
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