The clay-shoveler’s fracture, a rare occupational injury in the modern era: a case report

• Published in: Egyptian Journal of Neurosurgery
• Main Authors: Juan Sebastián Reyes Bello, Diego Fernando Castiblanco Varón, Jose Luis Rozo Saavedra, Claudia Marcela Restrepo Lugo, Juan Nicolas Perez Mendez, Luis Rafael Moscote Salazar
• Format: Article in Journal/Newspaper
• Language: English
• Published: SpringerOpen 2024
• Subjects: Spinous process; Fracture; Cervical spine; Thoracic spine; Occupational injuries; Case report; Surgery; RD1-811; Neurosciences. Biological psychiatry. Neuropsychiatry; RC321-571; Shoveler
• Online Access: https://doi.org/10.1186/s41984-024-00291-8; https://doaj.org/article/f1c1ae194eb54826a4ab120cf07a7587

Abstract Background The clay-shoveler fracture, named after Australian clay shovelers from the 1930s, results from high-energy, repetitive pulling mechanisms and is commonly associated with shoveling or digging. This injury primarily affects the lower cervical and upper thoracic vertebrae, particularly the C7 and T1 vertebrae. The avulsion mechanism, caused by stress on the spinous processes, may lead to sudden, severe upper back pain, limiting the affected individual’s ability to work effectively. Case presentation This report presents the case of a 27-year-old boiler operator who experienced persistent neck pain, which did not respond to conservative management. Imaging studies revealed a T1 spinous process fracture with associated soft tissue edema, diagnosed as a clay-shoveler fracture. Conventional treatment with a semirigid cervical collar, analgesia, and rest was administered, leading to a favorable outcome. The clay-shoveler fracture, though rare, should be considered in cases involving repetitive stress on the cervical and thoracic spine, especially in occupations that require heavy lifting. In most instances, conservative management proves effective in relieving pain and enabling recovery. Conclusion Recognizing the clay-shoveler fracture is crucial for timely diagnosis and treatment. This case report underscores the occupational nature of the injury and its association with specific work activities. Further research and reporting of similar cases will contribute to a deeper understanding of this unusual fracture pattern, its risk factors, and optimal management strategies.