Wedge fracture

Wedge fractures (also known as compression fractures) are hyperflexion injuries to the vertebral body resulting from axial loading. Most commonly affecting the anterior aspect of the vertebral body, wedge fractures are considered a single-column (i.e. stable) fracture.

Less commonly wedge fractures refer to a subtype of tibial plateau fractures. This article addresses vertebral wedge fractures.


Most common type (~50%) of thoracolumbar spine fractures .


Typically, these fractures are insufficiency fractures secondary to ostoporosis, although some are pathological secondary to a focal bone lesion. A small proportion is due to trauma in patients with normal underlying bone .

Radiographic features

Radiographs, CT, and MRI may show cortical disruption with impaction of the anterosuperior endplate. The anteroinferior endplate and posterior vertebral body remain unaffected. This results in the characteristic "wedged" appearance .

Differential diagnosis

  • burst fracture: fracture of the anterior and posterior vertebral body (i.e. two-column injury)

Practical points

  • care should be taken to assess for posterior ligamentous injury, indicative of potential instability