Which plane is a burst fracture most unstable in?

A burst fracture is characterized by the fracturing of the vertebral body, typically due to high-energy trauma, leading to fragment displacement. The instability of a burst fracture is most pronounced in the transverse plane. This is because the fracture disrupts the integrity of the bony structure, allowing fragments to move laterally, which can lead to potential compression or injury of surrounding neural structures, resulting in instability.

In the transverse plane, the lack of bony stability can contribute to misalignment and compromise the spinal column's ability to support weight and resist forces appropriately. Thus, in evaluating the stability of burst fractures, the focus on the transverse plane highlights the critical impact of lateral shifts and decompression dynamics, making it the most unstable.

Understanding this concept is essential for orthotic and prosthetic practices, as it informs treatment strategies and the design of interventions aimed at restoring stability and function to patients affected by such injuries.