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  4. Case report: A complete lower cervical fracture dislocation without permanent neurological impairment

Case report: A complete lower cervical fracture dislocation without permanent neurological impairment

BMC Musculoskeletal Disorders, 2024 · DOI: https://doi.org/10.1186/s12891-024-07586-9 · Published: June 11, 2024

Spinal Cord InjuryOrthopedicsResearch Methodology & Design

Simple Explanation

A rare condition known as "lucky fracture dislocation" occurs when a patient experiences a severe cervical spine fracture and dislocation but does not suffer severe spinal cord injury. This case report details the successful treatment of a 73-year-old male who sustained a complete fracture and dislocation of C7 following a fall, yet retained sensory movement in his limbs. The patient underwent surgical reduction and internal fixation, leading to significant pain relief and recovery of sensory and motor functions in the affected limbs over a two-year follow-up period.

Study Duration
2 Years
Participants
One 73-year-old male patient
Evidence Level
Level 4: Case Report

Key Findings

  • 1
    Initial cervical radiographs may not reveal significant abnormalities in patients with complete cervical fracture and dislocation, necessitating CT and MRI for accurate diagnosis.
  • 2
    Surgical intervention involving fracture reduction, internal fixation, and bone grafting can effectively restore spinal stability and neurological function in patients with "lucky fracture dislocations."
  • 3
    Even in the absence of immediate neurological deficits, careful handling and surgical positioning are crucial to prevent secondary spinal cord injury in patients with unstable cervical fractures and dislocations.

Research Summary

This case report presents a rare instance of a complete C7 fracture and dislocation without permanent paralysis in an elderly man. The patient's successful treatment involved surgical reduction, internal fixation, and bone grafting, resulting in pain relief and functional recovery. The study emphasizes the importance of thorough examination and imaging in trauma patients, even with minimal neurological symptoms, to avoid missed diagnoses and prevent potential complications.

Practical Implications

Diagnostic Vigilance

Clinicians should maintain a high index of suspicion for cervical fractures in trauma patients, even in the absence of significant neurological deficits, and utilize advanced imaging techniques like CT and MRI for accurate diagnosis.

Surgical Management

Early surgical intervention, including reduction, fixation, and decompression, is crucial for stabilizing the cervical spine and preventing secondary neurological injury in patients with unstable fracture-dislocations.

Protective Measures

Meticulous handling and positioning techniques during patient transport and surgical procedures are essential to minimize the risk of iatrogenic spinal cord injury in patients with "lucky fracture dislocations."

Study Limitations

  • 1
    Single case report limits generalizability
  • 2
    Lack of detailed biomechanical analysis of the fracture mechanism
  • 3
    Limited long-term follow-up beyond two years

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